Starting January 1, 2024 – we are consolidating the Memorial Hermann Advantage Plus HMO plan into the Memorial Hermann Advantage HMO $0 premium plan. The Advantage HMO Plus plan will no longer be available.
If you are currently enrolled in the Advantage HMO Plus plan, there is no action required on your part. You will be automatically moved to the Memorial Hermann Advantage HMO $0 premium plan, effective January 1, 2024.
At the end of September, you will receive the Annual Notice of Change and Evidence of Coverage documents for your new 2024 Memorial Hermann Advantage HMO plan. These important documents will provide extensive details on your 2024 coverage, including a detailed comparison of benefit changes from 2023 to 2024.
Please be aware that this change will have no impact on your doctors or selection of in-network hospitals and facilities. The comparison chart below represents some of the changes that will occur with your 2024 plan.
|
Current Plan: Memorial Hermann Advantage Plus HMO |
New for 2024: Memorial Hermann Advantage HMO Plan |
| Monthly Premium1 |
$25 |
$0 |
| Max Out of Pocket Expense |
$3,400 |
$2,950 |
| PCP Copay |
$0 |
$0 |
| Specialist Copay |
$20 |
$15 |
| Urgent Care Copay |
$25 |
$20 |
| In-Patient Hospital Copay |
$350 per Stay |
$350 per Stay |
| Delivered Meals Post In-Patient Hospitalization2 |
10 Meals |
10 Meals |
| Dental Coverage (preventive and comprehensive)3 |
$2,500
(Through Liberty Dental) |
$3,000
(Through Liberty Dental) |
| Vision4 |
$200 |
Flex Card: $1,500 Combined amount for 2024. Use dollars as needed for eye wear and/or hearing aids. |
| Hearing |
$400 |
Flex Card: $1,500 Combined amount for 2024. Use dollars as needed for eye wear and/or hearing aids. |
| Over-the-Counter5 |
$55 per Quarter |
Flex Card: $150 per Quarter |
| No Cost Transportation6 |
15 one-way trips |
20 one-way trips |
| No Cost Fitness Benefit |
Yes – Silver & Fit |
Yes – Silver & Fit |
| Pharmacy Deductible |
$0 |
$0 |
| Pharmacy Co-pays |
Tier 1: $0
Tier 2: $5
Tier 3: $39
Tier 4: $92
Tier 5: 33%
Tier 6: $0
(Preferred pharmacy copays are shown) |
Tier 1: $0
Tier 2: $0
Tier 3: $47
Tier 4: $100
Tier 5: 33%
Tier 6: $0
(These copays are the same for all in-network pharmacies for 2024) |
1You must continue to pay your monthly Part B premium for the Advantage HMO plan, as you do with your current plan.
2Meal Benefit. Mom’s Meals offers (10) meals post-discharge of an in-patient hospitalization stay. Service must be requested within 14 days of discharge. Click here for more information on this benefit.
3Dental Benefit. The DHMO (Liberty Dental Plan® Health Maintenance Organization) provides services on the Memorial Hermann Medicare Advantage HMO Plan. To learn more about the dental benefits offered with your specific plan, click here or visit Liberty Dental Plan. (Please note that by clicking on this link, you will be leaving Memorial Hermann Advantage website.)
4Flex Card. Members can use flex card to cover costs associated with supplemental benefits including Vision, Hearing, OTC and Grocery where applicable. (A $500 grocery benefit will be added to the flex card for those who have been enrolled in and successfully completed a Case Management program.) Click here for more information.
5Over-the-Counter Benefit. Available by either using the flex card at participating pharmacy outlets (such as CVS, Walgreens, Walmart and Kroger), or using the Medline mail-order catalog. For more information on the mail order catalog process from Medline, click here. For more information on your OTC benefits click here, or for more information on using your 2024 flex card at participating retail outlets, click here.
6Transportation Benefit. Click here for more information or visit ModivCare to schedule a ride. (Please note that by clicking on this link, you will be leaving Memorial Hermann Advantage website.)