The Dual Prime plan (HMO-SNP) is a Medicare Advantage Prescription Drug Plan for those with both Medicare and Medicaid (Maryland Medical Assistance Program) as a Qualified Medicare Beneficiary (QMB) or a Full Benefit Dual Eligible (FBDE). This plan combines your Medical, Hospital and Prescription Drug coverage with extra services and personalized programs focused on improving your health.
To be eligible for the University of Maryland Health Advantage Dual (HMO-SNP) plan, you must also have Medicare Parts A & B and reside in the following Maryland counties: Anne Arundel, Baltimore, Baltimore City, Caroline, Carroll, Cecil, Charles, Dorchester, Howard, Harford, Kent, Montgomery, Prince Georges, Queen Anne’s, and Talbot.
How Much You Pay for Covered Services
Monthly Plan Premium
$0 - $28.40
Part B Benefits Deductible
Primary Care Physician Visit
$0 or 20% coinsurance**
Inpatient Hospital Care
Days 1-60: $0 per day
Days 61-90: $0 per day
Days 91-150: $0 per Lifetime Reserve Day
Durable Medical Equipment
Part D Deductible
Prescription Drug Coverage
$0 copayment for 36 one-way trips per year
Coverage limit is $800 every year. Member is responsible for all costs over $800 annual maximum. $0 copay for the following:
Our plan pays up to $150 annually towards the purchase of eyewear
$150 quarterly allowance through UMHA OTC Catalog
$0 copay for up to 14 meals per 1 week period
**If Medicaid status changes from Full Benefit Dual Eligible (FBDE) or Qualified Medicare Beneficiary (QMB), your copays and coinsurances will increase to 20% of the total cost of the service and 25% of the total cost of the Part D drug.
Dual Prime (HMO-SNP) covers all Medicare benefits plus:
2020 Enrollment Form