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Generations Classic Plus (HMO)

H3706 - 023 - 0

(4 / 5)

Generations Classic Plus (HMO) is a Medicare Advantage Plan by GlobalHealth.

This page features plan details for 2025 Generations Classic Plus (HMO) H3706 – 023 – 0 available in Oklahoma City Metro.

Locations

Generations Classic Plus (HMO) is offered in the following locations.

Caddo County, Oklahoma

Canadian County, Oklahoma

Carter County, Oklahoma

Click to see more locations

Plan Overview

Generations Classic Plus (HMO) offers the following coverage and cost-sharing.

Insurer:	GlobalHealth
Health Plan Deductible:	$0
MOOP:	$3,900 In-network
Drugs Covered:	Yes

Ready to sign up for Generations Classic Plus (HMO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

Premium Breakdown

Generations Classic Plus (HMO) has a monthly premium of $0.00. This amount includes your Part C and D premiums but does not include your Part B premium. The following is a breakdown of your monthly premium with Part B costs included.

Part B	Part C	Part D	Part B Give Back	Total
$185.00	$0.00	$0.00	$	$

Please Note:

Your Part B premium may differ based on factors including late enrollment, income, and disability status.
You may also qualify for “Extra Help” on drug costs. See the Part D Premium Reduction section below for more details.

Drug Info

Generations Classic Plus (HMO) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Deductible:	$0.00
Drug Out-Of-Pocket maximum:	$2,000.00
Drug Benefit Type:	Enhanced Alternative

Part D Premium Reduction

The Low-Income Subsidy (also known as LIS or “Extra Help”) helps people with Medicare lower the cost of prescription drugs.

The table below shows how the LIS impacts the Part D premium of this plan.

Part D	LIS Full
$0.00	$0.00

Initial Coverage Phase

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 $2,000.00. Once you reach that amount, you will enter the next coverage phase.

30 Day

60 Day

90 Day

30 Day

Tier	Pref. Pharm	Std. Pharm	Pref. Mail	Std. Mail
1) Preferred Generic		$5.00 Copay		$5.00 Copay
2) Generic	$10.00 Copay	$15.00 Copay	$10.00 Copay	$15.00 Copay
3) Preferred Brand	$42.00 Copay	$47.00 Copay	$42.00 Copay	$47.00 Copay
4) Non-Preferred Drug	$90.00 Copay	$100.00 Copay	$90.00 Copay	$100.00 Copay
5) Specialty Tier	33.00% Coinsurance	33.00% Coinsurance	33.00% Coinsurance	33.00% Coinsurance

60 Day

90 Day

Tier	Pref. Pharm	Std. Pharm	Pref. Mail	Std. Mail
1) Preferred Generic		$15.00 Copay		$15.00 Copay
2) Generic		$45.00 Copay		$45.00 Copay
3) Preferred Brand	$84.00 Copay	$141.00 Copay	$84.00 Copay	$141.00 Copay
4) Non-Preferred Drug	$270.00 Copay	$300.00 Copay	$270.00 Copay	$300.00 Copay
5) Specialty Tier

Catastrophic Coverage Phase

After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $2,000.00, you pay nothing for Medicare Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit. Please note, that this plan has a Enhanced Alternative benefit type.

Additional Benefits

Generations Classic Plus (HMO) also provides the following benefits.

Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?

- In-Network: No

Comprehensive Dental

Adjunctive General Services
- In-Network: No Coins – No Co pay (Limits Apply)
Endodontics
- In-Network: 20 Coins – No Co pay (Limits Apply)
Maxillofacial Prosthetics
- In-Network: 20 Coins – No Co pay (Limits Apply)
Oral and Maxillofacial Surgery
- In-Network: 20 Coins – No Co pay (Limits Apply)
Periodontics
- In-Network: 0-20 Coins – No Co pay
Prosthodontics, fixed
- In-Network: 20 Coins – No Co pay (Limits Apply)
Prosthodontics, removable
- In-Network: 20 Coins – No Co pay (Limits Apply)
Restorative Services
- In-Network: 0-20 Coins – No Co pay

