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Health First Secure H1099-009 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Health First Secure H1099-009 (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Health First Secure H1099-009 (HMO) in 2026, please refer to our full plan details page.
Health First Secure H1099-009 (HMO) is a HMO plan offered by Health First Shared Services, Inc. available for enrollment in 2025 to people living in Brevard, Indian River. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Health First Secure H1099-009 (HMO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Health First Secure H1099-009 (HMO).
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 Health First Secure H1099-009 (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3000.00 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
Prescription drugs are not covered by Health First Secure H1099-009 (HMO).
Additional Benefits
The Health First Secure H1099-009 (HMO) plan offers robust medical coverage featuring no copays or coinsurance for primary care visits, preventive services, and home health care. For specialist visits, patients will pay a $20 copay, while emergency room visits carry a $150 copay that is waived if admitted to the hospital. Outpatient hospital services range from no copay to a $150 copay, whereas acute inpatient hospital stays require a $150 daily copay for the first seven days followed by no copay for subsequent days. This plan also includes valuable supplemental benefits, such as dental care with no copays or coinsurance up to a $1,000 annual limit, and vision coverage offering no copays for routine exams and up to $400 yearly for eyewear. Additionally, members benefit from hearing aid coverage up to $1,000 every two years and a $50 quarterly over-the-counter item reimbursement. While medical equipment and dialysis services require a 20% coinsurance, diagnostic laboratory tests and outpatient X-rays are available with no copay or coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Health First Secure H1099-009 (HMO) with no coinsurance, though prior authorization is required. Acute inpatient stays require a $150 daily copay for days 1 through 7 and no copay for days 8 through 90, while psychiatric stays require a $175 daily copay for days 1 through 10 and no copay for days 11 through 90; additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Health First Secure H1099-009 (HMO) covers outpatient services with no coinsurance, featuring a $0 to $150 copay for outpatient hospital services and a $150 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $20 copay with no coinsurance.
Partial Hospitalization See details
Health First Secure H1099-009 (HMO) covers partial hospitalization services with a $15.00 copay and no coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
Health First Secure H1099-009 (HMO) covers ground and air ambulance services with a $230 copay and no coinsurance, requiring prior authorization. Transportation services are partially covered, offering up to 32 one-way trips per year to any health-related location via bus or subway with no copay and no coinsurance, though plan-approved health-related location transportation is not covered.
Emergency Services See details
Health First Secure H1099-009 (HMO) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services carry a $25 copay with no coinsurance, and worldwide emergency services are covered up to a $50,000 maximum limit with no coinsurance and copays ranging from $150 to $230.
Primary Care See details
Health First Secure H1099-009 (HMO) covers primary care and opioid treatment with no copay and no coinsurance, while specialist, mental health, and psychiatric services require a $20 copay and no coinsurance. Therapy services require a $15 copay and no coinsurance, telehealth ranges from no copay to a $25 copay with no coinsurance, podiatry is not covered, and though some chiropractic services are covered, routine and other chiropractic services are not.
Preventive Services See details
Health First Secure H1099-009 (HMO) covers preventive services, including annual physicals and kidney disease education, with no copay and no coinsurance. Additional preventive benefits are partially covered, excluding services like health education, personal emergency response systems, weight management programs, and therapeutic massage.
Hearing Services See details
Health First Secure H1099-009 (HMO) partially covers hearing services, offering Medicare-covered exams for a $15 copay and no coinsurance, and annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered up to $1,000 every two years with no copay and no coinsurance, but OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Health First Secure H1099-009 (HMO) vision services are partially covered, as other eye exam services and eyewear upgrades are not covered. Covered benefits include one annual routine eye exam and eyewear up to a $400 yearly limit with no copay and no coinsurance, while other covered eye exams require a $15 copay and no coinsurance.
Dental Services See details
Health First Secure H1099-009 (HMO) covers preventive and comprehensive dental services with no copay and no coinsurance, up to a maximum plan benefit of $1,000 per year. Covered services include oral exams, cleanings, X-rays, restorative treatments, endodontics, periodontics, prosthodontics, oral surgery, and orthodontics, all with no copays or coinsurance.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Health First Secure H1099-009 (HMO) with no copay, although prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs require no coinsurance to 20% coinsurance, while Part B insulin drugs have a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Health First Secure H1099-009 (HMO) with no copay and a 20% coinsurance.
Medical Equipment See details
Health First Secure H1099-009 (HMO) covers medical equipment with no copays, though prior authorization is required. Durable medical equipment, prosthetics, and medical supplies are subject to a 20% coinsurance, while diabetic supplies range from no coinsurance to 20% coinsurance, and diabetic therapeutic shoes or inserts have no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Health First Secure H1099-009 (HMO) with prior authorization required. There is no copay and no coinsurance for diagnostic tests, lab services, and outpatient X-rays, while diagnostic radiological services require a minimum $125 copay with no coinsurance, and therapeutic radiological services require a minimum 20% coinsurance with no copay.
Home Health Services See details
Health First Secure H1099-009 (HMO) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Health First Secure H1099-009 (HMO) does not cover Cardiac Rehabilitation Services in practice, as all individual sub-services, including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation, are not covered.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) care is covered by Health First Secure H1099-009 (HMO) with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and a $100 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Health First Secure H1099-009 (HMO) partially covers Other Services, which includes Over-the-Counter (OTC) items with no copay and no coinsurance up to a maximum benefit of $50 every three months via reimbursement. Acupuncture, meal benefits, and other additional services are not covered under this plan benefit.
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