KelseyCare Advantage Essential (H0332-001), 2016 Health Maintenance Organization Medicare Advantage Plan, Harris County, TX by KelseyCare Advantage.
KelseyCare Advantage Essential is a Health Maintenance Organization (HMO) health insurance plan for seniors and other people with Medicare living in Harris County, Texas. It includes all of the benefits of Original Medicare and may include prescription drug coverage and other extras. The primary benefit of an HMO is that the out-of-pocket costs are lower and more predictable than with other types of plans. The monthly premium is $0.00.
Please note: You must use plan providers to avoid incurring additional costs. You will be responsible for the costs of out of network care. Referrals may be required for all but primary care physician visits.
Maximum Out-of-Pocket (MOOP) Expense
By law, private Medicare health insurance has an annual maximum out-of-pocket (MOOP) limit that helps protect you from financial disaster. The MOOP limit in 2018 is $6,700, but plans are allowed to have a MOOP as low as $3,400.
The most you will pay out-of-pocket, if you enroll in the KelseyCare Advantage Essential Medicare Advantage plan, is $3,400. This figure does not include your monthly premiums or your Medicare Part D coverage for prescriptions. This is what you pay out-of-pocket on co-payments and co-insurance.Be sure to compare the co-payments and co-insurance with traditional Medicare, but be aware that there are no out-of-pocket limits with Medicare Parts A and B. With Original Medicare you must buy supplemental insurance to cover the gaps or pay out-of-pocket.
CMS 5-Star Rating
To help shoppers compare private health insurance options, Medicare rates the quality of all Medicare Advantage plans. The Centers for Medicare and Medicare Services rates each plan using a one to five-star scale, with one star representing the lowest quality and five stars the highest.
The KelseyCare Advantage Essential Medicare Advantage plan has received a Excellent (as of 15 October, 2015).out of 5 star average rating. Overall, CMS considers this plan to be
Compare Medicare Advantage Plans
Compare KelseyCare Advantage Essential with these top rated Medicare Advantage Plans available in Harris County:
- KelseyCare Advantage Rx
- KelseyCare Advantage Essential+Choice
- KelseyCare Advantage Rx+Choice
- AARP MedicareComplete Plan 1
- Erickson Advantage Signature with Drugs
KelseyCare Advantage Essential Availability
KelseyCare Advantage Essential is available in Spring, Waller, Alief, South Houston, Seabrook, Galena Park, Katy, Houston, La Porte, Barker, Bellaire, Kingwood, Humble, Hufsmith, Deer Park, Pasadena, Channelview, Highlands, Tomball, Huffman, Webster, Hockley, Baytown, Crosby, North Houston, Cypress, and all other locations in Harris County.
For more information, see Medicare Advantage Plans in Harris County, TX.