A health plan with a Medicare contract available to Medicare-eligible individuals who reside in Harris, Fort Bend, Montgomery, Jefferson, Liberty, or Galveston county in Texas.
Questions? Contact Customer Service at (855) 645-8448
Your health is important to us, and we’re proud to offer a choice of Memorial Hermann Medicare Advantage plans that give you the comprehensive coverage you need along with the high-quality, local care you deserve.
For a quick glance at our available Memorial Hermann Medicare Advantage HMO plans, see the comparison chart below. If you are eligible for both Medicare and Medicaid, you may qualify for the Memorial Hermann Dual Advantage Special Needs Plan (D-SNP). To learn more, visit the D-SNP section of our website.
|Benefits & Features*||Memorial Hermann
Advantage Plus HMO
Advantage Jefferson HMO
|Monthly Plan Premium||$0||$50||$0|
|Maximum Out of Pocket (MOOP)||$3,900||$3,900||$3,400|
|In-Hospital Copay||$350 per Stay||$350 per Stay||$350 per Stay|
|Copay for Primary Care Physician (PCP)||$0||$0||$0|
|Copay for In-Network specialist (with no PCP referral needed)||$25||$20||$25|
|Prescription Drug (Part D) Coverage – at no additional cost||Yes||Yes||Yes|
|Copay for 90-day mail order of Tier 1 preferred generic drugs||$0||$0||$0|
|Prescription Drug Deductible||$300||$300||$300|
|Fitness Benefits and Wellness Program – at no extra cost||Yes||Yes||Yes|
|Vision and Hearing Coverage||Yes||Yes||Yes|
|National/worldwide urgent care and emergency coverage||Yes||Yes||Yes|
|Convenient Virtual Care options such as Teladoc and the Memorial Hermann Virtual Clinic||Yes||Yes||Yes|
|Lifestyle Drug Benefit4||No||Yes||No|
1 For the Dental Benefit, the DHMO (Liberty Dental Health Maintenance Organization) provides services on the Memorial Hermann Medicare Advantage HMO plan from a specific group of dentists within a service area. In the HMO plan, a member must designate a dentist. On the Memorial Hermann Medicare Advantage Plus HMO plan, the PPO (Preferred Provider Organization) benefit provides a larger network of dentists to choose from. In the Plus HMO plan, a member must see an in-network provider, but does not need to designate a dentist. To learn more about the dental benefits offered with your specific plan, visit Liberty Dental. (Please note that by clicking on this link, you will be leaving Memorial Hermann Advantage website.)
2 For the Over-the-Counter Benefit available on the Memorial Hermann Medicare Advantage Plus and Jefferson HMO plan, Medline At Home provides over-the-counter products covered under your specific plan at no additional cost to you. To view the Over-the-Counter (OTC) benefits catalog, click here (Coming Soon). To learn more about the Over-the-Counter (OTC) benefit offered with your specific plan, visit Medline At Home. (Please note that by clicking on this link, you will be leaving Memorial Hermann Advantage website.)
3 For Transportation Benefit available on the Medicare Advantage Jefferson HMO plan and Dual Advantage D-SNP. 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.)
4 For the Lifestyle Drug Benefit available on the Memorial Hermann Medicare Advantage Plus HMO plan, the Lifestyle Drug benefit helps with cost of drugs for Erectile Dysfunction.
*For a detailed description of our Advantage HMO benefits and features by plan, click here. If you are eligible for both Medicare and Medicaid, you may qualify for the Memorial Hermann Dual Advantage Special Needs Plan (D-SNP). To learn more, please visit the D-SNP section of our website.
*You must continue to pay your Medicare Part B premium. Benefits and features vary by plan. This information is not a complete description of benefits. Call Customer Service at (855) 645-8448 (TTY 711) for more information. Their hours of operation are 8 a.m. to 8 p.m. CT, 7 days a week from Oct. 1 – March 31 and 8 a.m. to 8 p.m. CT, Monday – Friday from April 1 – Sept. 30.
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