2026 Tribute (HMO)

Accepting enrollments

Plan Overview

$0 / month
Medical Deductible
This plan does not have any medical deductibles.
Pharmacy Deductible
Part D benefits are not offered with this plan.

Coverage Details

Maryland counties: Anne Arundel, Baltimore, Carroll, Frederick, Howard, Montgomery, Somerset, Washington, Wicomico and Worcestor.

Medical
Medical Deductible

This plan does not have any medical deductibles.

Primary Care Provider Visit

$0 copay

Specialist Visit

$50 copay

Referrals

Not required.
Applies to In-Network Medicare covered services only.

Telehealth

$0 copay

Urgent Care

$40 copay
The copay is not waived if you are admitted to the hospital.

Emergency Care

$115 copay
The copay is waived if you are admitted to the hospital within 24 hours for the same condition.

Worldwide Emergency & Urgently Needed Services

Not covered

Inpatient Hospital Stay

$350/day copay for days 1-5; $0 copay for days 6-90

Outpatient Surgery

$250 copay

Acupuncture

Medicare-covered Acupuncture: $0 – $50 copay, based on location of service

Non-Medicare covered Acupuncture: Not Covered

Chiropractic Services

Medicare-covered chiropractic care:
$10 copay

Non-Medicare covered chiropractic care:
Not covered

Podiatry Services

Medicare-covered podiatry care: $50 copay

Non-Medicare covered podiatry care: Not covered

Hearing Services

Learn more

$0 copay (hearing exam)
You pay a $399 copay per aid for Advanced hearing aids or $699 copay per aid for Premium hearing aids for up to two TruHearing-branded hearing aids every year (one per ear per year).

Silver&Fit® Program

Learn more

$0 copay for participating fitness centers.

Prescription
Pharmacy Deductible

Part D benefits are not offered with this plan.

Mail Order

Part D benefits are not offered with this plan.

Preferred Generic (Tier 1)

Part D benefits are not offered with this plan.

Generic (Tier 2)

Part D benefits are not offered with this plan.

Preferred Brand (Tier 3)

Part D benefits are not offered with this plan.

Non-Preferred Drug (Tier 4)

Part D benefits are not offered with this plan.

Specialty Tier (Tier 5)

Part D benefits are not offered with this plan.

Vision
Medicare-covered exam to diagnose and treat diseases and conditions of the eye

$50 copay

Yearly Glaucoma Screening

You pay nothing

Routine Eye Exam

(1 every year):
You pay nothing

Eyeglasses or Contact Lenses after Cataract Surgery

You pay nothing

Routine Eyewear

Our plan pays up to $300 every two years for supplemental eyewear from any in-network Superior Vision provider.

Dental
Medicare-covered Dental Services

$0 copay

Preventive Dental Services

(2 cleanings per year):
$0 copay

Oral exam(s) (Frequency determined by type of oral exam): $0 copay

Dental X-Ray(s) (Frequency determined by type of X-Ray): $0 copay

Fluoride Treatments

(2 fluoride treatments per year): $0 copay

Comprehensive Dental Services

(Frequency dependent on procedure.)
The plan has a maximum coverage amount of $2,000 per year for in-network non-Medicare-covered comprehensive dental services. Members are responsible for the difference between the allowed amount and the billed amount for any out-of-network services.

Optional Supplemental Benefits

Not available

Restorative services (such as inlays, onlays, crowns, resin restoration, etc.)

Frequency dependent on procedure.
In-network: $0 copay

Endodontics

Frequency dependent on procedure.
In-network: $0 copay

Periodontics

Frequency dependent on procedure.
In-network: $0 copay

Extractions

Frequency dependent on procedure.
In-network: $0 copay

Frequency dependent on procedure.
In-network: $0 copay

Documents

2027 Plans

Johns Hopkins Advantage MD (HMO) has an in-network out-of-pocket maximum of $8,950. Johns Hopkins Advantage MD Tribute (HMO) has an in-network out-of-pocket maximum of $7,200. Johns Hopkins Advantage MD (PPO) has an in-network out-of-pocket maximum of $7,950 and a combined in- and out-of-network maximum of $11,300. Johns Hopkins Advantage MD Plus (PPO) has an in-network out-of-pocket maximum of $7,550 and a combined in- and out-of-network maximum of $11,300. Johns Hopkins Advantage MD Access (PPO) has an in-network out-of-pocket maximum of $8,000 and a combined in- and out-of-network maximum of $11,300. Johns Hopkins Advantage MD BMORE Balanced (HMO-DSNP) and Johns Hopkins Advantage MD D-SNP (HMO) has an in-network out-of-pocket maximum of $9,850. Johns Hopkins Advantage MD Select (HMO) has an in-network out-of-pocket maximum of $9,250.

For out-of-network benefits, you pay a percentage for most covered services.

Limitations: 1. Members are responsible for the difference between the allowed amount and the billed amount. For more information, please review the Evidence of Coverage. 2. Johns Hopkins Advantage MD BMORE Balanced (HMO-DSNP) and Johns Hopkins Advantage MD Access (PPO) have a $1,000 allowance for comprehensive dental services added to your Flex Card. Johns Hopkins Advantage MD D-SNP (HMO) has $1,000 annual maximum for comprehensive dental services. Johns Hopkins Advantage MD Select (HMO) has $1,500 annual maximum for comprehensive dental services. Johns Hopkins Advantage MD Tribute (HMO) has $2,000 annual maximum for comprehensive dental services.

Prior authorizations may be required for some services, contact Member Services for more details.

2026 Plans

Johns Hopkins Advantage MD (HMO) has an in-network out-of-pocket maximum of $8,950. Johns Hopkins Advantage MD Tribute (HMO) has an in-network out-of-pocket maximum of $6,800. Johns Hopkins Advantage MD (PPO), Johns Hopkins Advantage MD Plus (PPO), Johns Hopkins Advantage MD Primary (PPO) have an in-network out-of-pocket maximum of $7,550 and a combined in- and out-of-network maximum of $11,300. Johns Hopkins Advantage MD D-SNP (HMO) has an in-network out-of-pocket maximum of $9,250. Johns Hopkins Advantage MD Select (HMO) has an in-network out-of-pocket maximum of $9,250

For out-of-network benefits, you pay a percentage for most covered services.

Limitations: 1. Members are responsible for the difference between the allowed amount and the billed amount. For more information, please review the Evidence of Coverage. 2. The comprehensive dental benefit for the Optional Supplement benefits for the Johns Hopkins Advantage MD (HMO), Johns Hopkins Advantage MD (PPO), Johns Hopkins Advantage MD Plus (PPO), and Johns Hopkins Advantage MD Primary (PPO) plan has a $1,000 Annual Maximum. The comprehensive dental benefit for the Johns Hopkins Advantage MD Tribute (HMO) and Johns Hopkins Advantage MD D-SNP (HMO) has a $2,000 Annual Maximum. The comprehensive dental benefit for the Johns Hopkins Advantage MD Select (HMO) has a $2,400 Annual Maximum.

Prior authorizations are required for the following: endodontics, general anesthesia when medically necessary and administered in connection with oral or dental surgery, oral surgery, periodontics, bridges, crowns, inlays, onlays, and dentures (full or partial).

Talk to a Medicare Specialist:

888-403-7682 (TTY: 711)†

8 a.m. to 8 p.m., Monday-Sunday

Questions? We’re a phone call away.

PPO: 877-293-5325 (TTY: 711)†
HMO: 877-293-4998 (TTY: 711)†

8 a.m. to 8 p.m., Monday-Friday

Scroll to Top