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HAP MSUHC HMO

Monthly Premium

  $0*  

Deductible

$0 Medical/$0 Rx

Max out of pocket

$5,000

Copays (PCP/Specialist)

$0/$30

Dental

$0 preventive - 2 cleanings; 2 exams & a set of bite-wing x-rays; 50% coinsurance for comprehensive services with $3,000 max benefit allowance.

Over-the-counter (OTC) benefit

Flex Card Option

Vision

$0 routine exam. $130 yearly allowance for eyeglasses or contact lenses. The flex card allowance can also apply to this benefit.

Hearing / Hearing Aids

$0 routine exam. Copays for hearing aids - 1 per ear/per year. The flex card allowance can also apply to this benefit.

Flex Card

$500 flexible benefit allowance per year without rollover. Up to $200 per year can be used for dental, vision, and hearing. Up to $300 can be used for OTC, transportation, companion care,** or a personal emergency response system (PERS)**.

Inpatient Hospital

$310/day for days 1-6; $0/day for Days 7-90

Preventive Care

No copay for services considered preventive.

Outpatient Diagnostic Labs, Procedures, Tests

$0 - $200 depending on service.

Emergency Room / Urgent Care

$90/$55 no limit; worldwide coverage

Physical, Occupational and Speech Therapy

$30 per visit; unlimited
* You must continue to pay your Medicare Part B premium. If you have a late enrollment penalty, it will still apply.
** Benefit needs to be purchased through NationsBenefits.
HAP Senior Plus (HMO-POS), HAP Medicare MedicalAccess (HMO), HAP Senior Plus Henry Ford Tiered Access (HMO), HAP Medicare Connect (HMO), HAP Medicare Superior (HMO), Henry Ford Select (HMO), HAP Senior Plus (PPO), HAP Medicare Explore (PPO), HAP Medicare Prime (PPO), HAP Member Assist (PPO), HAP Medicare Diabetes and Heart (HMO C-SNP), and HAP CareSource™ MI Coordinated Health (HMO D-SNP) has a contract with Medicare. Enrollment depends on contract renewal.