H5322 025 02 - hmopos

What is a dual special needs plan? If you can answer "yes" to the three questions below, there's a good chance you may qualify for this dual health plan. Search for doctors, hospitals, and specialists.

These SNP plans provide benefits beyond Original Medicare, such as transportation to medical appointments and routine vision exams. Members must have Medicaid to enroll. Health Maintenance Organization HMO plans use a network of contracted local physicians and hospitals to provide member care. Generally, members must use these care providers to receive benefits for covered services, except in emergencies. Some HMO plans do not require referrals for specialty care. Point of Service HMO-POS plans include all the features of HMO plans plus the ability to go outside the contracted network for certain health care services - typically at a higher cost. Some POS plans only cover out-of-network dental care.

H5322 025 02 - hmopos

We're dedicated to improving your health and well-being. Members have access to specialized behavioral health services, which includes mental health and may include substance use treatment. Coverage services may vary based on eligibility. Search for providers, clinics and treatment centers. This search option is only available for desktop users. Note that you can download a list of covered drugs below. Search for drugs covered by our plan. If we make a coverage decision and you are not satisfied with this decision, you can "appeal" the decision. An appeal is a formal way of asking us to review and change a coverage decision we have made. What to do if your current prescription drugs are not on the Drug List formulary or are restricted in some way.

Check Eligibility opens modal window Special eligibility requirements. Don't have time to see the doctor for a flu shot? Click on "Search for a Dentist" below to begin your search.

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Learn more about Texas Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price. The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage. The following vision services are covered, though there may be provider network restrictions. The following hearing services are covered, though there may be provider network restrictions. The following services are covered, though there may be provider network restrictions. When reviewing Texas Medicare plans, be sure to find out if your doctors are part of the plan network.

H5322 025 02 - hmopos

What is a dual special needs plan? If you can answer "yes" to the three questions below, there's a good chance you may qualify for this dual health plan. Search for doctors, hospitals, and specialists. Search for providers, clinics and treatment centers. Find medications covered by this plan. Get support from your Navigator, who is your go-to person to help you get the most out of your plan.

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This is done to find any drug-drug interactions or other medication concerns. Members must have Medicaid to enroll. TTY users should call between 7 a. Question Mark Icon. Select a County. Members do not need a referral for specialty care. Those reviews will be sent to your doctor. These documents can help you make sure you get the right coverage. The best time to get a flu shot is before flu season starts. View Drug List. We're dedicated to improving your health and well-being. AND You're a U. This plan is available in the following counties:.

We're dedicated to improving your health and well-being. Members have access to specialized behavioral health services, which includes mental health and may include substance use treatment.

English Opens in a new tab PDF 2. You may also be eligible for a one-time, temporary 1-month supply if you qualify for an emergency fill while residing in a long-term care LTC facility after the first 90 days as a new member or you have encountered a level of care change. Expand All. You must get your 1-month supply, as described in EOC, during the first 90 days of membership with the plan as a new member OR within the first 90 days of the calendar year if you are a continuing member and your drug has encountered a negative formulary change. How to Qualify This program is available at no additional cost. Starting October 15, , you may request a coverage review. It takes about 30 minutes. Point of Service HMO-POS plans include all the features of HMO plans plus the ability to go outside the contracted network for certain health care services - typically at a higher cost. Note that you can download a list of covered drugs below. Appeal a Coverage Decision If we make a coverage decision and you are not satisfied with this decision, you can "appeal" the decision. Health Icon.