A non-government entity
Select Health Medicare + Kroger (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Select Health Medicare + Kroger (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Select Health Medicare + Kroger (HMO) in 2026, please refer to our full plan details page.
Select Health Medicare + Kroger (HMO) is a HMO plan offered by Intermountain Health Care, Inc. available for enrollment in 2025 to people living in Colorado Front Range and Western Slope. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Select Health Medicare + Kroger (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 Select Health Medicare + Kroger (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 Select Health Medicare + Kroger (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.
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 $6275.00 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 Select Health Medicare + Kroger (HMO) plan features a $0 drug deductible, meaning your prescription drug coverage begins immediately. For Tier 1 preferred generic drugs, you will pay no copay for one-month, two-month, or three-month supplies at preferred pharmacies, standard pharmacies, and standard mail order. Tier 2 generic drugs also feature no copay when filled through standard mail order, with copays starting at $5 for a one-month supply at preferred pharmacies. Tier 3 preferred brand drugs carry a $40 copay for a one-month supply at preferred pharmacies and standard mail order, while standard pharmacies charge a $47 copay. Tier 4 non-preferred drugs cost a $90 copay for a one-month supply at preferred pharmacies and standard mail order, or $100 at standard pharmacies. For Tier 5 specialty drugs, you will pay a 33% coinsurance for a one-month supply across preferred, standard, and standard mail order pharmacies.
Additional Benefits
The Select Health Medicare + Kroger (HMO) plan offers comprehensive medical coverage with no copay for primary care visits, while specialist visits require a $55 copay. For hospital care, inpatient stays require a $495 daily copay for the first few days followed by no copay, and outpatient hospital services range from no copay to a $250 copay with 20% coinsurance. Emergency care is available with a $130 copay, which is waived upon admission, while urgent care visits require a $45 copay. This plan also features valuable supplemental benefits, including up to 24 one-way transportation trips per year to approved health locations with no copay. Routine dental care is covered with no copay up to a $1,500 annual limit, and routine eye exams require a $55 copay with up to $200 covered for eyewear at no copay. Hearing exams are available for a $55 copay, with prescription hearing aids requiring copays ranging from $325 to $1,799.
Inpatient Hospital See details
Select Health Medicare + Kroger (HMO) covers inpatient hospital services with no coinsurance, requiring a $495 daily copay for days 1 through 5 of acute stays and days 1 through 4 of psychiatric stays, followed by no copay for subsequent days. This benefit is partially covered because non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Select Health Medicare + Kroger (HMO) covers outpatient hospital services with a $0 to $250 copay and 20% coinsurance, and ambulatory surgical center services with a $150 copay and no coinsurance. Outpatient substance abuse services require a $15 to $25 copay with no coinsurance, while outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by Select Health Medicare + Kroger (HMO) with a $130.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under the Select Health Medicare + Kroger (HMO) plan, with ground and air ambulance services requiring a $350 copay and no coinsurance. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved health-related locations with no copay or coinsurance, though trips to any health-related location are not covered.
Emergency Services See details
Select Health Medicare + Kroger (HMO) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $45 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no coinsurance and copays of $130, $45, and $350 respectively.
Primary Care See details
Select Health Medicare + Kroger (HMO) offers primary care physician and opioid treatment services with no copay and no coinsurance, while specialist visits require a $55 copay with no coinsurance. Other benefits include physical, occupational, and mental health therapies with copays ranging from $15 to $75 and no coinsurance, though chiropractic services are not covered in practice.
Preventive Services See details
Preventive Services are partially covered by Select Health Medicare + Kroger (HMO) with no copay and no coinsurance for covered benefits, including annual physical exams, kidney disease education, and diabetes self-management training. While supplemental benefits like fitness programs, nutritional therapy, and home safety devices are included, several services are not covered, such as in-home safety assessments, personal emergency response systems, home-based palliative care, and therapeutic massages.
Hearing Services See details
Select Health Medicare + Kroger (HMO) covers hearing exams with a $55 copay and no coinsurance. Prescription hearing aids are partially covered with a copay ranging from $325 to $1,799 and no coinsurance, though inner ear, outer ear, over the ear, and over-the-counter hearing aids are not covered.
Vision Services See details
Select Health Medicare + Kroger (HMO) covers vision services, offering annual routine and refraction eye exams for a $55 copay and no coinsurance. Eyewear is partially covered with no copay or coinsurance up to a $200 annual limit for contact lenses and complete eyeglasses, though individual eyeglass lenses and frames are not covered.
Dental Services See details
Dental services are partially covered by Select Health Medicare + Kroger (HMO), offering Medicare-covered dental services for a $55 copay and no coinsurance, and other covered preventive and comprehensive services with no copay and no coinsurance up to a $1,500 yearly maximum. While most dental benefits are covered, orthodontics, implant services, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Select Health Medicare + Kroger (HMO) covers Home Infusion bundled Services with no copay, although prior authorization is required. Covered Medicare Part B drugs, including chemotherapy and radiation, feature a coinsurance ranging from no coinsurance up to 20%, while Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by Select Health Medicare + Kroger (HMO) with no copay and a 20% coinsurance.
Medical Equipment See details
Select Health Medicare + Kroger (HMO) provides coverage for medical equipment with no copays and coinsurance ranging from 0% to 20%, with prior authorization required. This benefit is partially covered, as durable medical equipment, prosthetics, and diabetic therapeutic shoes are covered, while diabetic supplies are not covered.
Diagnostic and Radiological Services See details
Select Health Medicare + Kroger (HMO) partially covers diagnostic and radiological services, excluding lab services and outpatient X-ray services. Covered diagnostic procedures and tests feature no coinsurance and a copay ranging from no copay to $55, while covered radiological services have no coinsurance and range from no copay for diagnostic radiological services to a copay starting at $85 for therapeutic radiological services.
Home Health Services See details
Home health services are covered by Select Health Medicare + Kroger (HMO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Select Health Medicare + Kroger (HMO) with no copay and no coinsurance, though prior authorization is required. However, some services are covered in practice, as standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Select Health Medicare + Kroger (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 to 20 and days 56 to 100, and a $218 daily copay for days 21 to 55. Prior authorization is required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Select Health Medicare + Kroger (HMO) partially covers other services, offering a meal benefit for chronic illnesses with no copay and no coinsurance, subject to prior authorization. Acupuncture and over-the-counter (OTC) items are not covered under this benefit.
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