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The Health Plan SecureCare – Option I, MA Only (HMO)

H3672 - 014 - 0

(4.5 / 5)

The Health Plan SecureCare – Option I, MA Only (HMO) is a Medicare Advantage Plan by The Health Plan.

This page features plan details for 2023 The Health Plan SecureCare – Option I, MA Only (HMO) H3672 – 014 – 0.

IMPORTANT: This page features the 2023 version of this plan. See the 2025 version using the link below:

No 2025 version found. You can use the location links below to find 2025 plans in your area.

Locations

The Health Plan SecureCare – Option I, MA Only (HMO) is offered in the following locations.

Adams County, Ohio

Ashland County, Ohio

Athens County, Ohio

Click to see more locations

Plan Overview

The Health Plan SecureCare – Option I, MA Only (HMO) offers the following coverage and cost-sharing.

Insurer:	The Health Plan
Health Plan Deductible:	$0.00
MOOP:	$3,900 In-network
Drugs Covered:	No

Ready to sign up for The Health Plan SecureCare – Option I, MA Only (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

Medicare Part B Give Back Benefit

The Part B Premium Reduction (Medicare Part B Give Back Benefit) lowers the cost of some Medicare Advantage plans.

The Health Plan SecureCare – Option I, MA Only (HMO) qualifies for a monthly Medicare Give Back Benefit of $15.00.

Premium Reduction:

$15.00

Premium Breakdown

The Health Plan SecureCare – Option I, MA Only (HMO) has a monthly premium of $0.00. This amount includes your Part C premium but does not include your Part B premium.

Part B	Part C	Part B Give Back	Total
$164.90	$0.00	$15.00	$

Please Note:

Your Part B premium may differ based on factors including late enrollment, income, and disability status.

Additional Benefits

The Health Plan SecureCare – Option I, MA Only (HMO) also provides the following benefits.

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

In-Network: No

Dental (comprehensive)

Diagnostic services:	$0 copay (limits may apply) (authorization required) (referral not required)
Endodontics:	50% coinsurance (limits may apply) (authorization required) (referral not required)
Extractions:	50% coinsurance (limits may apply) (authorization required) (referral not required)
Non-routine services:	Not covered (no limits)
Periodontics:	50% coinsurance (limits may apply) (authorization required) (referral not required)
Prosthodontics, other oral/maxillofacial surgery, other services:	50% coinsurance (limits may apply) (authorization required) (referral not required)
Restorative services:	20-50% coinsurance (limits may apply) (authorization required) (referral not required)

Dental (preventive)

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 procedures/lab services/imaging

Diagnostic radiology services (e.g., MRI):	$0-150 copay (authorization required) (referral not required)
Diagnostic tests and procedures:	$50 copay (authorization not required) (referral not required)
Lab services:	$0 copay (authorization not required) (referral not required)
Outpatient x-rays:	$50 copay (authorization required) (referral not required)

Doctor visits

Primary:	$0 copay
Specialist:	$35 copay per visit (authorization required) (referral not required)

Emergency care/Urgent care

Emergency:	$90 copay per visit (always covered)
Urgent care:	$45 copay per visit (always covered)

Foot care (podiatry services)

Foot exams and treatment:	$35 copay (authorization required) (referral not required)
Routine foot care:	$35 copay (limits may apply) (authorization required) (referral not required)

Ground ambulance

$200 copay

Health plan deductible

$0.00

Health plan deductibles (other)

In-Network: No

Hearing

Fitting/evaluation:	$0 copay (no limits) (authorization not required) (referral not required)
Hearing aids:	$599-899 copay (limits may apply) (authorization not required) (referral not required)
Hearing exam:	$35 copay (authorization not required) (referral not required)

Hospital coverage (inpatient)

$250 per day for days 1 through 5
$0 per day for days 6 through 90 (authorization required) (referral not required)

Hospital coverage (outpatient)

$0-250 copay per visit (authorization required) (referral not required)

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

$3,900 In-network

Medical equipment/supplies

Diabetes supplies:	0-20% coinsurance per item (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:	20% coinsurance (authorization required)
Other Part B drugs:	20% coinsurance (authorization required)

Mental health services

Inpatient hospital – psychiatric:	$250 per day for days 1 through 5 $0 per day for days 6 through 90 (authorization required) (referral not required)
Outpatient group therapy visit:	$35 copay (authorization required) (referral not required)
Outpatient group therapy visit with a psychiatrist:	$35 copay (authorization required) (referral not required)
Outpatient individual therapy visit:	$35 copay (authorization required) (referral not required)
Outpatient individual therapy visit with a psychiatrist:	$35 copay (authorization required) (referral not required)

Optional supplemental benefits

Yes

Preventive care

$0 copay (authorization required) (referral not required)

Rehabilitation services

Occupational therapy visit:	$40 copay (authorization required) (referral not required)
Physical therapy and speech and language therapy visit:	$40 copay (authorization required) (referral not required)

Skilled Nursing Facility

$0 per day for days 1 through 20
$178 per day for days 21 through 100 (authorization required) (referral not required)

Transportation

$0 copay (limits may apply) (authorization required) (referral not required)

Vision

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):	Not covered (no limits)
Other:	Not covered (no limits)
Routine eye exam:	$0 copay (limits may apply) (authorization not required) (referral not required)
Upgrades:	Not covered

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

Covered (authorization not required) (referral not required)

Optional Benefits

Package #1

Comprehensive dental:	Monthly Premium:	$22.60
Comprehensive dental:	Deductible:	N/A