Providence Medicare Focus Medical (HMO)
H9047 - 033 - 0
(3.5 / 5)
Providence Medicare Focus Medical (HMO) is a Medicare Advantage (Part C) Plan by Providence Medicare Advantage Plans.
This page features plan details for 2024 Providence Medicare Focus Medical (HMO) H9047 – 033 – 0 available in Portland, Willamette Valley, Clark, Central OR.
IMPORTANT: This page has been updated with plan and premium data for 2024.
Locations
Providence Medicare Focus Medical (HMO) is offered in the following locations.
Plan Overview
Providence Medicare Focus Medical (HMO) offers the following coverage and cost-sharing.
| Insurer: | Providence Medicare Advantage Plans |
| Health Plan Deductible: | $0.00 |
| MOOP: | $3,400.00 |
| Drugs Covered: | No |
Ready to sign up for Providence Medicare Focus Medical (HMO) ?
Premium Breakdown
Providence Medicare Focus Medical (HMO) has a monthly premium of $128.00. This amount includes your Part C premium but does not include your Part B premium.| Part B | Part C | Part B Give Back | Total |
|---|---|---|---|
| $174.70 | $128.00 | $0.00 | $302.70 |
- Your Part B premium may differ based on factors including late enrollment, income, and disability status.
Additional Benefits
Providence Medicare Focus Medical (HMO) also provides the following benefits.
| $0 |
| In-network | No |
| $3,400 In-network |
| Yes |
| In-network | No |
| $250 copay per visit (Authorization is required.) (Referral is not required.) |
| Primary | $0 copay (Not applicable.) (Not applicable.) |
| Specialist | $20 copay per visit (Authorization is not required.) (Referral is not required.) |
| $0 copay (Authorization is required.) (Referral is not required.) |
| Emergency | $70 copay per visit (always covered) (Not applicable.) (Not applicable.) |
| Urgent care | $25 copay per visit (always covered) (Not applicable.) (Not applicable.) |
| Diagnostic tests and procedures | 20% coinsurance (Authorization is required.) (Referral is not required.) |
| Lab services | $0 copay (Authorization is required.) (Referral is not required.) |
| Diagnostic radiology services (e.g., MRI) | 15% coinsurance (Authorization is required.) (Referral is not required.) |
| Outpatient x-rays | $0 copay (Authorization is required.) (Referral is not required.) |
| Hearing exam | $20 copay (Authorization is not required.) (Referral is not required.) |
| Fitting/evaluation | $0 copay (There are no limits.) (Authorization is not required.) (Referral is not required.) |
| Hearing aids | $399-699 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Oral exam | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Cleaning | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Fluoride treatment | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Dental x-ray(s) | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Non-routine services | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Diagnostic services | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Restorative services | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Endodontics | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Periodontics | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Extractions | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Prosthodontics, other oral/maxillofacial surgery, other services | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Routine eye exam | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Other | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Contact lenses | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Eyeglasses (frames and lenses) | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Eyeglass frames | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Eyeglass lenses | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Upgrades | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Occupational therapy visit | $20 copay (Authorization is required.) (Referral is not required.) |
| Physical therapy and speech and language therapy visit | $20 copay (Authorization is required.) (Referral is not required.) |
| $50-250 copay (Not applicable.) (Not applicable.) |
| Not covered (Not applicable.) (Not applicable.) |
| Foot exams and treatment | $20 copay (Authorization is not required.) (Referral is not required.) |
| Routine foot care | Not covered (Not applicable.) (Not applicable.) |
| Durable medical equipment (e.g., wheelchairs, oxygen) | 20% coinsurance per item (Authorization is required.) (Not applicable.) |
| Prosthetics (e.g., braces, artificial limbs) | 20% coinsurance per item (Authorization is required.) (Not applicable.) |
| Diabetes supplies | $0 copay (Authorization is required.) (Not applicable.) |
| Covered (Authorization is not required.) (Referral is not required.) |
| Chemotherapy | 0-20% coinsurance (Authorization is required.) (Not applicable.) |
| Other Part B drugs | 0-20% coinsurance (Authorization is required.) (Not applicable.) |
| Part B Insulin drugs | $35 copay or 0-20% coinsurance (Authorization is required.) (Not applicable.) |
| $250 per day for days 1 through 5 $0 per day for days 6 through 90 $0 per day for days 90 and beyond (Authorization is required.) (Referral is not required.) |
| Inpatient hospital – psychiatric | $200 per day for days 1 through 7 $0 per day for days 8 through 90 (Authorization is required.) (Referral is not required.) |
| Outpatient group therapy visit with a psychiatrist | $20 copay (Authorization is required.) (Referral is not required.) |
| Outpatient individual therapy visit with a psychiatrist | $20 copay (Authorization is required.) (Referral is not required.) |
| Outpatient group therapy visit | $20 copay (Authorization is required.) (Referral is not required.) |
| Outpatient individual therapy visit | $20 copay (Authorization is required.) (Referral is not required.) |
| $0 per day for days 1 through 20 $150 per day for days 21 through 100 (Authorization is required.) (Referral is not required.) |
| Monthly Premium | $33.00 |
| Deductible | $150.00 |
| Monthly Premium | $45.00 |
| Deductible | $150.00 |
Optional Benefits
Package #1
| Preventive dental: | Monthly Premium: | $32.50 |
| Preventive dental: | Deductible: | $150.00 |
| Comprehensive dental: | Monthly Premium: | $32.50 |
| Comprehensive dental: | Deductible: | $150.00 |
Package #2
| Preventive dental: | Monthly Premium: | $45.10 |
| Preventive dental: | Deductible: | $150.00 |
| Comprehensive dental: | Monthly Premium: | $45.10 |
| Comprehensive dental: | Deductible: | $150.00 |
Ready to sign up for Providence Medicare Focus Medical (HMO) ?
Table of Contents
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