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Select Health Medicare Flex (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Select Health Medicare Flex (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 Flex (HMO) in 2026, please refer to our full plan details page.
Select Health Medicare Flex (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 Flex (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 Flex (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 Flex (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 $5900.00 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 Select Health Medicare Flex (HMO)
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Drug Coverage
The Select Health Medicare Flex (HMO) plan features a $0 drug deductible, meaning your prescription coverage begins immediately. For Tier 1 preferred generic drugs, there is no copay for up to a three-month supply at standard pharmacies and through standard mail order. Tier 2 generic drugs also have no copay when filled through standard mail order, while standard pharmacies charge a copay of $6 for a one-month supply, $12 for two months, and $18 for three months. Higher-tier medications under this plan are subject to coinsurance rather than flat copays at both standard pharmacies and standard mail order services. Tier 3 preferred brand drugs require a 25% coinsurance, while Tier 4 non-preferred drugs carry a 30% coinsurance for one-, two-, or three-month supplies. Tier 5 specialty drugs require a 33% coinsurance and are limited to a one-month supply.
Additional Benefits
Select Health Medicare Flex (HMO) provides comprehensive medical coverage, featuring no copay or coinsurance for primary care visits and preventive services. Specialty care and emergency services require predictable copays with no coinsurance, while inpatient hospital stays have a daily copay of $450 for the first five days followed by no copay. Outpatient services generally range from no copay to a $250 copay with up to 20% coinsurance. This plan also includes robust dental, vision, and hearing benefits, offering routine exams and preventative care with no copay or low $30 copays. Members can also benefit from home health services and over-the-counter items with no copay, as well as skilled nursing care with no copay for the first 20 days. With no deductibles for dental and vision services, this plan helps keep your healthcare costs predictable.
Inpatient Hospital See details
Select Health Medicare Flex (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $450 daily copay for days 1 through 5 and no copay for days 6 through 90. Prior authorization is required, and while additional days are unlimited for acute stays, they are not covered for psychiatric care, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Select Health Medicare Flex (HMO) covers outpatient hospital services with a $0 to $250 copay and 20% coinsurance, and observation services with a $250 copay per stay. Ambulatory surgical center services are covered with a $150 copay and no coinsurance, while outpatient substance abuse services require a $20 to $30 copay and no coinsurance. Outpatient blood services are covered with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
Partial hospitalization is covered by Select Health Medicare Flex (HMO) with a $140.00 copay and no coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
Select Health Medicare Flex (HMO) covers ground and air ambulance services with a $350 copay and no coinsurance, subject to prior authorization. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Select Health Medicare Flex (HMO) covers emergency services with a $130 copay and urgently needed services with a $35 copay, with no coinsurance required for either service. Worldwide emergency, urgent, and transportation services are also covered with no coinsurance and copays of $130, $35, and $350, respectively.
Primary Care See details
Primary care benefits under the Select Health Medicare Flex (HMO) feature no copay and no coinsurance for primary care physician visits and opioid treatment. Specialist visits, mental health, and physical therapy are covered with no coinsurance and copays ranging from $20 to $75, while some chiropractic services are covered but routine and other chiropractic services are not covered.
Preventive Services See details
Select Health Medicare Flex (HMO) covers preventive services, including annual physical exams and kidney disease education, with no copay and no coinsurance. Additional preventive benefits are partially covered, excluding services such as in-home safety assessments, alternative therapies, therapeutic massage, and caregiver support.
Hearing Services See details
Hearing services are covered by Select Health Medicare Flex (HMO), including routine hearing exams and fittings for a $30 copay, no deductible, and no coinsurance up to a $1,200 annual maximum. Prescription hearing aids are partially covered with no copay and no coinsurance, but inner ear, outer ear, and over the ear prescription models are not covered, and over-the-counter (OTC) hearing aids are also excluded.
Vision Services See details
Select Health Medicare Flex (HMO) covers vision services with no deductibles, offering eye exams for a $30 copay and no coinsurance up to a $1,200 annual limit. Eyewear is partially covered with no copay or coinsurance for contact lenses and eyeglasses (lenses and frames), though individual eyeglass lenses and frames are not covered.
Dental Services See details
Dental services under the Select Health Medicare Flex (HMO) plan include Medicare-covered dental care for a $30 copay and no coinsurance, as well as comprehensive and preventive dental services with no copay and no coinsurance. Covered non-Medicare dental services, such as cleanings, exams, and implants, are subject to a maximum plan benefit of $1,200 every year.
Home Infusion bundled Services See details
Select Health Medicare Flex (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, carry no coinsurance to 20% coinsurance, with insulin also requiring a $35 copay.
Dialysis Services See details
Select Health Medicare Flex (HMO) covers Dialysis Services with no copay and a 20% coinsurance.
Medical Equipment See details
Select Health Medicare Flex (HMO) covers medical equipment with no copay, though prior authorization is required for all services. Durable medical equipment features no coinsurance to 20% coinsurance, while prosthetic devices, medical supplies, and diabetic therapeutic shoes require a 20% coinsurance. Diabetic equipment is only partially covered, as diabetic supplies are not covered by the plan.
Diagnostic and Radiological Services See details
Select Health Medicare Flex (HMO) partially covers diagnostic and radiological services, with lab services and outpatient x-ray services excluded from coverage. Prior-authorized diagnostic procedures have no coinsurance and a copay of no copay to $30, while radiological services have no coinsurance, with no copay for diagnostic scans and an $85 copay for therapeutic services.
Home Health Services See details
Select Health Medicare Flex (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Select Health Medicare Flex (HMO) covers some cardiac rehabilitation services with no copay and no coinsurance, though prior authorization is required and standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Select Health Medicare Flex (HMO) with no coinsurance, requiring prior authorization but waiving the three-day prior hospital stay. There is no copay for days 1 through 20 and days 56 through 100, but a $218 daily copay applies for days 21 through 55, and additional days beyond the standard 100 days are not covered.
Other Services See details
Select Health Medicare Flex (HMO) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for the meal benefit, while acupuncture, nicotine replacement therapy, and other additional services are not covered.
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