Value (HMO) Plan 2017
Generations Advantage Value (HMO) offers comprehensive medical and hospital benefits, but with no Part D Prescription Drug coverage. This may be an option if you already have prescription drug coverage through the VA or an employer plan.
- HMO – With this plan you must use in-network providers for all plan services
- $0 monthly premium (remember, you must continue to pay your Medicare Part B premium)
- $0 annual routine physical and annual routine vision and hearing exams
- No Deductible
- $0 copays for primary care office visits
- $0 copays for a range of preventive services
- $40 copays for specialist visits
- Out-of-pocket maximum for medical services: $6,700. Your plan premium does not count toward this maximum.
- Emergency care coverage worldwide
- Urgent care coverage nationwide
- This plan is available in all counties in Maine
- Large network of doctors across Maine
- 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
Getting a Flu Shot? Know before you go!
Here are some pointers to help you know what to expect when you go for your flu shot this season.
As a Generations Advantage Value plan member, you have two ways to get your annual flu shot at no cost:
1. Get the shot at your Primary Care Provider’s office. (You may have to pay a copayment for the office visit, but there will be no cost for the flu shot.)
2. Get the shot at a pharmacy. You will have to pay for the vaccine up front and then request a reimbursement from your plan. The Reimbursement Form is on the Plan Documents page. You can also call Member Engagement to request a paper copy of this form.
What seasonal flu vaccines are covered3 through the Vaccine Pharmacy Network?
This season your Generations Advantage plan covers most flu vaccines!
- Trivalent (high dose)
What should you do if you have questions related to your flu shot?
If you have questions about the flu shot, or any other benefit, please call Member Services.
Thank you for taking care of yourself by getting this important vaccination.
1Influenza (flu) vaccines are covered under your Medicare Part B benefit through Generations Advantage Value. Limitations, copayments, and restrictions may apply. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan.
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 and medications, pharmacy network, premium and/or copays/coinsurance may change on January 1 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 to February 14, and Monday through Friday the rest of the year. Calls to these numbers are free.