Plan details

HAP Empowered Duals (HMO SNP)

  • Overview
    Plan year
    2019
    Premium
    $0-$32.90
    Medical deductible
    Part B Deductible
    Prescription coverage
    Yes
    Maximum out-of-pocket cost
    $6,700
    Choice of doctors
    HAP Empowered Duals
    Primary doctor office visit
    20%
    Specialist office visit
    20%
    Telehealth
    $0 copay
    Outpatient diagnostics
    20% diag proc/tests / $0 Lab
    Standard x-rays
    20%
    Hospital stay copay
    Standard Medicare
  • Prescription coverage
    Brand-name and generic prescription drugs are covered at thousands of pharmacies in our network, including those with nationwide locations.
    Prescription deductible
    $415 deductible
    Coverage in gap
    No
    Tier 1 - Rx preferred generic
    25%
    Tier 2 - Rx generic
    25%
    Tier 3 - Rx preferred brand
    25%
    Tier 4 - Rx non-preferred drug
    25%
    Tier 5 - Rx specialty
    25%
  • Preventive care coverage
    Welcome to Medicare exam/annual wellness visit
    Covered
    Medicare covered immunizations
    Covered
    Diagnostic lab services
    Covered
    Cardiovascular screening
    Covered
    Diabetes screening
    Covered
  • Inpatient services
    Hospital stay copay
    Standard Medicare
    Skilled nursing facility
    Standard Medicare
  • Outpatient services
    Hospital outpatient facility
    20%
    Ambulatory surgery center
    20%
    Rehabilitation services - outpatient
    You pay a 20% coinsurance for each Medicare covered visit for cardiac or pulmonary rehabilitation; physical, speech or occupational therapy services.
  • Other health care services
    Home health care
    $0
    Chiropractic care
    20%
    Routine hearing and eye exams
    Hearing exam: $0 copay/exam; 1x per calendar year
    Eye exam: $0 copay/exam; 1x per calendar year
    Hearing aids
    $689 to $2039 copay/hearing aid; 2 hearing aids (one per ear)/year
    Learn more about hearing aid coverage. (PDF)
    Over the counter (OTC) coverage
    Over the counter (OTC) items and medication coverage is also included with this plan. HAP will cover $75 per quarter for OTC items and medication.
    Explore the OTC product catalog to see what you can order. (PDF)
  • Urgent and emergency services
    Urgent care
    20% coinsurance
    Max/visit: $65
    Emergency room
    20% coinsurance
    Max/visit: $90
    Ambulance
    20%
  • Dental coverage
    Preventive - 1 oral exam, 1 prophylaxis, 1 set of bitewing x-rays/1x per calendar year. Dental coverage is not available with this plan.
  • Vision coverage
    A $100 combined benefit max is available towards the purchase of contact lenses, eyeglass lenses or eyeglass frames every calendar year in network. No restriction or limit to the amount of eyewear purchased, but member is responsible for any amount above the eyewear coverage limit. One pair of eyeglasses or contact lenses after each cataract surgery that includes insertion of an intraocular lens is available at no cost to the member.
  • Silver&FitĀ®
    $0 fitness programs through Silver&FitĀ® that provide access to gym memberships or home fitness kits

HAP Empowered Duals (HMO SNP)

Copyright © 2018 HAP
2018 Health Alliance Plan of Michigan
Y0076_2019 HAP Website
CMS Accepted: 10/1/18

* Premium for male nonsmoker at age 65. For additional premiums, contact HAP.

HAP Senior Plus (HMO)/(HMO-POS)/(PPO) and HAP Primary Choice Medicare (HMO) are health plans with Medicare contracts. HAP Empowered Duals (HMO SNP) is a Medicare health plan with a Medicare contract and a contract with the Michigan Medicaid Program. Enrollment in the plans depends on contract renewals. HAP Senior Plus (PPO) is a product of Alliance Health and Life Insurance company, a wholly owned subsidiary of HAP.

This information is not a complete description of benefits. For more information call Medicare Michigan customer service at (800) 868-9885 (TTY: 711) 8 a.m. to 8 p.m., seven days a week (Oct. 1 – March 31) / 8 a.m. to 8 p.m., Monday through Friday (April 1 - Sept. 30).

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Contact us

  • Membership

    Current members

    (800) 422-4621

     

    Prospective - Medicare eligible

    (800) 868-9885 (TTY: 711)

    M - F 8 a.m. to 8 p.m. ET

    Seven days a week

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