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Johns Hopkins Advantage MD Select (HMO)

H1339 - 001 - 0
Plan Not Rated

Johns Hopkins Advantage MD Select (HMO) is a Medicare Advantage Plan by Johns Hopkins Advantage MD.

This page features plan details for 2025 Johns Hopkins Advantage MD Select (HMO) H1339 – 001 – 0 available in Arlington county, Fairfax City, Falls Church City.

Locations

Johns Hopkins Advantage MD Select (HMO) is offered in the following locations.

Arlington County, Virginia
Fairfax City County, Virginia
Falls Church City County, Virginia

Click to see more locations

Plan Overview

Johns Hopkins Advantage MD Select (HMO) offers the following coverage and cost-sharing.

Insurer:Johns Hopkins Advantage MD
Health Plan Deductible:$0
MOOP:$7,500 In-network
Drugs Covered:Yes

Ready to sign up for Johns Hopkins Advantage MD Select (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

Johns Hopkins Advantage MD Select (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

Johns Hopkins Advantage MD Select (HMO) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Deductible: $590.00
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 DLIS Full
$0.00$0.00

Initial Coverage Phase

After you pay your $590.00 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.

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

Johns Hopkins Advantage MD Select (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 (Authorization Required)
  • Endodontics
    • In-Network: No Coins – No Co pay (Authorization Required)
  • Implant Services
    • In-Network: No Coins – No Co pay (Authorization Required)
  • Maxillofacial Prosthetics
    • In-Network: No Coins – No Co pay (Authorization Required)
  • Oral and Maxillofacial Surgery
    • In-Network: No Coins – No Co pay (Authorization Required)
  • Periodontics
    • In-Network: No Coins – No Co pay (Authorization Required)
  • Prosthodontics, fixed
    • In-Network: No Coins – No Co pay (Authorization Required)
  • Prosthodontics, removable
    • In-Network: No Coins – No Co pay (Authorization Required)
  • Restorative Services
    • In-Network: No Coins – No Co pay (Authorization Required)

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
  • Prophylaxis (cleaning)
    • In-Network: No Coins – No Copay

Diagnostic procedures/lab services/imaging

  • Diagnostic tests and procedures
    • 20% coinsurance (Authorization Required)
  • Diagnostic radiology services (e.g., MRI)
    • $250 copay (Authorization Required)
  • Outpatient x-rays
    • $20 copay (Authorization Required)
  • Lab services
    • $0 copay (Authorization Required)

Doctor visits

  • Primary
    • $0 copay
  • Specialist
    • $40 copay per visit (Referral Required)

Emergency care/Urgent care

  • Emergency
    • $110 copay per visit (always covered)
  • Urgent care
    • $45 copay per visit (always covered)

Foot care (podiatry services)

  • Foot exams and treatment
    • $50 copay
  • Routine foot care
    • 20% coinsurance (Limits Apply)

Ground ambulance

    • $300 copay

Health plan deductible

    • $0

Hearing

  • Hearing aids OTC
    • Not covered
  • Hearing aids
    • $399-699 copay (Limits Apply)
  • Medicare-Covered Hearing Exam
    • $0 copay
  • Fitting/evaluation
    • $0 copay

Inpatient hospital coverage

    • $350 per day for days 1 through 5
      $0 per day for days 6 through 90 (Authorization Required)

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

    • $7,500 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)
    • 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 individual therapy visit with a psychiatrist
    • $40 copay
  • Outpatient group therapy visit
    • $20 copay (Authorization Required)
  • Outpatient individual therapy visit
    • $20 copay (Authorization Required)
  • Inpatient hospital – psychiatric
    • $350 per day for days 1 through 5
      $0 per day for days 6 through 90 (Authorization Required)
  • Outpatient group therapy visit with a psychiatrist
    • $40 copay

Optional supplemental benefits

    • No

Other health plan deductibles?

    • In-Network: No

Outpatient hospital coverage

    • $325 copay per visit (Authorization Required)

Preventive care

    • $0 copay

Rehabilitation services

  • Occupational therapy visit
    • $30 copay (Authorization Required)
  • Physical therapy and speech and language therapy visit
    • $30 copay (Authorization Required)

Skilled Nursing Facility

    • $0 per day for days 1 through 20
      $203 per day for days 21 through 100 (Authorization Required)

Transportation

    • $0 copay (Limits Apply, Authorization Required)

Vision

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

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

    • Covered

Ready to sign up for Johns Hopkins Advantage MD Select (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

Need more information on Johns Hopkins Advantage MD Select (HMO)? See 2025 Johns Hopkins Advantage MD Select (HMO) at MedicareAdvantageRX.com.

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