The 2021 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 Dual Prime (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 - $32.30 (Depending on your level of extra help)
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 24 one-way trips per year
Coverage limit is $1,000 every year. Member is responsible for all costs over $1,000 annual maximum. $0 copay for the following:
Our plan pays up to $150 annually towards the purchase of eyewear
$90 quarterly allowance through the plan's OTC Catalog
Meals with Medical Nutrition Therapy
$0 copay - 12 consecutive weeks of meals for members with COPD, CHF, Diabetes, or ESRD. Members will also receive up to 4 medical nutrition therapy sessions
**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.