KelseyCare Advantage Essential+Choice (H0332-003), 2016 Health Maintenance Organization Medicare Advantage Plan, Harris County, TX by KelseyCare Advantage.
KelseyCare Advantage Essential+Choice 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
The new healthcare law allows for a maximum limit of $6,700 on your out of pocket medical costs for 2018 Medicare Advantage plans. This amount is commonly called the plan MOOP (Maximum Out of Pocket). A plan's MOOP does not include your prescriptions or the monthly premiums you pay for your health plan.
Although the mandatory MOOP limit is $6,700, the Affordable Care Act law allows for a “Voluntary MOOP” that can be as low as $3,400. The MOOP on this plan is $3,400. You need to take this figure into as much consideration as the premiums and the co-payments.
If you are comparing this Medicare Advantage plan with your Original Medicare benefits, take into consideration that the government does not have out-of-pocket limits on Medicare Parts A and B. With traditional Medicare the only way to protect yourself is to purchase a Medigap insurance policy to supplement your coverage.
CMS 5-Star Rating
The Centers for Medicare and Medicaid Services (CMS) rates the relative quality of all private health insurance offered through the Medicare Advantage program. The ratings are designed to assist people considering enrolling. CMS rates plans on a one to five-star scale, with five stars representing the best quality.
The KelseyCare Advantage Essential+Choice 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+Choice with these top rated Medicare Advantage Plans available in Harris County:
- KelseyCare Advantage Essential
- KelseyCare Advantage Rx
- KelseyCare Advantage Rx+Choice
- AARP MedicareComplete Plan 1
- Erickson Advantage Signature with Drugs
KelseyCare Advantage Essential+Choice Availability
KelseyCare Advantage Essential+Choice is available in Katy, Baytown, Humble, Crosby, Channelview, South Houston, Cypress, Pasadena, Spring, Webster, Barker, North Houston, Deer Park, Hockley, Seabrook, La Porte, Hufsmith, Waller, Alief, Bellaire, Huffman, Highlands, Galena Park, Kingwood, Tomball, Houston, and all other locations in Harris County.
For more information, see Medicare Advantage Plans in Harris County, TX.