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Plans and Services 2018

Click here for 2017 Plans and Services


Miami-Dade County

Available to Medicare beneficiaries in Miami-Dade County

Medica HealthCare Plans MedicareMax (HMO) is a plan with benefits that include comprehensive medical benefits with low or no copays, unlimited routine transportation to plan approved locations, prescription drug coverage and $0 plan premium. The prescription drug benefit has a $0 deductible and copayments of $0 for drugs in Tier 1 (Preferred Generic), $0 for Tier 2 (Generic), $30 for Tier 3 (Preferred Brand), $65 for Tier 4 (Non-Preferred Drugs) and a 33% for Specialty Tier Drugs in Tier 5.

Medica HealthCare Plans MedicareMax (HMO)

 
Summary of Benefits
 
Benefits Highlights
 
Evidence of Coverage
 

Broward County

Available to Medicare beneficiaries in Broward County

Medica HealthCare Plans MedicareMax (HMO) is a plan with benefits that include comprehensive medical benefits with low or no copays, prescription drug coverage including coverage of .Tier 1 (Preferred Generic) and Tier 2 (Generic) drugs through the coverage gap and $0 plan premium. The prescription drug benefit has a $0 deductible and copayments of $0 for Preferred Generic drugs in Tier 1, $0 for Generic drugs in Tier 2, $47 for Preferred Brand drugs in Tier 3, $100 for Non-Preferred Drugs in Tier 4, and a 33% co-insurance for Specialty Tier Drugs in Tier 5.

Medica HealthCare Plans MedicareMax (HMO)

 
Summary of Benefits
 
Benefits Highlights
 
Evidence of Coverage
 
 
 

Miami-Dade and Broward Counties

Available to Medicare beneficiaries in Miami-Dade and Broward Counties

Medica HealthCare offers special Case Management and Wellness programs for members of Medica HealthCare Plans MedicareMax Plus (HMO SNP). If you would like to learn more information about these programs, please contact the Customer Service Department.

Medica HealthCare Plans MedicareMax Plus (HMO SNP) is a Medicare Special Needs Plan and is only available for Medicare beneficiaries with Medicaid. The benefits include comprehensive  medical and dental services, unlimited routine transportation to plan approved locations, and up to $82 a month for over the counter items and products. The cost-sharing for covered Part D prescription drugs is determined by the amount of extra help you receive with your prescription drug costs.

Medica HealthCare Plans MedicareMax Plus (HMO SNP)

You must have Medicare and Florida Medicaid to enroll in this plan

Summary of Benefits

Benefits Highlights

Evidence of Coverage

 

As a Medica HealthCare member, you can enjoy the Optum® Fitness Advantage program at no additional cost. Basic membership to participating locations. Access to exercise equipment, classes and social activities. Classes an equipment vary by location.  Access to all participating locations within your state. An at-home kit is available for members who live 15 miles or more from a participating location. Want to find a participating location near you? For more information please call Customer Service at the number on the back of your member ID card.