Check out our plan benefits below to determine if a CoxHealth MedicarePlus (HMO) plan is right for YOU.

 

Hospital and Medical Coverage

For more details and a complete list of all benefits, please review our Summary of Benefits.

CoxHealth MedicarePlus (HMO)
Monthly Premium
Monthly Premium $0
Maximum Out-of-Pocket Limit
Maximum Out-of-Pocket Limit $3,200 Per Year
Annual Deductible
Annual Deductible $0 Per Year
Preventive Care/Screenings
Preventive Care/Screenings $0 Copay
Primary Care Physician Visits
Primary Care Physician Visits $0 Copay
Specialist Doctor Visits
Specialist Doctor Visits $35 Copay
Urgent Care
Urgent Care $45 Copay
Emergency Care
Emergency Care $120 Copay
Lab Services
Lab Services $5 Copay
Home Health Care
Home Health Care 100% Coverage
Chiropractic Care
Chiropractic Care $20 Copay
Inpatient Hospital Care
Inpatient Hospital Care $295 Copay Per Day, Per Stay for Days 1-6
$0 Per Day, Per Stay for Days 7 and Beyond
Outpatient Surgery at Hospital
Outpatient Surgery at Hospital $220 Copay
Outpatient Surgery at Ambulatory Surgery Center
Outpatient Surgery at Ambulatory Surgery Center $220 Copay

Part D Drug Coverage

Each Essence plan also includes generous prescription drug coverage. While we offer low copays
at all participating pharmacies, you also have the option of saving even more if you get your
prescriptions filled at a preferred pharmacy.

CoxHealth MedicarePlus (HMO)

Preferred Pharmacies
Other Network Pharmacies
Annual Deductible
Annual Deductible $0
Annual Deductible $0
Tier 1 – Preferred Generic
Tier 1 – Preferred Generic $0 Copay*
Tier 1 – Preferred Generic $5 Copay*
Tier 2 – Generics
Tier 2 – Generics $5 Copay*
Tier 2 – Generics $10 Copay*
Tier 3 – Preferred Brands
Tier 3 – Preferred Brands $42 Copay*
Tier 3 – Preferred Brands $47 Copay*
Tier 4 – Non-Preferred Brands
Tier 4 – Non-Preferred Brands $95 Copay*
Tier 4 – Non-Preferred Brands $100 Copay*
Tier 5 – Specialty Drugs
Tier 5 – Specialty Drugs 33% Co-insurance*
Tier 5 – Specialty Drugs 33% Co-insurance*
Tier 6 – Insulins
Tier 6 – Insulins $0 Copay*
Tier 6 – Insulins $0 Copay*
Initial Coverage Limits
Initial Coverage Limits $4,430 Per Year
Initial Coverage Limits $4,430 Per Year

*30-Day Supply

Ready to learn more about CoxHealth MedicarePlus (HMO)?

Get the nitty-gritty details about the all-in-one CoxHealth MedicarePlus (HMO) plan available to Southwest, MO residents

Request your FREE CoxHealth MedicarePlus (HMO) Information Kit.