Focus DC (HMO SNP) Plan 2019

Generations Advantage Focus DC (HMO SNP) offers complete medical, hospital, and Part D Prescription Drug coverage, with focused care and benefits for people living with diabetes in Cumberland County1. All benefits are for in-network services only, except urgent and emergency care.

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Costs

  • $0 monthly premium
    Remember, you must continue to pay your Medicare Part B premium
  • No Deductibles
  • $0 annual routine physical and annual routine vision exam (in-network) 
  • $0 copays for primary care office visits
  • $0 copays for a range of preventive services
  • $0 copays for endocrinologists, podiatrists, mental health and substance use specialists 
  • $40 copays for all other specialist visits
  • $0 copays for many generics at Hannaford Pharmacies2

Features

  • Part D Prescription Drug coverage with no deductibles
    Search our Formulary (drug list) to see if your drugs are covered
  • Emergency care coverage worldwide
  • Urgent care coverage nationwide
  • Large network of doctors across Maine and New Hampshire
  • Includes preventive dental services (Delta Dental PPO Network)
  • Over-the counter: The plan will cover up to $25 monthly for members to purchase select CVS brand over-the-counter (OTC) products
  • Wellness Wallet: The plan will reimburse up to $450 each year in total for fitness, naturopathic services, acupuncture, nutritional/dietary education, and weight management programs.

Peace of Mind

  • $5,500 out-of-pocket maximum, which means a predictable limit on costs, even in the case of a serious health problem. Your plan premium and prescription drug copayments don't count toward this maximum.

Looking for plan documents? Click here to go to the member resource page. 

Prime Select Focus DC Plans Drug  Copays Charts

*For 90-day supply multiply 30-day supply amount by three

Preventive Dental

Click Focus DC plan Preventive Dental benefit for more information.

Flu Shot Benefit

Click Focus DC plan Flu Shot benefit for more information.


1 This plan is available (in Cumberland County only) to anyone with Medicare who has been diagnosed with diabetes by a doctor or other licensed professional.

2 Limitations, copays, and restrictions may apply. At pharmacies with preferred cost-sharing, you pay $0 for Cost-Sharing Tier 1 (preferred generic drugs and certain preferred brand name drugs). Other pharmacies are available in our network.

The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information, contact the plan. Limitations, restrictions, and copays may apply. Benefits, formulary, pharmacy network, premium and/or copays/coinsurance may change on January 1 of each year.
Martin’s Point Generations Advantage is a health plan with a Medicare contract offering HMO, HMO-POS, HMO SNP, Local and Regional PPO products. Enrollment in a Martin's Point Generations Advantage plan depends on contract renewal.

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The materials on this page may be made available in other formats such as Braille, large print or other alternate formats. Please contact us for more information. Call Member Services at 1-866-544-7504 (TTY: 711). We are available 8 am-8 pm, seven days a week from October 1 to March 31, and Monday through Friday the rest of the year. Calls to these numbers are free.