Which Plan Is Right for Me?
Compare our Advantage MD plans with Original Medicare using the chart below, or use our interactive tool.
Switch between Advantage MD Plans*, Supplemental Dental Plan and Original Medicare
| 2018 Advantage MD Plans | |||
|---|---|---|---|
| Plans & Monthly Plan Premium | |||
| Plans & Monthly Plan Premium | NEW! | | |
| MEDICAL BENEFITS (partial listing: in-network) | |||
| MEDICAL BENEFITS (partial listing: in-network) | |||
| Medical Deductible | |||
| Medical Deductible | $0 | $0 | $0 |
| Primary Care Provider Visit | |||
| Primary Care Provider Visit | $5 copay | $10 copay | $5 copay |
| Specialist Visit | |||
| Specialist Visit | $50 copay | $50 copay | $40 copay |
| Referrals | |||
| Referrals | May be required | Not required | Not required |
| Urgent Care | |||
| Urgent Care | $45 copay | $45 copay | $40 copay |
| Ambulatory Surgical Centers Outpatient Surgery | |||
| Ambulatory Surgical Centers Outpatient Surgery | $250 copay | $275 copay | $200 copay |
| Emergency Care | |||
| Emergency Care | $80 copay | $80 copay | $80 copay |
| Worldwide Emergency Care | |||
| Worldwide Emergency Care | Not covered | Not covered | $80 copayment for worldwide ER visits (up to $50,000 per year outside of U.S.) |
| Inpatient Hospital Stay | |||
| Inpatient Hospital Stay | $285/day copay for days 1-7; $0 copay for days 8 and beyond | $285/day copay for days 1-7; $0 copay for days 8 and beyond | $255/day copay for days 1-7; $0 copay for days 8 and beyond |
| Annual Routine Vision Exam | |||
| Annual Routine Vision Exam | $0 copay once per year; up to $150 allowance for eyewear every two years | $0 copay once per year | $0 copay once per year; up to $150 allowance for eyewear every two years |
| Routine Podiatry Services | |||
| Routine Podiatry Services | 20% coinsurance (up to 6 times per year) | 20% coinsurance (up to 6 times per year) | 20% coinsurance (up to 6 times per year) |
| Acupuncture | |||
| Acupuncture | Not covered | Not covered | $200 annual allowance |
| Preventive Dental Services | |||
| Preventive Dental Services | $55 copay single office visit (cleaning, oral exam, dental x-ray) | $15 copay (cleaning); $15 copay (oral exam); $25 copay (dental x-ray) | $10 copay (cleaning); $10 copay (oral exam); $20 copay (dental x-ray) |
| Supplemental Dental Learn More | |||
| Supplemental Dental Learn More | Optional | Optional | Optional |
| Routine Chiropractic Services | |||
| Routine Chiropractic Services | Not covered | Not covered | $20 copay (up to 12 times per year) |
| Hearing Aid Services Learn More | |||
| Hearing Aid Services Learn More | Two options available through TruHearing (up to two per year); copay from $699 per aid | Two options available through TruHearing (up to two per year); copay from $699 per aid | Two options available through TruHearing (up to two per year); copay from $699 per aid |
| Silver&Fit® Program Learn More | |||
| Silver&Fit® Program Learn More | N/A | N/A | Included |
| PRESCRIPTION DRUG BENEFITS (30-day supply; in-network pharmacy) | |||
| PRESCRIPTION DRUG BENEFITS (30-day supply; in-network pharmacy) | |||
| Deductible | |||
| Deductible | $0 | $0 | $0 |
| Preferred Generic | |||
| Preferred Generic | $0 copay | $7 copay | $4 copay |
| Generic | |||
| Generic | $10 copay | $15 copay | $12 copay |
| Preferred Brand | |||
| Preferred Brand | $47 copay | $45 copay | $42 copay |
| Non-Preferred Drug | |||
| Non-Preferred Drug | $100 copay | $95 copay | $92 copay |
| Specialty Tier | |||
| Specialty Tier | 33% of the cost | 33% of the cost | 33% of the cost |
| Mail Order Learn More | |||
| Mail Order Learn More | Available | Available | Available |
*Please note: this information does not apply to Advantage MD Group.
