Martin’s Point Generations Advantage Alliance (HMO) is a Medicare Advantage (Part C) Plan by Martin’s Point Generations Advantage.
This page features plan details for 2023 Martin’s Point Generations Advantage Alliance (HMO) H5591 – 003 – 0 available in All Maine & NH Counties.
IMPORTANT: This page has been updated with plan and premium data for 2023.
Martin’s Point Generations Advantage Alliance (HMO) is offered in the following locations.
Martin’s Point Generations Advantage Alliance (HMO) offers the following coverage and cost-sharing.
Insurer: | Martin’s Point Generations Advantage |
Health Plan Deductible: | $0.00 |
MOOP: | $5,000 In-network |
Drugs Covered: | No |
Ready to sign up for Martin’s Point Generations Advantage Alliance (HMO) ?
Get help from a licensed insurance agent.
Click to Call 1-877-354-4611 TTY 711.
Mon-Fri 8am-9pm EST | Sat 8am-8pm EST.
The Part B Premium Reduction (Medicare Part B Give Back Benefit) lowers the cost of some Medicare Advantage plans.
Martin’s Point Generations Advantage Alliance (HMO) qualifies for a monthly Medicare Give Back Benefit of $50.00.
Premium Reduction: | $50.00 |
Part B | Part C | Part B Give Back | Total |
---|---|---|---|
$164.90 | $0.00 | $50.00 | $114.90 |
Martin’s Point Generations Advantage Alliance (HMO) also provides the following benefits.
In-Network: Yes, contact plan for further details |
Diagnostic services: | 20% coinsurance (limits may apply) (authorization required) (referral required) |
Endodontics: | 20% coinsurance (limits may apply) (authorization required) (referral required) |
Extractions: | 20% coinsurance (limits may apply) (authorization required) (referral required) |
Non-routine services: | 20% coinsurance (limits may apply) (authorization required) (referral required) |
Periodontics: | 20% coinsurance (limits may apply) (authorization required) (referral required) |
Prosthodontics, other oral/maxillofacial surgery, other services: | 50% coinsurance (limits may apply) (authorization required) (referral required) |
Restorative services: | 50% coinsurance (limits may apply) (authorization required) (referral required) |
Cleaning: | $0 copay (limits may apply) (authorization not required) (referral not required) |
Dental x-ray(s): | $0 copay (limits may apply) (authorization not required) (referral not required) |
Fluoride treatment: | Not covered (no limits) |
Oral exam: | $0 copay (limits may apply) (authorization not required) (referral not required) |
Diagnostic radiology services (e.g., MRI): | 20% coinsurance (authorization required) (referral required) |
Diagnostic tests and procedures: | 0-5% coinsurance (authorization required) (referral required) |
Lab services: | $0-5 copay or 0-20% coinsurance (authorization required) (referral required) |
Outpatient x-rays: | 5% coinsurance (authorization required) (referral required) |
Primary: | $0 copay |
Specialist: | $5 copay per visit (authorization not required) (referral required) |
Emergency: | $110 copay per visit (always covered) |
Urgent care: | $0 copay |
Foot exams and treatment: | $5 copay (authorization not required) (referral required) |
Routine foot care: | Not covered |
$325 copay |
$0.00 |
In-Network: No |
Fitting/evaluation: | $0 copay (limits may apply) (authorization not required) (referral required) |
Hearing aids: | $295-1,895 copay (limits may apply) (authorization not required) (referral not required) |
Hearing exam: | $5 copay (authorization not required) (referral required) |
$375 per day for days 1 through 5 $0 per day for days 6 through 90 (authorization required) (referral not required) |
$0-275 copay per visit (authorization required) (referral not required) |
$5,000 In-network |
Diabetes supplies: | $0 copay (authorization not required) |
Durable medical equipment (e.g., wheelchairs, oxygen): | 10% coinsurance per item (authorization required) |
Prosthetics (e.g., braces, artificial limbs): | 10% coinsurance per item (authorization required) |
Chemotherapy: | 20% coinsurance (authorization required) |
Other Part B drugs: | 20% coinsurance (authorization required) |
Inpatient hospital – psychiatric: | $220 per day for days 1 through 7 $0 per day for days 8 through 90 (authorization required) (referral not 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 not required) (referral not required) |
Occupational therapy visit: | $0 copay (authorization not required) (referral required) |
Physical therapy and speech and language therapy visit: | $0 copay (authorization not required) (referral required) |
$10 per day for days 1 through 20 $196 per day for days 21 through 100 (authorization required) (referral not required) |
Not covered |
Contact lenses: | $0 copay (limits may apply) (authorization not required) (referral not required) |
Eyeglass frames: | $0 copay (limits may apply) (authorization not required) (referral not required) |
Eyeglass lenses: | $0 copay (limits may apply) (authorization not required) (referral not required) |
Eyeglasses (frames and lenses): | $0 copay (limits may apply) (authorization not required) (referral not required) |
Other: | Not covered (no limits) |
Routine eye exam: | $0 copay (limits may apply) (authorization not required) (referral not required) |
Upgrades: | $0 copay (limits may apply) (authorization not required) (referral not required) |
Covered (authorization not required) (referral not required) |
Ready to sign up for Martin’s Point Generations Advantage Alliance (HMO) ?
Get help from a licensed insurance agent.
Click to Call 1-877-354-4611 TTY 711.
Mon-Fri 8am-9pm EST | Sat 8am-8pm EST.
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