AARP Medicare Advantage SecureHorizons 2 Plan (HMO-POS) H0609-036-002 2023 Plan Details & Costs (2023)

Visit to the doctor's office:
Visit to the office of primary care copay0,00 $

Specialist visit:
Specialist visit copay$30,00
Prior authorization is required to see a specialist

Services in the acute hospital:
$275,00per day for days 1 to 6
0,00 $per day for days 7 to 90
Prior approval is required for acute hospital services

Worldwide Coverage:
Co-payment for global emergency response0,00 $

Worldwide Coverage:
Co-pay for global emergency response0,00 $
Worldwide Emergency Transportation Co-Payment0,00 $

Ambulance:
Co-payment for ground rescue services$230,00

Ambulance:
Co-payment for air ambulance services$230,00

Section B - General 10a Notice - AUTHORIZATION NOTE: Medicare-covered non-emergency ground and air ambulance transport requires an authorization. The ambulance does not require a permit.
Please note the rules on pre-approval in the proof of cover.

Chiropractic Services:
Co-payment for Medicare-covered chiropractic services$10,00
Regular care allowance$10,00

• Maximum 12 routine care per year

Accessories and services for diabetics:
Copay for Medicare covered diabetic items0,00 $
Co-insurance for Medicare-covered diabetic therapy shoes or insoles20%
Prior approval is required for diabetic services and supplies

Durable Medical Equipment:
Co-insurance for Medicare-covered long-life medical devices20%
Prior approval is required for long-life medical devices

Outpatient diagnostic procedures/examinations/laboratory services:
Co-payment for Medicare-covered diagnostic procedures/tests$25,00
Copay for Medicare-covered laboratory services0,00 $
Prior approval is required for ambulatory laboratory/testing/diagnostic processing services

Outpatient radiodiagnostic/therapeutic services:
Co-payment for Medicare-covered diagnostic radiology services0,00 $A$105,00
Co-payment for Medicare-covered therapeutic radiology services$60,00
Co-payment for Medicare-covered X-ray services$15,00
Prior approval is required for outpatient diagnostic/therapeutic services

General Practitioner Services:
Co-payment for Medicare-covered home healthcare services0,00 $
Prior authorization is required for GP services

Psychiatric hospital services:
$275,00per day for days 1 to 6
0,00 $per day for days 7 to 90
Prior approval is required for psychiatric hospital services

Outpatient psychiatric services:
Co-payment for Medicare-covered individual sessions$25,00
Copay for Medicare-covered group sessions$15,00
Prior approval is required for outpatient mental health services

Hospital ambulances:
Co-payment for Medicare-covered outpatient hospital services0,00 $A$250,00
Prior approval is required for outpatient hospital services

Ambulatory Observation Services:
Co-payment for Medicare-covered monitoring services: per day$250,00
Prior approval is required for outpatient observation services

Ambulatory surgery center services:
Co-payment for outpatient surgical center services0,00 $A175,00 $
Prior approval is required for outpatient surgical center services

Outpatient addiction help:
Co-payment for Medicare-covered individual sessions$25,00
Copay for Medicare-covered group sessions$15,00
Prior approval is required for outpatient substance abuse services

Over-the-Counter (OTC)-Artikel:
Copay for Over-the-Counter (OTC) items0,00 $
Maximum plan utility$60,00every three months
Nicotine Replacement Therapy (NRT) provided as an OTC service pursuant to Part C

Podiatry services:
Copay for Medicare-covered podiatry services$30,00
Co-payment for routine foot care$30,00

• Maximum 6 visits per year

Qualified care service:
0,00 $per day for days 1 to 20
196,00 $per day for days 21 to 43
0,00 $per day for days 44 to 100
Prior approval is required for qualified care facilities

Preventive Dentistry:
Additional payment for oral exams0,00 $

• Maximum 2 visits per year

• Maximum 3 visits per year

• Maximum 2 visits per year

• Maximum 1 visit (see proof of cover for details)

Comprehensive Dentistry:
Co-insurance for Medicare-covered services20%
Copay for non-routine services0,00 $
Co-payment for diagnostic services0,00 $

• Maximum 1 visit (see proof of cover for details)

• Maximum 1 visit (see proof of cover for details)

• Maximum 1 visit (see proof of cover for details)

• Maximum 1 visit (see proof of cover for details)

• Maximum 1 visit (see proof of cover for details)

• Maximum 1 visit (see proof of cover for details)

eye exams:
Co-payment for Medicare-covered benefits0,00 $
Co-payment for routine eye exams0,00 $

• Maximum 1 routine eye exam per year

Glasses:
Co-payment for Medicare-covered benefits0,00 $
Supplement for contact lenses0,00 $
Additional payment for glasses (lenses and frames)0,00 $

• Maximum 1 pair per year

Hearing Tests:
Co-payment for Medicare-covered benefits0,00 $
Co-payment for routine hearing tests0,00 $

• Maximum 1 visit per year

Headphones:
Co-payment for hearing aids175,00 $A$1225,00

• Maximum 2 hearing aids per year

Screening for abdominal aortic aneurysm
Counseling and screening for alcohol abuse
Bone mass measurements (bone density)
Cardiovascular disease screening
Cardiovascular diseases (behavioral therapy)
Screening for cervical and vaginal cancer
Colorectal Cancer Prevention
Depressionsscreenings
Diabetes-Screenings
Diabetes self-management training
Glaucoma-Test
Screening for hepatitis B infection (HBV)
Hepatitis-C-Screening
HIV-Screening
lung cancer screening
Mammographie (Screening)
nutritional therapy services.
Obesity screening and counseling
Welcome to Medicare One Time Preventive Visit
Prostate Cancer Screening Tests (PSA)
Screening and counseling for sexually transmitted infections
shots:

• Covid-19 vaccinations

• Summary of Benefits
• star ratings