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2020 Medicare Advantage Plan Benefit Details for the MMM ELITE DADE (HMO)

2020 Medicare Advantage Plan Details
Medicare Plan Name:MMM ELITE DADE (HMO)
Location:Miami-Dade, Florida
Plan ID:H3293 - 001 - 0     Click to see other plans
Member Services:1-844-212-9858 TTY users 1-833-523-2620
— Enrollment Options —
Medicare Contact Information:1-800-MEDICARE (1-800-633-4227)
TTY users 1-877-486-2048
Speak to a licensed sales agent to learn more and enroll.
Call Medicare Solutions at 855-373-9484 / TTY 711

Monday ‐ Friday 8:30am — 10pm EST
Email a copy of the MMM ELITE DADE (HMO) benefit details
— Medicare Plan Features —
Monthly Premium:$0.00 (see Plan Premium Details below)
Annual Deductible:$0
Annual Initial Coverage Limit (ICL):$6,000
Health Plan Type:Local HMO
Maximum Out-of-Pocket Limit for Parts A & B (MOOP):$3,400
Additional Gap Coverage?Yes, some additional gap coverage.
Total Number of Formulary Drugs:3,309 drugsBrowse the MMM ELITE DADE (HMO) Formulary
This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers
Formulary Drug Details:Tier 1Tier 2Tier 3Tier 4Tier 5
Preferred Pharmacy
  Cost-Sharing during
  initial coverage phase:
Number of Drugs per
Plan's Pharmacy Search:http://www.mmm-fl.com
Plan Offers Mail Order?Yes
Number of Members enrolled in this plan in Miami-Dade, Florida:243 members
Number of Members enrolled in this plan in (H3293 - 001):252 members
Plan’s Summary Star Rating: New plan - No summary rating as of yet.
Customer Service Rating: New plan - not yet rated.
Member Experience Rating: New plan - not yet rated.
Drug Cost Accuracy Rating: Does not apply.
— Plan Premium Details —
The Monthly Premium is Split as Follows:
Part C
Part D Base
Part D Supplemental
Monthly Premium with Extra Help Low-Income Subsidy (LIS):100%
Monthly Part D Premium with LIS:$0.00$0.00$0.00$0.00
Total Monthly Premium with LIS (Parts C & D):$0.00$0.00$0.00$0.00
— Plan Health Benefits —
** Base Plan **
Premium Total monthly premium: $0.00
  Health plan premium: $0.00
  Drug plan premium: $0.00
  Standard Part B premium: $135.50
  Part B premium reduction: No
Deductible Health plan deductible: $0
  Drug plan deductible: $0.00
Estimated yearly costs Estimated total yearly costs for care: $2,694.00
Out-of-pocket max Out-of-pocket max: $3,400 In-network
Doctor services Primary doctor visit: $0 copay
  Specialist visit: $0 copay, Limits apply
Tests, labs, & imaging Diagnostic tests & procedures: $0-25, Limits apply
  Lab services: $0 copay, Limits apply
  Diagnostic radiology services (like MRI): $0-25, Limits apply
  Outpatient x-rays: $0 copay, Limits apply
  Emergency care: $25 per visit (always covered)
  Urgent care: $0 copay
Hospital services Inpatient hospital coverage: $0 copay, Limits apply
  Outpatient hospital coverage: $50 per visit, Limits apply
Skilled nursing facility Skilled nursing facility: $0 per day for days 1 through 20 $25 per day for days 21 through 100, Limits apply
Preventive services Preventive services: $0 copay, Limits apply
Ambulance Ground ambulance: $25
Therapy services Occupational therapy visit: $0 copay, Limits apply
  Physical therapy & speech & language therapy visit: $0 copay, Limits apply
Mental health services Outpatient group therapy with a psychiatrist: $0 copay, Limits apply
  Outpatient individual therapy with a psychiatrist: $0 copay, Limits apply
  Outpatient group therapy visit: $0 copay, Limits apply
  Outpatient individual therapy visit: $0 copay, Limits apply
Opioid treatment services Opioid treatment services: Covered
Other services Durable medical equipment (like wheelchairs & oxygen): 0-20% per item, Limits apply
  Prosthetics (like braces, artificial limbs): $0 copay, Limits apply
  Diabetes supplies: $0 copay, Limits apply
Hearing Hearing exam: $0 copay, Limits apply
  Fitting/evaluation: $0 copay, Limits apply
  Hearing aids - All types: $0 copay, Limits apply
Preventive dental Oral exam: $0 copay, Limits apply
  Cleaning: $0 copay, Limits apply
  Fluoride treatment: $0 copay, Limits apply
  Dental x-rays: $0 copay, Limits apply
Comprehensive dental Non-routine services: Not covered
  Diagnostic services: $0 copay, Limits apply
  Restorative services: $0 copay, Limits apply
  Endodontics: Not covered
  Periodontics: Not covered
  Extractions: $0 copay, Limits apply
  Prosthodontics, other oral/maxillofacial surgery, other services: $0 copay, Limits apply
Vision Routine eye exam: $0 copay, Limits apply
  Contact lenses: $0 copay, Limits apply
  Eyeglasses (frames & lenses): $0 copay, Limits apply
  Eyeglass frames (only): Not covered
  Eyeglass lenses (only): Not covered
  Upgrades: Not covered
More benefits Fitness benefit: Limited coverage
  Transportation services for non-emergency care: Any health-related locations: Not covered
  Transportation services for non-emergency care: Plan-approved locations: Limited coverage
  Over the counter drug benefits: Limited coverage
  In-home support services: Not covered
  Routine chiropractic service: Limited coverage
  Home and bathroom safety devices: Not covered
  Meals for short duration: Limited coverage
  Annual physical exams: Not covered
  Telehealth: Not covered
Part B drugs Chemotherapy drugs: 20%, Limits apply
  Other Part B drugs: 0-20%, Limits apply

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