$0 medicare advantage plan

Experience Health Medicare AdvantageSM (HMO) 2022 benefits include:

  • $0 monthly premium
  • $0 medical deductible
  • $0 drug deductible
  • $0 primary care copay
  • $0 copays for commonly prescribed drugs
  • $0 SilverSneakers® fitness membership
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This $0 premium plan includes
over $7,000 in value-added extras:

Care Support

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Dental Reimbursement

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OTC Allowance

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Routine Eye Exam

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Silversneakers® fitness membership

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Eyewear Allowance

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Meals Program

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Mental Health

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Hearing Exam/Hearing Aids

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Acupuncture

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Worldwide Travel Coverage

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Part D Senior Savings Model (PDSS)

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Transportation Services

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In-home Support Services

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Personal Emergency Response System (PERS)

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This 2022 plan is everything you want in a Medicare plan and more, including a $0 monthly premium, a long list of valuable extras and low Maximum Out-of-Pocket costs to help protect your savings.

2021 Plan Highlights Experience Health Medicare Advantage (HMO)
Monthly Plan Premium $0
Maximum Out-of-Pocket Amount $4,200 per calendar year (in-network covered hospital and medical services)
Doctor and Hospital Visits
Primary Care Doctor $0 copay per visit
Specialist $20 copay per visit
Physical Therapy $20 copay per visit
Mental Health Service $0 copay Outpatient individual/group therapy visit
Urgent Care $35 copay per visit
Emergency Room Visit $90 copay per visit
Outpatient Hospital $200 copay per visit
Inpatient Hospital $295 per day for days 1 – 6; $0 for days 7 and beyond
Skilled Nursing Facility $0 per day for days 1 – 20; $165 per day for days 21 – 52; $0 per day for days 53 – 100
Ambulance Services $375 copay
Diagnostics and Supplies
Lab Services $8 copay
X-rays (Outpatient) $10 copay
Diagnostic Radiology Scans $75 copay – CT Scan; $100 copay – MRI;
$150 copay – PET
Durable Medical Equipment 20% of cost
Diabetic Supplies $0 copay
Insulin $35 copay for on-formulary insulins through Part D Senior Savings Model (PDSS), which is applicable in the Initial Coverage and Coverage Gap phases of the Part D benefit. Only non-LIS enrollees are eligible for the $35 copay under the PDSS Model
Medicare Part B Drugs (including chemotherapy) 20% of cost
Additional Benefits
SilverSneakers® Fitness Program $0 copay
Dental Reimbursement Allowance $500 annual preventive coverage and $1500 annual comprehensive coverage
Routine Eye Exam $0 copay
Eyewear Allowance (contacts, eyeglasses, eyeglass frames, eyeglass lenses) $250 per calendar year
OTC $400 allowance per calendar year ($100 per quarter)
Meals Program $0 copay for up to 20 home-delivered meals after each inpatient hospitalization
Acupuncture $50 reimbursement allowance per visit for up to 20 visits per year (in addition to Medicare coverage for chronic lower back pain)
Hearing Exam/
Hearing Aids
$0 copay for routine exam;
$599 - $899 copay per hearing aid
Transportation $0 copay for up to 12 one-way trips to approved health care locations
Personal Emergency Response System (PERS) $0 copay for a medical alert system (wristband and pendant options) through NationsResponse®, powered by ADT®. Your medical alert system will give you the help you need at the push of a button.
In-Home Support Services $0 copay for up to 6 hours of in-home support services per month. Members can get assistance with common tasks such as meal preparation, light housekeeping, errands, technology and accompaniment to appointments.
Prescription Drug Benefits 30-Day 90-Day
Mail Order
Tier 1: Preferred Generic $0 copay $0 copay
Tier 2: Generic $5 copay $12.50 copay
Tier 3: Preferred Brand $45 copay $112.50 copay
Tier 4: Non-preferred Drug $99 copay $247.50 copay
Tier 5: Specialty 33% coinsurance 33% coinsurance
Tier 6: Select Care Drugs $0 copay $0 copay