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This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.

2013 AARP MedicareComplete SecureHorizons Essential (HMO) in Tarrant, Texas

Medicare Advantage Plan Benefit Details in Plain Text
The following Medicare Advantage plan benefits apply to the AARP MedicareComplete SecureHorizons Essential (HMO) (H4590 - 027) in Tarrant, Texas .

This plan is administered by .  To switch to a different Medicare Advantage plan or to change your location, click here.
Click here to see the AARP MedicareComplete SecureHorizons Essential (HMO) health benefit details in chart format or email and view benefits chart

Plan Premium
This plan has a $0.00 monthly premium. Although you pay no additional monthly premium, you must continue to pay your Medicare Part B premium. If you have a premium penalty, your premium will be higher. Or if you have a higher income you would be subject to the Income Related Adjustment Amount (IRMAA).

This Medicare Advantage Plan without Prescription Drug Coverage is a Local HMO * plan.

Plan Membership and Plan Ratings
The AARP MedicareComplete SecureHorizons Essential (HMO) (H4590 - 027) currently has 1,205 members.

The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 3.5 stars. The detail CMS plan carrier ratings are as follows:
  • Customer Service Rating of 5 out of 5 stars
  • Member Experience Rating of 4 out of 5 stars
Please be aware that this plan does NOT include Prescription Drug Coverage!
The AARP MedicareComplete SecureHorizons Essential (HMO) offers many Health Coverage Benefits. The following section will describe these benefits in detail.

