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Hamaspik Medicare Select (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Hamaspik Medicare Select (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Hamaspik Medicare Select (HMO D-SNP) in 2026, please refer to our full plan details page.
Hamaspik Medicare Select (HMO D-SNP) is a HMO D-SNP plan offered by Hamaspik of Rockland County, Inc. available for enrollment in 2025 to people living in New York City Metro, Hudson Valley, Albany Metro. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Hamaspik Medicare Select (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Hamaspik Medicare Select (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Hamaspik Medicare Select (HMO D-SNP).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Hamaspik Medicare Select (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $34.50. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Hamaspik Medicare Select (HMO D-SNP) prescription drug plan features an annual drug deductible of $615. This means you will pay the first $615 for your prescription medications out-of-pocket before your plan coverage begins to pay. Specific drug coverage tier details, including individual copays and coinsurance rates, are currently not available for this plan. To determine how your specific medications are covered under the Hamaspik Medicare Select (HMO D-SNP), it is recommended to review the plan's formulary.
Additional Benefits
The Hamaspik Medicare Select (HMO D-SNP) plan offers comprehensive medical coverage, featuring no copays and no coinsurance for inpatient hospital stays, home health services, and skilled nursing facility care. For outpatient services, primary care, specialist visits, and emergency care, members will pay no copay but are responsible for a 20% coinsurance. Diagnostic hearing exams and most preventive and comprehensive dental treatments are also covered with no copays or coinsurance. Vision benefits include a $200 eyewear allowance every two years with no copay, though a 20% coinsurance applies to routine eye exams and contact lenses. Additionally, the plan provides valuable extra benefits like an over-the-counter allowance of up to $190 monthly and acupuncture coverage with no copay or coinsurance. However, some services such as routine hearing aids and health-related transportation are not covered under this plan.
Inpatient Hospital See details
Hamaspik Medicare Select (HMO D-SNP) inpatient hospital benefits are partially covered, offering acute and psychiatric hospital stays with no copay and no coinsurance. Prior authorization is required, and this plan does not cover additional hospital days, upgrades, or non-Medicare-covered stays.
Outpatient Services See details
Hamaspik Medicare Select (HMO D-SNP) covers outpatient services with no copays, but a 20% coinsurance applies to outpatient hospital, observation, ambulatory surgical center, substance abuse, and blood services. Prior authorization is required for outpatient hospital, observation, and ambulatory surgical center services.
Partial Hospitalization See details
Hamaspik Medicare Select (HMO D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Hamaspik Medicare Select (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, though prior authorization is required. For transportation services, some services are covered, but trips to plan-approved health-related locations and any other health-related locations are not covered.
Emergency Services See details
Emergency services and urgently needed services are covered by Hamaspik Medicare Select (HMO D-SNP) with a 20% coinsurance and no copay, which is waived if you are admitted to the hospital within 48 hours. Worldwide emergency, urgent, and transportation services are also covered with no copay and no coinsurance up to a $50,000 maximum benefit limit.
Primary Care See details
Hamaspik Medicare Select (HMO D-SNP) covers primary care, specialist, therapy, mental health, psychiatric, telehealth, and opioid treatment services with no copay and 20% coinsurance. Podiatry services are not covered, and while some chiropractic services are covered, routine and other chiropractic care are not covered.
Preventive Services See details
Hamaspik Medicare Select (HMO D-SNP) partially covers preventive services, offering Medicare-covered zero-dollar services, fitness benefits, and remote access technologies with no copay and no coinsurance. Kidney disease education, glaucoma screenings, diabetes self-management, digital rectal exams, and post-welcome-visit EKGs feature no copay but require a 20% coinsurance. Not covered services include annual physical exams, health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation counseling, disease management, telemonitoring, home/bathroom safety devices, and counseling.
Hearing Services See details
Hamaspik Medicare Select (HMO D-SNP) covers diagnostic hearing exams with no copay, no coinsurance, and no deductible. However, routine hearing exams, fitting and evaluation services, and both prescription and OTC hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Hamaspik Medicare Select (HMO D-SNP), with other eye exam services not covered. Covered exams and eyewear have no deductible and no copay, though a 20% coinsurance applies to routine eye exams and contact lenses, with up to $200 in eyewear coverage every two years.
Dental Services See details
Hamaspik Medicare Select (HMO D-SNP) offers partially covered dental services with no copay and no coinsurance for most preventive and comprehensive treatments, while Medicare-covered dental services require no copay and a 20% coinsurance. Maxillofacial prosthetics and orthodontics are not covered, and prior authorization is required for select services.
Home Infusion bundled Services See details
Hamaspik Medicare Select (HMO D-SNP) covers home infusion bundled services with no copay, though associated Medicare Part B chemotherapy, radiation, and other drugs carry a coinsurance ranging from no coinsurance to 20%. Medicare Part B insulin is covered with a $35 copay and a coinsurance ranging from no coinsurance to 20%, and step therapy may be required.
Dialysis Services See details
Dialysis services are covered under the Hamaspik Medicare Select (HMO D-SNP) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Hamaspik Medicare Select (HMO D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment with no copay and 20% coinsurance. Prior authorization is required for these benefits, which do not have any manufacturer or vendor restrictions.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered under Hamaspik Medicare Select (HMO D-SNP) and require prior authorization. Covered services, including diagnostic procedures, radiological services, and outpatient X-rays, require a 20% coinsurance and no copay, though lab services are not covered.
Home Health Services See details
Home Health Services are covered under the Hamaspik Medicare Select (HMO D-SNP) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered under Hamaspik Medicare Select (HMO D-SNP) with no copay, but prior authorization is required. While some services are covered, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Hamaspik Medicare Select (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, although prior authorization is required. This benefit does not require a three-day inpatient hospital stay prior to admission, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Hamaspik Medicare Select (HMO D-SNP) partially covers other services, offering acupuncture limited to 20 treatments per year and over-the-counter (OTC) items up to $190 monthly with no copay and no coinsurance. Meal benefits and nicotine replacement therapy are not covered under this benefit.
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