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Sonder My Choice Medicare Advantage (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Sonder My Choice Medicare Advantage (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Sonder My Choice Medicare Advantage (HMO) in 2025, please refer to our full plan details page.
Sonder My Choice Medicare Advantage (HMO) is a HMO plan offered by Avian Health Holdings, LLC available for enrollment in 2025 to people living in Central Georgia Areas. This plan received an overall rating of 2 out of 5 stars in 2025.
It's important to know that Sonder My Choice Medicare Advantage (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Sonder My Choice Medicare Advantage (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 Sonder My Choice Medicare Advantage (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. Additionally, this plan comes with a Part B Premium reduction of $0.10. 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6700.00 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 Sonder My Choice Medicare Advantage (HMO) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you'll pay a copay for your prescriptions, with costs varying depending on the drug tier and pharmacy. For example, you'll pay a $10 copay for preferred generic drugs at a standard pharmacy. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for covered Part D drugs. Please note that this plan's premium may be reduced if you qualify for the low-income subsidy.
Additional Benefits
The Sonder My Choice Medicare Advantage (HMO) plan offers coverage for a wide range of services. This plan includes inpatient and outpatient hospital care, with varying copays for different services. It also covers ambulance services, emergency care, primary care visits, preventive services, and specific therapies like physical and occupational therapy. Additional benefits include coverage for hearing and vision services, dental care with coinsurance, and home health services with no copay. The plan also provides access to medical equipment, diagnostic services, and skilled nursing facility care. Other covered services include acupuncture, over-the-counter items, and a meal benefit for chronic illnesses.
Inpatient Hospital See details
Inpatient Hospital benefits, including services not usually covered by Medicare, are covered, with a copay of $350 for days 1-6, and no copay for days 7-90. Additional days for Inpatient Hospital-Acute are covered, but Non-Medicare-covered stay and Upgrades are not covered. Inpatient Hospital Psychiatric benefits are covered, with a copay of $350 for days 1-6, and no copay for days 7-90, but additional days and Non-Medicare-covered stays are not covered.
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 services have a $300 copay, observation services have a $350 copay, ambulatory surgical center services have a $150 copay, individual outpatient substance abuse sessions have a $25 copay, and group outpatient substance abuse sessions have a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Sonder My Choice Medicare Advantage (HMO) plan, but requires prior authorization. You will have a $60 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered. Ground ambulance services have a $325 copay, and air ambulance services have a $750 copay; there is no coinsurance for either. Transportation Services to any health-related location are covered for 12 one-way trips per year via bus/subway, medical transport, or other means. Transportation services to a plan-approved health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Sonder My Choice Medicare Advantage (HMO) plan. Emergency Services have a $125 copay, and Urgently Needed Services have a $30 copay; both have no coinsurance. Worldwide Emergency Transportation is not covered.
Primary Care See details
The Sonder My Choice Medicare Advantage (HMO) plan covers Primary Care Physician Services, Chiropractic Services with a $20 copay, Occupational Therapy Services with a $45 copay, Physician Specialist Services, Mental Health Specialty Services with a $40 copay for individual and group sessions, Other Health Care Professional services with a copay between $0 and $40, Psychiatric Services with a $40 copay for individual and group sessions, Physical Therapy and Speech-Language Pathology Services with a $45 copay, Additional Telehealth Benefits, and Opioid Treatment Program Services. Podiatry Services are not covered.
Preventive Services See details
The Sonder My Choice Medicare Advantage (HMO) plan covers preventive services, including Medicare-covered services with no copay, and additional services like In-Home Safety Assessment, Alternative Therapies (6 visits), Fitness Benefit, Remote Access Technologies, and In-Home Support Services. Barium Enemas have a $60 copay, and the plan does not cover services such as the Annual Physical Exam, Health Education, Personal Emergency Response System, and others.
Hearing Services See details
Hearing services include routine hearing exams for a $40 copay, and prescription hearing aids, but fitting and evaluation for hearing aids, OTC hearing aids, inner ear hearing aids, outer ear hearing aids, and over the ear hearing aids are not covered. The plan maximum benefit coverage for hearing exams is $3,000 every year.
Vision Services See details
Vision services include routine eye exams, eyewear, and contact lenses. Eyewear has a $40 copay for contact lenses, and eyeglasses (lenses and frames) are covered. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The Sonder My Choice Medicare Advantage (HMO) plan covers dental services with a 20% coinsurance. Other dental services have a maximum plan benefit coverage of $4,000 every year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered under the Sonder My Choice Medicare Advantage (HMO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits are covered under the Sonder My Choice Medicare Advantage (HMO) plan. Durable Medical Equipment (DME) has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies and Diabetic Equipment are covered, with a 20% coinsurance for Medicare-covered prosthetic devices, medical supplies, Medicare-covered diabetic supplies, and therapeutic shoes or inserts.
Diagnostic and Radiological Services See details
Under the Sonder My Choice Medicare Advantage (HMO) plan, Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests have a copay between $0 and $100, while Lab Services have no copay, and Diagnostic Radiological Services have a copay of at most $300.
Home Health Services See details
Home Health Services are covered with no copay and no coinsurance, but a referral is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Sonder My Choice Medicare Advantage (HMO), but the specific services are not covered. Prior authorization is required for this benefit, but no cost-sharing information is provided.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Sonder My Choice Medicare Advantage (HMO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $203. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Sonder My Choice Medicare Advantage (HMO) plan covers acupuncture with a limit of 12 treatments per year. It also offers over-the-counter (OTC) items with a maximum benefit of $200 every three months, and a meal benefit for chronic illnesses. However, several other services are not covered.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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