** Cost **
Premium and Other Important Information
$0.00 monthly plan premium in addition to your monthly Medicare Part B premium.
Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more information about Part B premiums based on income call Medicare at 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. You may also call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778.
$3 500 out-of-pocket limit for Medicare-covered services.
** Doctor and Hospital Choice **
Doctor and Hospital Choice
You must go to network doctors specialists and hospitals.
Referral required for network hospitals and specialists (for certain benefits).
** Extra Benefits **
Over-the-Counter Items
The plan does not cover Over-the-Counter items.
Transportation
This plan does not cover supplemental routine transportation.
** Important Information **
Premium and Other Important Information
$0.00 monthly plan premium in addition to your monthly Medicare Part B premium.
Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more information about Part B premiums based on income call Medicare at 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. You may also call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778.
$3 500 out-of-pocket limit for Medicare-covered services.
Doctor and Hospital Choice
You must go to network doctors specialists and hospitals.
Referral required for network hospitals and specialists (for certain benefits).
** Inpatient Care **
Inpatient Hospital Care
No limit to the number of days covered by the plan each hospital stay.
For Medicare-covered hospital stays:
  • Days 1 - 5: $150 copay per day
  • Days 6 - 90: $0 copay per day
    • $0 copay for each additional hospital day.
    Inpatient Mental Health Care
    You get up to 190 days of inpatient psychiatric hospital care in a lifetime. Inpatient psychiatric hospital services count toward the 190-day lifetime limitation only if certain conditions are met. This limitation does not apply to inpatient psychiatric services furnished in a general hospital.
    For Medicare-covered hospital stays:
    • Days 1 - 5: $150 copay per day
  • Days 6 - 90: $0 copay per day
    • Skilled Nursing Facility (SNF)
    Plan covers up to 100 days each benefit period
    No prior hospital stay is required.
    For Medicare-covered SNF stays:
    • Days 1 - 20: $0 copay per day
  • Days 21 - 44: $150 copay per day
  • Days 45 - 100: $0 copay per day
    • Home Health Care
    $0 copay for each Medicare-covered home health visit
    Hospice
    You must get care from a Medicare-certified hospice. Your plan will pay for a consultative visit before you select hospice.
    ** Outpatient Care **
    Doctor Office Visits
    $0 copay for each Medicare-covered primary care doctor visit.
    $20 copay for each Medicare-covered specialist visit.
    Chiropractic Services
    $20 copay for each Medicare-covered chiropractic visit
    Medicare-covered chiropractic visits are for manual manipulation of the spine to correct subluxation (a displacement or misalignment of a joint or body part) if you get it from a chiropractor.
    Podiatry Services
    $20 copay for each Medicare-covered podiatry visit
    $20 copay for up to 6 supplemental routine podiatry visit(s) every year
    Medicare-covered podiatry visits are for medically-necessary foot care.
    Outpatient Mental Health Care
    $40 copay for each Medicare-covered individual therapy visit
    $30 copay for each Medicare-covered group therapy visit
    $40 copay for each Medicare-covered individual therapy visit with a psychiatrist
    $30 copay for each Medicare-covered group therapy visit with a psychiatrist
    $60 copay for Medicare-covered partial hospitalization program services
    Outpatient Substance Abuse Care
    $40 copay for Medicare-covered individual substance abuse outpatient treatment visits
    $30 copay for Medicare-covered group substance abuse outpatient treatment visits
    Outpatient Services
    $150 copay for each Medicare-covered ambulatory surgical center visit
    $150 copay for each Medicare-covered outpatient hospital facility visit
    Ambulance Services
    $200 copay for Medicare-covered ambulance benefits.
    Emergency Care
    $65 copay for Medicare-covered emergency room visits
    Worldwide coverage.
    If you are admitted to the hospital within 24-hour(s) for the same condition you pay $0 for the emergency room visit.
    Urgently Needed Care
    $20 to $40 copay for Medicare-covered urgently-needed-care visits
    Outpatient Rehabilitation Services
    $20 copay for Medicare-covered Occupational Therapy visits
    $20 copay for Medicare-covered Physical Therapy and/or Speech and Language Pathology visits
    ** Outpatient Medical Services and Supplies **
    Durable Medical Equipment
    20% of the cost for Medicare-covered durable medical equipment
    Prosthetic Devices
    20% of the cost for Medicare-covered prosthetic devices
    Diabetes Programs and Supplies
    $0 copay for Medicare-covered Diabetes self-management training
    $0 copay for Medicare-covered Diabetes monitoring supplies
    20% of the cost for Medicare-covered Therapeutic shoes or inserts
    Diagnostic Tests, X-Rays, Lab Services, and Radiology Services
    $10 copay for Medicare-covered lab services
    20% of the cost for Medicare-covered diagnostic procedures and tests
    $15 copay for Medicare-covered X-rays
    20% of the cost for Medicare-covered diagnostic radiology services (not including X-rays)
    20% of the cost for Medicare-covered therapeutic radiology services
    ** Preventive Services **
    Cardiac and Pulmonary Rehabilitation Services
