The UMHA Dual plan (HMO-SNP) is a Medicare Advantage Prescription Drug Plan for those with both Medicare and Medicaid (Maryland Medical Assistance Program) as a Qualified Medicare Beneficiary (QMB) or a Full Benefit Dual Eligible (FBDE). This plan combines your Medical, Hospital and Prescription Drug coverage with extra services and personalized programs focused on improving your health.
To be eligible for the University of Maryland Health Advantage Dual (HMO-SNP) plan, you must also have Medicare Parts A & B and reside in the following Maryland counties: Anne Arundel, Baltimore, Baltimore City, Caroline, Carroll, Cecil, Charles, Dorchester, Howard, Harford, Kent, Montgomery, Prince Georges, Queen Anne’s, and Talbot.
How Much You Pay for Covered Services
Monthly Plan Premium
$0 - $27.80
Maximum Out-of-Pocket
$6,700
Part B Benefits Deductible
$0
Primary Care Physician Visit
$0 or 20% coinsurance**
Specialist Visit
Inpatient Hospital Care
Days 1-60: $0 per day Days 61-90: $0 per day Days 91-150: $0 per Lifetime Reserve Day
Emergency Care
Durable Medical Equipment
Part D Deductible
Prescription Drug Coverage (30-day supply)
Preventive Services
$0 copayment
Routine Podiatry
Transportation
$0 copayment for 36 one-way trips per year
Preventive Dental
Coverage limit is $1,500 every year. Member is responsible for all costs over $1,500 annual maximum. $0 copay for the following:
Over-The-Counter
$110 monthly allowance through UMHA OTC Catalog
Meals
$0 copay for up to 18 meals post-discharge from inpatient stay
**If Medicaid status changes from Full Benefit Dual Eligible (FBDE) or Qualified Medicare Beneficiary (QMB), your copays and coinsurances will increase to 20% of the total cost of the service and 25% of the total cost of the Part D drug.
UMHA Dual (HMO-SNP) covers all Medicare benefits plus: