Compare Plans

Memorial Hermann Medicare Advantage HMO Plans

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.

Benefits of our Medicare Advantage HMO Plans

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 HMO	Memorial Hermann Advantage Plus HMO	Memorial Hermann Advantage Golden Triangle HMO (formally Jefferson HMO)	Memorial Hermann Advantage Prime Value MA-Only HMO
County Availability	Harris, Montgomery, Fort Bend, Brazoria, Galveston, Liberty	Harris, Montgomery, Fort Bend, Brazoria, Galveston, Liberty	Jefferson, Hardin	Harris, Montgomery, Fort Bend
Monthly Plan Premium	$0	$25	$0	$0
Maximum Out of Pocket (MOOP)	$3,400	$3,400	$3,400	$3,400
In-Hospital Copay	$350 per Stay	$350 per Stay	$350 per Stay	$500 per Stay
Copay for Primary Care Physician (PCP)	$0	$0	$0	$0
Copay for In-Network specialist (with no PCP referral needed)	$25	$20	$25	$30
Prescription Drug (Part D) Coverage – at no additional cost	Yes	Yes	Yes	No
Copay for 90-day mail order of Tier 1 preferred generic drugs	$0	$0	$0	N/A
Prescription Drug Deductible	$0	$0	$0	N/A
Fitness Benefits and Wellness Program – at no extra cost	Yes	Yes	Yes	Yes
Vision and Hearing Coverage	Yes	Yes	Yes	Yes
Dental Benefit¹	DHMO	PPO	PPO	PPO
National/worldwide urgent care and emergency coverage	Yes	Yes	Yes	Yes
Convenient Virtual Care options such as Teladoc and the Memorial Hermann Virtual Care	Yes	Yes	Yes	Yes
Over-the-Counter Benefit²	Yes	Yes	Yes	Yes
Transportation Benefit³	Yes	Yes	Yes	Yes
Meal Benefit⁴	Yes	Yes	Yes	Yes

¹For the Dental Benefit, the DHMO (Liberty Dental Plan® 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 all other Memorial Hermann Medicare Advantage HMO Plans, the PPO (Preferred Provider Organization) benefit provides a larger network of dentists to choose from. In these plans, 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 Plan. (Please note that by clicking on this link, you will be leaving Memorial Hermann Advantage website.)
²For 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.)
³For Transportation Benefit available on all plans. 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.)
⁴For Meal Benefit available on all plans, offers members a certain amount of meals post-discharge of an in-patient hospitalization stay.

*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.

What to Consider Before Enrolling in a Memorial Hermann Advantage HMO Plan

You cannot enroll in a Medicare Advantage Plan if you are not already enrolled in Medicare Part A and Part B. To enroll in original Medicare, visit the Social Security Administration’s website, medicare.gov. (Please note that by clicking on this link, you will be leaving Memorial Hermann Advantage website.)
In order to be eligible for a Memorial Hermann Advantage HMO Plan, you must live within Harris, Fort Bend, Montgomery, Liberty, Hardin, Brazoria, Galveston or Jefferson county in Texas.
If you have both Medicare and Medicaid coverage and live within Harris, Fort Bend or Montgomery county, you may be eligible for the Memorial Hermann Dual Advantage Special Needs Plan (D-SNP). Click here to learn more.
If your current doctor does not participate in the Memorial Hermann Advantage HMO Plan Network, you can talk to an authorized plan representative at (866) 350-2715 (TTY 711) to learn about other providers. You can also view a list of Memorial Hermann Advantage HMO providers, by clicking on the Memorial Hermann Advantage HMO Provider Directory.
The plan requires you to use doctors and other health care professionals that participate in the Memorial Hermann Medicare Advantage HMO Plan Network. With the exception of emergency situations like ER visits, urgent care stays and renal dialysis services, without authorization, neither Medicare nor Memorial Hermann Advantage HMO will pay for these services.

*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.