Amerigroup Medicare-Medicaid Plan (Medicare-Medicaid Plan) is a Medicare Advantage (Part C) Medicare-Medicaid Plan by Amerigroup STAR+PLUS MMP.
This page features plan details for 2023 Amerigroup Medicare-Medicaid Plan (Medicare-Medicaid Plan) H8786 – 001 – 0 available in Select TX Service Areas.
Amerigroup Medicare-Medicaid Plan (Medicare-Medicaid Plan) is offered in the following locations.
Amerigroup Medicare-Medicaid Plan (Medicare-Medicaid Plan) offers the following coverage and cost-sharing.
| Insurer: | Amerigroup STAR+PLUS MMP |
| Health Plan Deductible: | $0.00 |
| MOOP: | |
| Drugs Covered: | Yes |
Ready to sign up for Amerigroup Medicare-Medicaid Plan (Medicare-Medicaid Plan) ?
| Part B | Part C | Part D | Part B Give Back | Total |
|---|---|---|---|---|
| $164.90 | $0.00 | $0.00 | $0.00 | $0.00 |
Amerigroup Medicare-Medicaid Plan (Medicare-Medicaid Plan) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.
| Drug Deductible: | $0.00 |
| Initial Coverage Limit: | $ |
| Catastrophic Coverage Limit: | $7,400.00 |
| Drug Benefit Type: | Enhanced |
| Gap Coverage: | All Generics and All Brands |
| Formulary Link: | Formulary Link |
| Part D | LIS 25% | LIS 50% | LIS 75% | LIS Full |
|---|---|---|---|---|
| $0.00 | $43.40 | $34.80 | $26.30 | $17.70 |
After you pay your $0.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $. Once you reach that amount, you will enter the next coverage phase.
| Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
|---|---|---|---|---|
| 1 (Generic Drugs) | ||||
| 2 (Brand Drugs) | ||||
| 3 (Non-Medicare Rx Drugs) | ||||
| 4 (Non-Medicare OTC Drugs) |
| Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
|---|---|---|---|---|
| 1 (Generic Drugs) | $0.00 copay | $0.00 copay | ||
| 2 (Brand Drugs) | $0.00 – 10.35 copay | $0.00 – 10.35 copay | ||
| 3 (Non-Medicare Rx Drugs) | $0.00 copay | $0 copay | ||
| 4 (Non-Medicare OTC Drugs) | $0.00 copay | $0 copay |
| Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
|---|---|---|---|---|
| 1 (Generic Drugs) | ||||
| 2 (Brand Drugs) | ||||
| 3 (Non-Medicare Rx Drugs) | ||||
| 4 (Non-Medicare OTC Drugs) |
After your total drug costs (including what this plan has paid and what you have paid) reach $, you will pay no more than the amounts below for any drug tier until you reach $7,400.00.
| Tier | Cost |
|---|---|
| All other tiers (Generic) | 25% |
| All other tiers (Brand-name) | 25% |
After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7,400.00, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs.
| Drug Type | Cost Share |
|---|---|
| Generic drugs | $0 copay |
| Brand-name drugs | $0 copay |
Amerigroup Medicare-Medicaid Plan (Medicare-Medicaid Plan) also provides the following benefits.
