A non-government entity
Select Health Medicare NoRx (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Select Health Medicare NoRx (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 NoRx (HMO) in 2026, please refer to our full plan details page.
Select Health Medicare NoRx (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 NoRx (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 Select Health Medicare NoRx (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 NoRx (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 $121.00. 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.
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 $6750.00 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 Select Health Medicare NoRx (HMO).
Additional Benefits
The Select Health Medicare NoRx (HMO) plan offers comprehensive medical coverage, featuring no copay and no coinsurance for primary care visits, preventive services, and home health care. For specialist visits, outpatient services, and inpatient hospital stays, members will pay predictable copays with low-to-no coinsurance, including a $50 to $75 copay for specialist care. Emergency and urgent care are also covered with flat copayments and no coinsurance, which are waived if you are admitted to the hospital. This plan also includes valuable dental, vision, and hearing benefits with no deductibles and annual coverage limits up to $1,200. Members benefit from no copay and no coinsurance for routine dental cleanings, prescription hearing aids, eyewear, and over-the-counter items. Routine vision and hearing exams are available with a $70 copay and no coinsurance.
Inpatient Hospital See details
Select Health Medicare NoRx (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $450 daily copay for days 1 to 5 and no copay for days 6 to 90. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Select Health Medicare NoRx (HMO), including outpatient hospital visits with a $0 to $400 copay and 20% coinsurance, and ambulatory surgical center services with a $400 copay and no coinsurance. Outpatient substance abuse services require a $50 to $60 copay with no coinsurance, while outpatient blood services are provided with no copay or coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by Select Health Medicare NoRx (HMO) with a $140 copay and no coinsurance. Prior authorization is required for some of these covered services.
Ambulance and Transportation Services See details
Select Health Medicare NoRx (HMO) covers ground and air ambulance services with a $350 copayment and no coinsurance, though prior authorization is required. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Select Health Medicare NoRx (HMO) covers emergency services with a $130 copay and urgently needed services with a $50 copay, both featuring no coinsurance and copay waivers if admitted to the hospital within 24 hours. Worldwide emergency coverage, urgent coverage, and emergency transportation are also covered with no coinsurance and copays of $130, $50, and $350 respectively.
Primary Care See details
Select Health Medicare NoRx (HMO) offers primary care physician services and opioid treatment with no copay and no coinsurance, while chiropractic services are not covered in practice. Other covered services feature no coinsurance, with copays ranging from $50 to $75 for specialists, physical therapy, occupational therapy, and mental health services.
Preventive Services See details
Preventive services are partially covered by Select Health Medicare NoRx (HMO) with no copay and no coinsurance for annual physicals, fitness benefits, and nutritional therapy. However, several sub-services are not covered, including in-home safety assessments, post-discharge medication reconciliation, readmission prevention, chemotherapy wigs, alternative therapies, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, and counseling.
Hearing Services See details
Hearing services are covered by Select Health Medicare NoRx (HMO) with no deductible, offering routine exams and evaluations for a $70 copay and no coinsurance up to a $1,200 annual maximum. Prescription hearing aids are available with no copay and no coinsurance, but coverage is partial as OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Select Health Medicare NoRx (HMO) offers partially covered vision services with no deductibles, featuring eye exams for a $70 copay and no coinsurance up to a $1,200 annual limit. Eyewear is covered with no copay and no coinsurance, though individual eyeglass lenses and individual eyeglass frames are not covered.
Dental Services See details
Select Health Medicare NoRx (HMO) covers Medicare-approved dental services for a $70 copay and no coinsurance. Other preventive and comprehensive dental services, such as cleanings, exams, and restorative treatments, are covered with no copay and no coinsurance up to a maximum annual benefit of $1,200.
Home Infusion bundled Services See details
Select Health Medicare NoRx (HMO) covers Home Infusion bundled services with no copay, though prior authorization is required. Related Medicare Part B chemotherapy, radiation, and other drugs have coinsurance ranging from no coinsurance up to 20%, while covered insulin requires a $35 copay and coinsurance from no coinsurance up to 20%.
Dialysis Services See details
Select Health Medicare NoRx (HMO) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Select Health Medicare NoRx (HMO) partially covers medical equipment with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes, though prior authorization is required. Diabetic supplies are not covered under this plan.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services under the Select Health Medicare NoRx (HMO) plan are partially covered with prior authorization required, though lab services are not covered. Diagnostic procedures and tests have no coinsurance and a copay ranging from no copay up to $70, while radiological services feature no coinsurance with copays of $50 for X-rays, at least an $85 copay for therapeutic radiology, and no copay for diagnostic radiology.
Home Health Services See details
Home Health Services are covered under the Select Health Medicare NoRx (HMO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Select Health Medicare NoRx (HMO) covers some cardiac rehabilitation services with no coinsurance, though prior authorization is required. However, standard cardiac rehabilitation (with a $40 copay), intensive cardiac rehabilitation (with a $50 copay), pulmonary rehabilitation (with a $35 copay), and supervised exercise therapy for peripheral artery disease (with a $25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Select Health Medicare NoRx (HMO) covers up to 100 days of Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 to 20 and days 56 to 100, a $218 daily copay for days 21 to 55, and any additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Select Health Medicare NoRx (HMO) partially covers other services, providing over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, and nicotine replacement therapy are not covered under this plan.
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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.
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