    $20 copay for Medicare-covered Cardiac Rehabilitation Services
    $20 copay for Medicare-covered Intensive Cardiac Rehabilitation Services
    $20 copay for Medicare-covered Pulmonary Rehabilitation Services
    Preventive Services and Wellness/Education Programs
    $0 copay for all preventive services covered under Original Medicare at zero cost sharing. Any additional preventive services approved by Medicare mid-year will be covered by the plan or by Original Medicare.
    $0 copay for an annual physical exam
    The plan covers the following supplemental education/wellness programs:
    • Health Club Membership/Fitness Classes
  • Nursing Hotline
    • $0 copay for Additional Preventive Services. Contact plan for details.
    Kidney Disease and Conditions
    20% of the cost for Medicare-covered renal dialysis
    $0 copay for Medicare-covered kidney disease education services
    Outpatient Prescription Drugs
    Most drugs not covered.
    20% of the cost for Medicare Part B chemotherapy drugs and other Part B drugs.
    This plan does not offer prescription drug coverage.
    Dental Services
    In general preventive dental benefits (such as cleaning) not covered.
    $20 copay for Medicare-covered dental benefits
    Hearing Services
    $0 copay for:
    $20 copay for Medicare-covered diagnostic hearing exams
    $0 copay for up to 1 supplemental routine hearing exam(s) every year
    $150 copay for up to 2 inner-ear hearing aid(s) every year
    $100 copay for up to 2 over-the-ear hearing aid(s) every year
    ** Additional Benefits **
    Vision Services
    • $0 copay for one pair of Medicare-covered eyeglasses or contact lenses after cataract surgery.
  • $0 to $20 copay for Medicare-covered exams to diagnose and treat diseases and conditions of the eye.
  • $20 copay for up to 1 supplemental routine eye exam(s) every year
  • $30 copay for contacts
  • $0 copay for up to 1 pair(s) of lenses every two years
  • $30 copay for up to 1 frame(s) every two years
    • $105 plan coverage limit for contact lenses every two years.
    $70 plan coverage limit for eye glass frames every two years.
    Over-the-Counter Items
    The plan does not cover Over-the-Counter items.
    Transportation
    This plan does not cover supplemental routine transportation.
    Acupuncture
    This plan does not cover Acupuncture.
    ** Inpatient Care **
    Inpatient Hospital Care
    No limit to the number of days covered by the plan each hospital stay.
    For Medicare-covered hospital stays:
    • Days 1 - 5: $150 copay per day
  • Days 6 - 90: $0 copay per day
    • $0 copay for each additional hospital day.
    ** Outpatient Care **
    Doctor Office Visits
    $0 copay for each Medicare-covered primary care doctor visit.
    $20 copay for each Medicare-covered specialist visit.
    Outpatient Services
    $150 copay for each Medicare-covered ambulatory surgical center visit
    $150 copay for each Medicare-covered outpatient hospital facility visit
    Ambulance Services
    $200 copay for Medicare-covered ambulance benefits.
    ** Outpatient Medical Services and Supplies **
    Durable Medical Equipment
    20% of the cost for Medicare-covered durable medical equipment
    Diagnostic Tests, X-Rays, Lab Services, and Radiology Services
    $10 copay for Medicare-covered lab services
    20% of the cost for Medicare-covered diagnostic procedures and tests
    $15 copay for Medicare-covered X-rays
    20% of the cost for Medicare-covered diagnostic radiology services (not including X-rays)
    20% of the cost for Medicare-covered therapeutic radiology services
    ** Additional Benefits **
    Over-the-Counter Items
    The plan does not cover Over-the-Counter items.
    Transportation
    This plan does not cover supplemental routine transportation.
    ** Cost **
    Premium and Other Important Information
    Package: 1 - Deluxe Rider:
    $36 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits:
    • Preventive Dental
    • Comprehensive Dental
    • Eye Exams
    • Eye Wear
    • Hearing Aids
    ** Important Information **
    Package: 1 - Deluxe Rider:
    $36 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits:
    • Preventive Dental
    • Comprehensive Dental
    • Eye Exams
    • Eye Wear
    • Hearing Aids
    ** Preventive Services **
    Dental Services
    Plan offers additional comprehensive dental benefits.
  • $0 copay for up to 1 cleaning(s) every six months
  • $0 copay for up to 1 fluoride treatment(s) every six months
  • $0 copay for up to 1 oral exam(s) every six months
  • $0 copay for up to 1 dental x-ray(s)
    • $1 000 plan coverage limit for dental benefits every year
    Hearing Services
    $100 copay for up to 2 inner-ear hearing aid(s) every year
    $50 copay for up to 2 over-the-ear hearing aid(s) every year
    ** Additional Benefits **
    Vision Services
    • $15 copay for contacts
  • $0 copay for up to 1 pair(s) of lenses every year
  • $15 copay for up to 1 frame(s) every year
  • $15 copay for up to 1 supplemental routine eye exam(s) every year
    • ** Cost **
    Premium and Other Important Information
    Package: 2 - Dental 467 Rider:
    $15 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits:
    • Preventive Dental
    ** Important Information **
    Package: 2 - Dental 467 Rider:
    $15 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits:
    • Preventive Dental
    ** Preventive Services **
    Dental Services
    • $0 copay for up to 1 cleaning(s) every six months
  • $0 copay for up to 1 oral exam(s) every six months
  • $0 copay for up to 1 dental x-ray(s)




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