| In-Network: No |
| Diagnostic services: | $0 copay (limits may apply) (authorization required) (referral required) |
| Endodontics: | $0 copay (limits may apply) (authorization required) (referral required) |
| Extractions: | $0 copay (limits may apply) (authorization required) (referral required) |
| Non-routine services: | $0 copay (limits may apply) (authorization required) (referral required) |
| Periodontics: | $0 copay (limits may apply) (authorization required) (referral required) |
| Prosthodontics, other oral/maxillofacial surgery, other services: | Not covered (no limits) |
| Restorative services: | $0 copay (limits may apply) (authorization required) (referral required) |
| Cleaning: | $0 copay (limits may apply) (authorization required) (referral not required) |
| Dental x-ray(s): | $0 copay (limits may apply) (authorization required) (referral not required) |
| Fluoride treatment: | Not covered (no limits) |
| Oral exam: | $0 copay (limits may apply) (authorization required) (referral not required) |
| Diagnostic radiology services (e.g., MRI): | $0 copay (authorization required) (referral required) |
| Diagnostic tests and procedures: | $0 copay (authorization required) (referral required) |
| Lab services: | $0 copay (authorization required) (referral required) |
| Outpatient x-rays: | $0 copay (authorization required) (referral required) |
| Primary: | $0 copay |
| Specialist: | $0 copay (authorization required) (referral required) |
| Emergency: | $0 copay |
| Urgent care: | $0 copay |
| Foot exams and treatment: | $0 copay (authorization required) (referral required) |
| Routine foot care: | $0 copay (limits may apply) (authorization required) (referral required) |
| $0 copay |
| $0.00 |
| In-Network: No |
| Fitting/evaluation: | $0 copay (no limits) (authorization required) (referral required) |
| Hearing aids: | $0 copay (limits may apply) (authorization required) (referral required) |
| Hearing exam: | $0 copay (authorization required) (referral required) |
| $0 copay (authorization required) (referral not required) |
| $0 copay (authorization required) (referral required) |
| Not Applicable |
| Diabetes supplies: | $0 copay (authorization required) |
| Durable medical equipment (e.g., wheelchairs, oxygen): | $0 copay (authorization required) |
| Prosthetics (e.g., braces, artificial limbs): | $0 copay (authorization required) |
| Chemotherapy: | $0 copay (authorization required) |
| Other Part B drugs: | $0 copay (authorization required) |
| Inpatient hospital – psychiatric: | $0 copay (authorization required) (referral required) |
| Outpatient group therapy visit: | $0 copay (authorization required) (referral not required) |
| Outpatient group therapy visit with a psychiatrist: | $0 copay (authorization required) (referral not required) |
| Outpatient individual therapy visit: | $0 copay (authorization required) (referral not required) |
| Outpatient individual therapy visit with a psychiatrist: | $0 copay (authorization required) (referral not required) |
| No |
| $0 copay (authorization required) (referral required) |
| Occupational therapy visit: | $0 copay (authorization required) (referral required) |
| Physical therapy and speech and language therapy visit: | $0 copay (authorization required) (referral required) |
| $0 copay (authorization required) (referral not required) |
| Not covered |
| Contact lenses: | $0 copay (limits may apply) (authorization required) (referral not required) |
| Eyeglass frames: | Not covered (no limits) |
| Eyeglass lenses: | Not covered (no limits) |
| Eyeglasses (frames and lenses): | $0 copay (limits may apply) (authorization required) (referral not required) |
| Other: | Not covered (no limits) |
| Routine eye exam: | $0 copay (limits may apply) (authorization required) (referral not required) |
| Upgrades: | $0 copay (no limits) (authorization required) (referral not required) |
| Covered (authorization required) (referral required) |
Ready to sign up for Amerigroup Medicare-Medicaid Plan (Medicare-Medicaid Plan) ?
SMID: MULTIPLAN_HCIHNDOGMED01_M
Factsonmedicare.com is a free-to-use informational website by Dog Media Solutions LLC. All insurance agents and enrollment platforms linked to this site have their own terms and conditions.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B Premium give-back is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
All plan-related information on this site is from CMS.gov and Medicare.gov. We only use data released publicly each year. While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. Contact a plan for a Summary of Benefits.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do feature in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
HealthCompare Insurance Services does not offer every plan available in your area. Currently we represent 18 organizations, which offers 52,101 products in your area.
We do not feature every plan available in your area. Any information we provide is limited to those plans we do feature in your area. Enrollment is offered through our partners including HealthCompare Insurance Services Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
HealthCompare Insurance Services represents Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan’s contract renewal.
Medicare has neither approved nor endorsed any information on this site.