Prime (HMO-POS) Plan

Generations Advantage Prime (HMO-POS) offers complete medical, hospital, and Part D Prescription Drug coverage. You can use in-network doctors and health service providers and pay low copayments for medical services. You also have the flexibility to go outside the network for certain planned services with the Point of Service (POS) benefit. It is available throughout Maine and in Hillsborough and Strafford counties in New Hampshire.

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Costs

  • Low 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
  • $40 copays for specialist visits
  • $0 copays for many generic drugs at Hannaford Pharmacies1

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)
  • Flexibility to see out-of-network providers for many services with the Point of Service benefit (you may pay more for out-of-network services)2
  • Wellness Wallet: The plan will reimburse up to $400 each year in total for Fitness Benefit, Naturopathic Services, and Acupuncture

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.

Drug Copays chart

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

Preventive Dental

Click Prime Plan Preventive Dental benefit for more information. 

Flu Shot Benefit

Click Prime Plan Flu Shot benefit for more information.

1Limitations, 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.

2There is a plan limit of $25,000 for Point of Service Benefits. Once you and the plan have paid $25,000 for POS benefits, you will be responsible for these costs if you continue to use out-of-network providers.

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-POS, PPO, HMO, and HMO SNP 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 - February 14, and Monday through Friday the rest of the year. Calls to this number are free.