Value (HMO) Plan 2020

Generations Advantage Value (HMO) offers comprehensive medical and hospital benefits, and rich supplemental benefits. The Value Plan does not offer Part D Prescription Drug coverage. This is an excellent choice if you already have prescription drug coverage through the VA or an employer plan. It is available in all counties in Maine and New Hampshire. With this plan you must use in-network providers for all plan services, except for urgent and emergency care. 


Your Area

Value Benefits

Costs

  • Please enter your Zip Code above to see your plan premium.
    • Save $55 monthly with Part B premium reduction (members must continue to pay the remaining portion of their Medicare Part B premium)
    • No deductibles
    • $0 annual routine physical
    • $0 annual routine vision exam
    • $0 copays for primary care office visits
    • $0 copays for a range of preventive services
    • $5 copays for specialist visits
    • $0 copay for outpatient rehabilitation services (physical therapy, occupational therapy, speech pathology)
    • $20 copay for routine chiropractic services
    • $0 copay for personal emergency response system

    Maximum Out-of-Pocket

    • Get peace of mind with a predictable limit on costs, even in the case of a serious health problem.
    • $5,000 for in-network services (all services must be in-network)
    • Your plan premium does not count toward this maximum.

Features

  • Please note: You cannot have a Medicare Part D Prescription Drug plan if you enroll in the Value plan.
  • Emergency care coverage worldwide
  • Urgent care coverage nationwide
  • Large network of doctors across Maine and New Hampshire (see if your doctor is in-network)
  • Over-the-counter (OTC): Up to $180 quarterly for members to purchase select CVS-brand, over-the-counter products
  • Wellness Wallet: Up to $350 reimbursed each year in total for eyewear, fitness, naturopathic services, acupuncture, nutritional/dietary education, and weight management program
  • Eyewear: $400 for prescription lenses, frames, and contact lenses
  • Hearing Aids: $0/$95/$295 copay per ear, depending on tier selected (no copays for fittings or evaluations)
  • Flu shots: Get your annual flu shot at no cost, either at your primary care provider’s office (who may charge an office visit copay) or get your pharmacy flu shot reimbursed.3

Comprehensive Dental Benefits

  • No waiting periods for coverage
  • $5 office visit copay
  • $2,000 benefit maximum
  • See a Delta Dental PPO/Martin’s Point Generations Advantage network dentist in Maine, New Hampshire, or Vermont.
  • Diagnostic and preventive services are fully covered with no coinsurance or deductible (includes cleaning, exams, and X-rays).
  • Basic restorative services are covered with 20% coinsurance and no deductible (includes fillings, oral surgery, root canals, and periodontal maintenance).
  • Major restorative services are covered with 50% coinsurance and no deductible (includes dentures, bridges, crowns, onlays, and implants).
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Enroll Now
Have questions? We’re here to help.

Talk to a health plan specialist 8 am–8 pm, Monday - Friday.

Enroll:
1-800-603-0652 
(TTY: 711)

Current Members:
1-866-544-7504

Plan Benefit Details and Documents
Additional Resources

Ready to enroll? Let’s get started

Find out how to enroll in your plan choice and what documentation you’ll need to complete your online enrollment.
1Influenza (flu) vaccines are covered under your Medicare Part B benefit through Generations Advantage Value plan.

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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).


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