Value Plus (HMO) Plan 2020

Generations Advantage Value Plus (HMO) offers comprehensive medical and hospital benefits and Part D Prescription Drug coverage. You can use in-network doctors and health service providers and pay low copayments for medical services. This plan may be a good option if you seek a low-cost plan with prescription drug coverage. It is available throughout Maine (except Cumberland County), and in Hillsborough and Strafford counties in New Hampshire. 
 

Your Area

Value Plus Benefits

Costs

  • Please enter your Zip Code above to see your plan premium.
    • No medical or hospital deductibles
    • $275 Part D prescription deductible for Tiers 3–5 drugs only
    • $0 annual routine physical and annual wellness visit
    • $0 annual routine vision
    • $0 post-discharge doctor visits
    • $0 copay for a range of preventive services
    • $10 copays for primary care office visits
    • $50 copays for specialist visits
    • $0 copays for many generics at Hannaford Pharmacies1

    Maximum Out-of-Pocket

    • Get peace of mind with a predictable limit on costs, even in the case of a serious health problem.
    • $6,700 for in-network services (all services must be in-network)
    • Your plan premium and prescription drug copayments don't count toward this maximum.

Features

  • Part D prescription drug coverage (see if your drugs are covered)
  • 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 $50 quarterly for members to purchase select CVS-brand, over-the-counter items
  • Wellness Wallet: Up to $300 reimbursed each year in total for eyewear, fitness, naturopathic services, acupuncture, nutritional/dietary education, and weight management programs
  • Hearing aids: $595/$695/$895 copay per ear, depending on tier selected (no copays for fittings or evaluations)
  • Flu shots: Get your annual flu shot2 at no cost, either at your primary care provider’s office (who may charge an office visit copay) or a participating pharmacy,3

 

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

Part D Prescription Drug Copayments

$275 Prescription deductible for Tiers 3–5 drugs only.

Tier 1 2 3 4 5
Pharmacies with preferred cost sharing (including Hannaford pharmacies), 30-day supply* $0 $10 $40 $95 28% of cost
Pharmacies with standard cost sharing, 30-day supply* $4 $18 $47 $100 28% of cost
Mail-order, 90-day supply $10 $45 $117.50 $250 28% of cost
*For 90-day supply cost, multiply by three. 

 

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.
1At pharmacies with preferred cost-sharing, you pay $0 for Cost-Sharing Tier 1 (preferred generic drugs and certain preferred brand name drugs). Other pharmacies are available in our network.

2Influenza (flu) vaccines are covered under your Medicare Part B benefit through Generations Advantage Value Plus and costs do not count toward your Part D drug spend or out-of-pocket costs

3The Vaccine Pharmacy Network is offered through our relationship with our pharmacy benefit manager, CVS Caremark. Pharmacy network may change on January 1 of each year. Other pharmacies are available in our network.

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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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