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Navigated to Miami Dade (HMO Prime): Summary of Benefits page

Miami Dade (HMO Prime): Summary of Benefits


Monthly Premium
$29.70
And you still have to pay for your Medicare Part B premium.

Annual Out-of-Pocket Maximum
$3,400
This is the most you'd have to pay in a year for covered medical services. Once you reach it, your plan pays all of the costs.

Primary Card Provider (PCP) Visits
$0 copay

Specialist Visits
$0 copay

Hospital Stays
$0 copay
For surgery or other medical reasons

Urgent Care
$0 copay

Emergency Room Visit
$25 copay
If you get checked in to the hospital, you won't have to pay this.

Outpatient Surgery
$0 copay

Labs
$0 copay

X-rays
$0 copay

Tests or Procedures (EKGs, Biopsies, Colonoscopies, etc.)
$0 copay

30-Day Supply Retail Pharmacy
$0 copay
Tiers 1 and 2

25% of cost
Tiers 3, 4, and 5

90-Day Supply Mail-order Pharmacy
$0 copay
Tiers 1 and 2

25% of cost
Tiers 3, 4, and 5

Dental Services
Yes
You're covered for things like check ups, cleanings, fillings, and dentures

Vision
$300 a year
For glasses and contact lenses.

Hearing Aids
$750 a year (per ear)

Over-the-counter Health and Wellness Products
$75 a month
$900 a year for things like pain relievers, vitamins, and first aid supplies.

Rides to and from Your Doctor
Yes

Fitness Benefit
Yes

Acupuncture
Yes

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