2022 Amerivantage Classic Plus (HMO)
Amerivantage Classic Plus (HMO) H8849-008 is a 2022 Medicare Advantage Plan or Part-C by Amerigroup available to residents in Texas. This plan includes additional prescription drug (Part-D) coverage. The Amerivantage Classic Plus (HMO) has a monthly premium of $0 and has an in-network maximum out-of-pocket limit of $5,500 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay
$5,500 out-of-pocket. This can be a extremely nice safety net.
Amerivantage Classic Plus (HMO) is a Local HMO. With a health maintenance organization (HMO) you will be required to receive most of your health care from an in-network provider. Health maintenance organizations require that you select a primary care physician (PCP). Your PCP will serve as your personal doctor to provide all of your basic healthcare services. If you require specialized care or a physician specialist, your primary care physician will make the arrangements and inform you where you can go in the network. You will need your PCPs okay, called a referral. Services received from an out-of-network provider are not typically covered.
Amerigroup works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Amerivantage Classic Plus (HMO) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Amerigroup and not Original Medicare. With Medicare Advantage you are always covered for urgently needed and emergency care. Plus you receive all the benefits of Original Medicare from Amerigroup except hospice care. Original Medicare still provides you with hospice care even if you sign up for Medicare Advantage.
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2022 Amerigroup Medicare Advantage Plan Costs
Name: | Amerivantage Classic Plus (HMO) |
Plan ID: | H8849-008 |
Provider: | Amerigroup |
Year: | 2022 |
Type: | Local HMO |
Monthly Premium C+D: | $0 |
Part C Premium: | $0.00 |
MOOP: | $5,500 |
Part D (Drug) Premium: | $0.00 |
Part D Supplemental Premium | $0.00 |
Total Part D Premium: | $0.00 |
Drug Deductible: | $0.00 |
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Tiers with No Deductible: | 0 |
Gap Coverage: | Yes |
Benchmark: | not below the regional benchmark |
Type of Medicare Health: | Enhanced Alternative |
Drug Benefit Type: | Enhanced |
Similar Plan: | H8849-009 |
New Plan: | 2023 H8849-009 |
Amerivantage Classic Plus (HMO) Part-C Premium
Amerigroup charges a $0.00 Part-C premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.
H8849-008 Part-D Deductible and Premium
Amerivantage Classic Plus (HMO) has a monthly drug premium of $0.00 and a $0.00 drug deductible. This Amerigroup plan offers a $0.00 Part-D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0.00 this Premium covers any enhanced plan benefits offered by Amerigroup above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $0.00 . The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lowered due to negative basic or supplemental premiums.
Amerigroup Gap Coverage
In 2022 once you and your plan provider have spent $4430 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will be required to pay 25% for prescription drugs unless your plan offers additional coverage. This Amerigroup plan does offer additional coverage through the gap.
H8849-008 Formulary or Drug Coverage
Amerivantage Classic Plus (HMO) formulary is divided into Tiers or levels of coverage based on usage and according to the medication costs. Each tier will have a defined copay that you must pay to receive the drug. Drugs in lower tiers will usually cost less than those in higher tiers.
By reviewing different Medicare Drug formularies, you can pick a Medicare Advantage plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price. You can see complete 2022 Amerivantage Classic Plus (HMO) H8849-008 Formulary here.
2021 Amerivantage Classic Plus (HMO) Summary of Benefits
*This will be updated with 2022 data when available.
Additional Benefits
Comprehensive Dental
Diagnostic services |
$0 copay |
Endodontics |
$0 copay |
Extractions |
$0 copay |
Non-routine services |
$0 copay |
Periodontics |
$0 copay |
Prosthodontics, other oral/maxillofacial surgery, other services |
$0 copay |
Restorative services |
$0 copay |
Deductible
Diagnostic Tests and Procedures
Diagnostic radiology services (e.g., MRI) |
$125-250 copay |
Diagnostic tests and procedures |
$0-150 copay |
Lab services |
$0 copay |
Outpatient x-rays |
$35-60 copay |
Doctor Visits
Primary |
$0 copay |
Specialist |
$35 copay per visit |
Emergency care/Urgent Care
Emergency |
$90 copay per visit (always covered) |
Urgent care |
$35 copay per visit (always covered) |
Foot Care (podiatry services)
Foot exams and treatment |
$0-35 copay |
Routine foot care |
$0 copay |
Ground Ambulance
Hearing
Fitting/evaluation |
$0 copay |
Hearing aids |
$0 copay |
Hearing exam |
$35 copay |
Inpatient Hospital Coverage
$275 per day for days 1 through 5 $0 per day for days 6 through 90 |
|
|
Medical Equipment/Supplies
Diabetes supplies |
$0 copay |
Durable medical equipment (e.g., wheelchairs, oxygen) |
0-20% coinsurance per item |
Prosthetics (e.g., braces, artificial limbs) |
20% coinsurance per item |
Medicare Part B Drugs
Chemotherapy |
20% coinsurance |
Other Part B drugs |
20% coinsurance |
Mental Health Services
Inpatient hospital - psychiatric |
$265 per day for days 1 through 7 $0 per day for days 8 through 90 |
Outpatient group therapy visit |
$35 copay |
Outpatient group therapy visit with a psychiatrist |
$35 copay |
Outpatient individual therapy visit |
$35 copay |
Outpatient individual therapy visit with a psychiatrist |
$35 copay |
MOOP
Option
Optional supplemental benefits
Outpatient Hospital Coverage
Preventive Care
Preventive Dental
Cleaning |
$0 copay |
Dental x-ray(s) |
$0 copay |
Fluoride treatment |
$0 copay |
Oral exam |
$0 copay |
Rehabilitation Services
Occupational therapy visit |
$35 copay |
Physical therapy and speech and language therapy visit |
$35 copay |
Skilled Nursing Facility
$0 per day for days 1 through 20 $140 per day for days 21 through 100 |
|
|
Transportation
Vision
Contact lenses |
$0 copay |
Eyeglass frames |
$0 copay |
Eyeglass lenses |
$0 copay |
Eyeglasses (frames and lenses) |
$0 copay |
Other |
Not covered |
Routine eye exam |
$0 copay |
Upgrades |
Not covered |
Wellness Programs (e.g. fitness nursing hotline)
Ready to Enroll?
Click Here |
Or Call
1-855-778-4180
Mon-Fri 8am-8pm EST
Sat 8am-8pm EST
Coverage Area for Amerivantage Classic Plus (HMO)
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Source: CMS.
Data as of September 1, 2021.
Notes: Data are subject to change as contracts are finalized. For 2022, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit.
Includes 2022 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.