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Monthly Premium



$0 Medical/$0 Rx

Max out of pocket


Copays (PCP/Specialist)



$0 preventive - 2 cleanings; 2 exams & a set of bite-wing x-rays; 50% coinsurance for comprehensive services with $3,000 max benefit allowance.

Over-the-counter (OTC) benefit

Flex Card Option


$0 routine exam. $130 yearly allowance for eyeglasses or contact lenses. The flex card allowance can also apply to this benefit.

Hearing / Hearing Aids

$0 routine exam. Copays for hearing aids - 1 per ear/per year. The flex card allowance can also apply to this benefit.

Flex Card

$500 flexible benefit allowance per year without rollover. Up to $200 per year can be used for dental, vision, and hearing. Up to $300 can be used for OTC, transportation, companion care,** or a personal emergency response system (PERS)**.

Inpatient Hospital

$310/day for days 1-6; $0/day for Days 7-90

Preventive Care

No copay for services considered preventive.

Outpatient Diagnostic Labs, Procedures, Tests

$0 - $200 depending on service.

Emergency Room / Urgent Care

$90/$55 no limit; worldwide coverage

Physical, Occupational and Speech Therapy

$30 per visit; unlimited
* You must continue to pay your Medicare Part B premium. If you have a late enrollment penalty, it will still apply.
** Benefit needs to be purchased through NationsBenefits.

Health Alliance Plan (HAP) has HMO, HMO-POS, PPO plans with Medicare contracts. HAP Medicare Complete Duals (HMO D-SNP) is a Medicare health plan with a Medicare contract and a contract with the Michigan Medicaid Program. Enrollment depends on contract renewals.