Value (HMO) Plan 2020

Generations Advantage Value (HMO) offers comprehensive medical and hospital benefits, and rich supplemental benefits. The Value Plan does not offer Part D Prescription Drug coverage. This is an excellent choice if you already have prescription drug coverage through the VA or an employer plan. It is available in all counties in Maine and New Hampshire. With this plan you must use in-network providers for all plan services.

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Please note: You cannot have a Medicare Part D Prescription Drug plan if you enroll in the Value plan.

Costs

  • $0 monthly premium
    $55 monthly Part-B Premium Reduction (Members must continue to pay the remaining portion of their 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
  • $5 copays for specialist visits
  • $0 copay for outpatient rehabilitation services (physical therapy, occupational therapy, speech pathology)
  • $20 copay for routine chiropractic services
  • $0 copay for personal emergency response system

Features

  • Emergency care coverage worldwide
  • Urgent care coverage nationwide
  • Large network of doctors across Maine
  • Includes preventive and comprehensive dental services (Delta Dental PPO Network)
  • Over-the counter: The plan will cover up to $180 quarterly for members to purchase select CVS brand over-the-counter (OTC) products
  • Wellness Wallet: The plan will reimburse up to $350 each year in total for eyewear, fitness, naturopathic services, acupuncture, nutritional/dietary education, and weight management programs.
  • Eyewear: $400 for prescription lenses, frames and contract lenses
  • Hearing Aids: $0/$95/$295 copay per ear, depending on tier selected

Peace of Mind

  • $5,000 out-of-pocket maximum, which means a predictable limit on costs, even in the case of a serious health problem. Your plan premium does not count toward this maximum.

Please note: You cannot have a Medicare Part D Prescription Drug plan if you enroll in the Value plan

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

Flu Shot Benefit

Click Value Plan Flu Shot benefit for more information.

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.

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