Diagnostic and Preventive Dental

Dental X-Rays
- In-Network: No Coins – No Copay
Fluoride Treatment
- In-Network: No Coins – No Copay
Oral Exams
- In-Network: No Coins – No Copay
Other Diagnostic Dental Services
- In-Network: No Coins – No Copay (Limits Apply)
Prophylaxis (cleaning)
- In-Network: No Coins – No Copay

Diagnostic procedures/lab services/imaging

Outpatient x-rays
- $0 copay (Authorization Required, Referral Required)
Diagnostic tests and procedures
- $0-100 copay (Authorization Required, Referral Required)
Lab services
- $0 copay (Authorization Required, Referral Required)
Diagnostic radiology services (e.g., MRI)
- $0-275 copay (Authorization Required, Referral Required)

Doctor visits

Primary
- $0 copay
Specialist
- $30 copay per visit (Authorization Required, Referral Required)

Emergency care/Urgent care

Urgent care
- $30 copay per visit (always covered)
Emergency
- $90 copay per visit (always covered)

Foot care (podiatry services)

Foot exams and treatment
- $30 copay (Authorization Required, Referral Required)
Routine foot care
- Not covered

Ground ambulance

- $250 copay

Health plan deductible

- $0

Hearing

Hearing aids OTC
- Not covered
Fitting/evaluation
- $0 copay (Limits Apply)
Hearing aids
- $0 copay (Limits Apply)
Medicare-Covered Hearing Exam
- $0-30 copay

Inpatient hospital coverage

- $245 per day for days 1 through 7
  $0 per day for days 8 through 90 (Authorization Required, Referral Required)

Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)

- $3,900 In-network

Medical equipment/supplies

Diabetes supplies
- $0 copay (Authorization Required)
Durable medical equipment (e.g., wheelchairs, oxygen)
- 20% coinsurance per item (Authorization Required)
Prosthetics (e.g., braces, artificial limbs)
- 0-20% coinsurance per item (Authorization Required)

Medicare Part B drugs

Chemotherapy
- 0-20% coinsurance (Authorization Required)
Other Part B drugs
- 0-20% coinsurance (Authorization Required)

Mental health services

Outpatient group therapy visit with a psychiatrist
- $30 copay (Authorization Required, Referral Required)
Outpatient group therapy visit
- $30 copay (Authorization Required, Referral Required)
Outpatient individual therapy visit
- $30 copay (Authorization Required, Referral Required)
Inpatient hospital – psychiatric
- $245 per day for days 1 through 7
  $0 per day for days 8 through 90 (Authorization Required, Referral Required)
Outpatient individual therapy visit with a psychiatrist
- $30 copay (Authorization Required, Referral Required)

Optional supplemental benefits

- No

Other health plan deductibles?

- In-Network: No

Outpatient hospital coverage

- $20-275 copay per visit (Authorization Required, Referral Required)

Preventive care

- $0 copay

Rehabilitation services

Occupational therapy visit
- $30 copay (Authorization Required, Referral Required)
Physical therapy and speech and language therapy visit
- $30 copay (Authorization Required, Referral Required)

Skilled Nursing Facility

- $0 per day for days 1 through 20
  $184 per day for days 21 through 100 (Authorization Required, Referral Required)

Transportation

- $0 copay (Limits Apply)

Vision

Eyeglass frames
- $0 copay (Limits Apply)
Routine eye exam
- $0 copay (Limits Apply)
Contact lenses
- $0 copay (Limits Apply)
Eyeglass lenses
- $0 copay (Limits Apply)
Eyeglasses (frames and lenses)
- $0 copay (Limits Apply)
Other
- Not covered
Upgrades
- Not covered

Wellness programs (e.g., fitness, nursing hotline)

- Covered