Johns Hopkins Advantage MD (PPO) has an in-network out-of-pocket maximum of $6,700 and a combined in- and out-of-network maximum of $10,000 for 2018. Johns Hopkins Advantage MD Plus (PPO) has an in-network out-of-pocket maximum of $5,900 and a combined in- and out-of-network maximum of $10,000 for 2018. Johns Hopkins Advantage MD (HMO) has an in-network out-of-pocket maximum of $6,700.
For out-of-network benefits, you pay a percentage for most covered services.
This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/coinsurances may change on January 1 of each year.
You must continue to pay your Part B premium.
A Doctor, Specialist or Hospitalhttps://medicareadvantage.healthtrioconnect.com/public-app/consumer/provdir/entry.page
A Dental Providerhttps://govservices.dentaquest.com/Router.jsp?component=Main&source=Logon&action=ProviderDirectory2&state=MD&locale=en
A Vision Providerhttps://www.superiorvision.com/Member/locate_provider
A PPO Prescription Drughttps://www.medicareplanrx.com/jccf/Johnshopkins_formulary_18.html- An HMO Prescription Drughttps://www.medicareplanrx.com/jccf/Johnshopkins_hmo_formulary_18.html
A Pharmacyhttps://www.medicareplanrx.com/jccf/johnshopkins_pharmacy_18.html
The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.
If you want a Provider Directory mailed to you, if you need help finding an in-network provider, or if you are looking for a medical equipment provider, please call us. For the PPO network, call 1-877-293-5325 (TTY: 711). For the HMO network, call 1-877-293-4998 (TTY: 711). We are available October 1 through February 14, Monday through Sunday, 8 a.m. to 8 p.m., and February 15 through September 30, Monday through Friday, 8 a.m. to 8 p.m.
The online Vision Directory is not an all-inclusive list of vision providers. You can also find vision providers by searching through the online directory link above. Search for a specialist/vendor and select the specialty you are interested in from the list under specialty.
Find doctors, hospitals, prescription drugs, and pharmacies within the Advantage MD network.
Explanation of Hearing Aid Coverage
Johns Hopkins Advantage MD covers up to two hearing aids per year when purchased through TruHearing. The 2018 Flyte hearing aid models feature smartphone compatibility, the latest digital signal processing technology, a variety of colors and styles, a high power option, and more.
Coverage includes
- 2 hearing aids per year when purchased through TruHearing
- 3 follow-up visits with an in-network provider for fitting and adjustment of hearing aids
- 45-day trial
- 3-year manufacturer warranty for repairs and one-time loss and damage replacement
- 48 batteries per aid
Copayments
- Flyte™ 770: $699 per aid
- Flyte™ 990: $999 per aid
- Initial hearing exam: $0
The Silver&Fit® Exercise and Healthy Aging Program
The Silver&Fit® program is designed for older adults and is provided at no additional cost for members who choose the Advantage MD Plus plan. With this program, you may choose one out of the following two enrollment options:
- Work out at a participating fitness facility. Enjoy all of the standard amenities* of the fitness facility including cardiovascular and strength training equipment.
- Work out at home. If you choose the Home Fitness program, you can order up to two home fitness kits per benefit year. Choose from a selection of 17 kits including: yoga, Chair Pilates, tai chi, cardio strength, and many others.
You also have access to the following Silver&Fit® program features:
- Healthy Aging education classes (online or have DVDs mailed to you)
- The Silver Slate® – Stay up-to-date on fitness, nutrition, and weight management with our newsletter
- The Silver&Fit Connected!™ Program – a fun and easy way to track exercise at a facility or through a wearable fitness device**
- Earn Rewards** for tracking your activity
*Services that require an additional cost are not included.
**Rewards subject to change; purchase of device or app is not included.
Learn more and see what fitness facilities participate by going to www.silverandfit.com.
The Silver&Fit® program is provided by American Specialty Health Fitness, Inc. (ASH Fitness), a subsidiary of American Specialty Health Incorporated (ASH). Silver&Fit®, Silver&Fit Connected!™ and The Silver Slate® are trademarks of ASH and used with permission herein. All programs and services are not available in all areas.
Please note: the information in this section does not apply to Advantage MD Group.
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