A non-government entity
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 2025, 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 2.5 out of 5 stars in 2025.
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 $57.90. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $3.80. You must continue to pay paying your reduced 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 $590.00 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 $9350.00 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:
Sign up for Hamaspik Medicare Select (HMO D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Hamaspik Medicare Select (HMO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible, you will pay the costs for your drugs based on the drug tier and pharmacy you use. Once your total drug costs reach $2,000, you enter the next coverage phase. If you qualify for the low-income subsidy (LIS), your monthly premium for Part D drugs is $57.90. After your yearly out-of-pocket drug costs reach $2,000, you pay nothing for your covered Part D drugs, though you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The Hamaspik Medicare Select (HMO D-SNP) plan offers a wide array of benefits. This plan covers inpatient and outpatient services, including emergency, primary care, and preventive services, with a 20% coinsurance for many services. The plan also includes coverage for hearing, vision, and dental services, as well as home health services with no copay. Additional benefits include ambulance services with no copay, home infusion services, and medical equipment, all with varying coinsurance amounts. The plan also covers dialysis and other services like acupuncture and over-the-counter items. However, certain services such as cardiac rehabilitation, private duty nursing, and additional hours of care are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered, but additional days and non-Medicare covered stays are not covered. You will pay the Medicare-defined cost share for tier 1 services, but more information about the coinsurance is available in the plan details.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient hospital and observation services have a 20% coinsurance, while outpatient blood services also have a 20% coinsurance. Individual and group sessions for outpatient substance abuse also have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization, and has a 20% coinsurance.
Ambulance and Transportation Services See details
The Hamaspik Medicare Select (HMO D-SNP) plan covers ambulance services with no copay and a 20% coinsurance for both ground and air ambulance services. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Hamaspik Medicare Select (HMO D-SNP) plan. Emergency and Urgently Needed Services have a 20% coinsurance, while Worldwide Emergency Services has a maximum benefit coverage of $50,000.
Primary Care See details
The Hamaspik Medicare Select (HMO D-SNP) plan covers Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services with a 20% coinsurance; however, Routine Chiropractic Care and Podiatry Services are not covered.
Preventive Services See details
Preventive services are covered, including Medicare-covered zero-dollar preventive services, however, the annual physical exam is not covered. Kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit are covered with 20% coinsurance.
Hearing Services See details
Hearing Services are covered, but Routine Hearing Exams, Fitting/Evaluation for Hearing Aid, Prescription Hearing Aids (all types), Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, Prescription Hearing Aids - Over the Ear and OTC Hearing Aids are not covered. Hearing Exams have a coinsurance of at most 20%, and there is no deductible.
Vision Services See details
Vision services include coverage for eye exams and eyewear. Eye exams have a 20% coinsurance, and you are eligible for one routine eye exam every two years. Eyewear also has a 20% coinsurance, and the plan covers up to $200 every two years for contact lenses, eyeglass lenses, frames, and upgrades.
Dental Services See details
Dental services are covered, including Medicare dental services with 20% coinsurance, oral exams limited to 2 per year, dental x-rays limited to 2 per year, other diagnostic dental services, prophylaxis (cleaning) limited to 2 per year, fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable), implant services, prosthodontics (fixed), and oral and maxillofacial surgery. Maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay, and the coinsurance ranges from 0% to 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are also covered, with coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by the Hamaspik Medicare Select (HMO D-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered by this plan. DME has a 20% coinsurance with prior authorization required, while Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies and Therapeutic Shoes/Inserts have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
The Hamaspik Medicare Select (HMO D-SNP) plan covers diagnostic and radiological services, but lab services are not covered. For diagnostic procedures and tests, and for diagnostic, therapeutic, and outpatient x-ray services, there is a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Hamaspik Medicare Select (HMO D-SNP) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Hamaspik Medicare Select (HMO D-SNP) plan. Prior authorization is required for this benefit, but the plan does not cover any of the sub-services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but the plan does not cover additional days beyond Medicare-covered, nor does it cover non-Medicare-covered stays. Prior authorization is required, and you will pay the Medicare-defined cost share for tier 1.
Other Services See details
Other Services includes acupuncture, which is limited to 20 treatments per year, and over-the-counter (OTC) items with a maximum benefit of $190.00 per month. Meal Benefit, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved