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2017 University of Maryland Health Advantage Dual (HMO-SNP)

The University of Maryland Health Advantage Dual 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, Dorchester, Howard, Harford, Kent, Montgomery, Queen Anne’s, and Talbot.

How Much You Pay for Covered Services

Benefits What You Pay with University
of Maryland Health Advantage Dual

Monthly Plan Premium

$0 - $33.20

Maximum Out-of-Pocket

$6,700

Part B Benefits Deductible

$0 - $186

Primary Care Physician Visit

$0 or 20% coinsurance

Specialist Visit

$0 or 20% coinsurance

Inpatient Hospital Care

Days 1-60: $0 - $1,316 deductible
Days 61-90: $0 - $329 per day
Days 91-150: Lifetime Reserve Days
$0 - $658 per day
The deductible and cost-shares listed are for the calendar year of 2016 and may change effective January 1, 2017.

Emergency Care

$0 or 20% coinsurance

Durable Medical Equipment

$0 or 20% coinsurance

Part D Deductible

$0 - $82 (depending on level of “extra help”

Prescription Drug Coverage
(30-day supply)

For generic drugs (including brand drugs treated as generic), you pay either: $0, $1.20, or $3.30 copay.   For all other drugs, you pay either: $0, $3.70, or $8.25 copay.

Preventive Services

$0 copayment

Routine Podiatry

$0 copayment

Transportation
24 one-way trips per year

$0 copayment

Over-The-Counter

$50 quarterly allowance

Meals

$0 (up to 42 meals post discharge)

Preventive Dental

$0 copayment 
  • 1 periodic exam every year or 1 comprehensive exam once every 3 years
  • 1 cleaning every year
  • 1 set of bitewing X-rays every year (2 or 4 films) 

 

 

University of Maryland Health Advantage Dual (HMO-SNP) covers all Medicare benefits plus:

  • Prescription Drugs
  • Preventive and Comprehensive Dental (dentures and extractions included)
  • Vision
  • Fitness/Gym Membership
  • Meals post discharge from a hospital or SNF
  • Over-the-Counter Drugs and Products
  • Transportation
  • Annual Physical Exam
  • Care Management
  • 24/7 Nurse Hotline