MMM Elite Excel (HMO POS) - 2017 ImprimirPrint

The MMM Elite Excel plan features a list of benefits with low copayments and $0 premium, with no deductibles. This plan also covers all Medicare-covered preventive services with zero cost sharing.

 

 

What do we offer?

Medical visits and Hospital stays

$0copay

Primary Care Physician (PCP)

  • $5copay

    Preferred Network Specialists

  • $7copay on Medicare covered visits

    Chiropractic

  • $50copay per admission

    Preferred Network Hospital stay

  • $65copay

    Emergency care, $100 in worldwide coverage

Drug Coverage*

$1copay

Preferred Generic Drugs

  • $6copay

    Generic Drugs

  • $20copay

    Preferred Brand Drugs

  • $30copay

    Non Preferred Brand Drugs

  • 33%coinsurance

    Specialty Drugs

More Benefits

$15copay

Preventive Dental Services

  • $1,000Up to $1,000 a year

    Removable prosthodontics

  • $0One pair a year

    Eyeglasses or contact lenses

  • $200every three years

    Hearing aids

  • $25Up to $25 every three months

    Overt-the-Counter Items (OTC)

  • 20%coinsurance

    Out-of-Network Coverage *

 

*Out-of-Network Coverage  covers up to $ 5,000 per year and requires preauthorization. In the Drug Coverage, while you are in the Coverage Gap, you will pay 40% of the cost for brand name drugs (plus dispensing fee), through the Medicare Gap Coverage Discount Program, and generally pay no more than 51% of the cost for generic drugs. This plan offers additional coverage in the gap for some drugs.

 

Do you need a printed copy of any of these documents? We can send it by mail, request it here.