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Select Health Medicare Active (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Select Health Medicare Active (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 Active (HMO) in 2026, please refer to our full plan details page.
Select Health Medicare Active (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 Active (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 Active (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 Active (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 $0.50. 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 $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:
Sign up for Select Health Medicare Active (HMO)
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Drug Coverage
The Select Health Medicare Active (HMO) plan features a $0 drug deductible, meaning your prescription coverage begins immediately. You will pay no copay for Tier 1 preferred generic drugs at standard pharmacies and through standard mail order. Tier 2 generic drugs also have no copay when filled via standard mail order, while standard pharmacy refills cost a $6 copay for a one-month supply, $12 for a two-month supply, and $18 for a three-month supply. For higher-tier prescriptions, the plan utilizes coinsurance rather than flat copays for both standard pharmacy and standard mail order options. You will pay a 25% coinsurance for Tier 3 preferred brand drugs and a 30% coinsurance for Tier 4 non-preferred drugs. Tier 5 specialty drugs require a 33% coinsurance for a one-month supply.
Additional Benefits
Select Health Medicare Active (HMO) offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, preventive services, and home health care. Specialist visits require a $35 copay, while inpatient hospital stays cost a $450 daily copay for the first five days and no copay for days 6 through 90. Outpatient services carry copays ranging from no copay up to $400 along with a 20% coinsurance, and emergency room visits have a $130 copay, which is waived if you are admitted. This plan also includes valuable dental, vision, and hearing benefits, such as preventive and comprehensive dental care with no copay up to a $2,000 annual limit. Routine eye and hearing exams require a $35 copay, with additional allowances of up to $300 for eyewear and coverage for up to two hearing aids per year. Furthermore, skilled nursing facility stays have no copay for the first 20 days, and members receive coverage for over-the-counter items and chronic illness meals with no copay.
Inpatient Hospital See details
Select Health Medicare Active (HMO) covers inpatient hospital acute and psychiatric stays with no coinsurance, requiring a $450 copay per day for days 1 through 5 and no copay for days 6 through 90. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Select Health Medicare Active (HMO) covers outpatient hospital services with a copay ranging from $0 to $400 and a 20% coinsurance, and ambulatory surgical center services with a $300 copay and no coinsurance. Outpatient substance abuse services have no coinsurance and a $30 to $40 copay per session, while outpatient blood services are fully covered with no copay, coinsurance, or deductible.
Partial Hospitalization See details
Partial hospitalization is covered by Select Health Medicare Active (HMO) with a $140.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Select Health Medicare Active (HMO) covers ground and air ambulance services with a $350 copay and no coinsurance, requiring prior authorization. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Select Health Medicare Active (HMO) covers emergency services with a $130 copay and urgently needed services with a $40 copay, both with no coinsurance and copays waived if admitted to the hospital within 24 hours. Worldwide emergency services are also covered with no coinsurance, requiring copays of $130 for emergency care, $40 for urgent care, and $350 for emergency transportation.
Primary Care See details
Select Health Medicare Active (HMO) provides primary care physician services and opioid treatment programs with no copay and no coinsurance, while specialist visits require a $35 copay and no coinsurance. Additional covered services include physical therapy for a $75 copay, occupational therapy for a $50 copay, and mental health therapy for a $30 to $40 copay, all with no coinsurance, though routine chiropractic services are not covered.
Preventive Services See details
Select Health Medicare Active (HMO) preventive services are covered with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes screenings. Additional preventive services are partially covered with no copay and no coinsurance, excluding health education, in-home safety assessments, PERS, post-discharge medication reconciliation, re-admission prevention, wigs, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, home safety devices, and counseling.
Hearing Services See details
Hearing services covered by Select Health Medicare Active (HMO) include one annual routine exam and fitting evaluation for a $35 copay and no coinsurance. Up to two prescription hearing aids are covered per year with no coinsurance and copays ranging from $325 to $1,799, though OTC, inner ear, outer ear, and over-the-ear models are not covered.
Vision Services See details
Vision services are covered by Select Health Medicare Active (HMO) with no deductibles, offering annual eye exams for a $35 copay and no coinsurance, and eyewear up to a $300 annual limit with no copay and no coinsurance. The benefit is partially covered because individual eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Select Health Medicare Active (HMO) partially covers dental services, offering covered preventive and comprehensive care with no copay and no coinsurance up to a $2,000 annual maximum, while Medicare-covered dental services require a $35 copay and no coinsurance. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered under Select Health Medicare Active (HMO) with no copay, although prior authorization and step therapy are required. Covered Medicare Part B chemotherapy, radiation, and other drugs carry no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin requires a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by the Select Health Medicare Active (HMO) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Select Health Medicare Active (HMO) covers durable medical equipment and prosthetics with no copay and coinsurance ranging from no coinsurance to 20%, subject to prior authorization. Diabetic equipment is partially covered with no copay and 20% coinsurance for therapeutic shoes and inserts, but diabetic supplies are not covered.
Diagnostic and Radiological Services See details
Select Health Medicare Active (HMO) partially covers diagnostic and radiological services with prior authorization required, though lab services are not covered. Covered diagnostic procedures and radiological services require no coinsurance, with copays ranging from no copay up to $35 for diagnostic tests, no copay for diagnostic radiology, $10 for outpatient X-rays, and $85 for therapeutic radiology.
Home Health Services See details
Home health services are covered under the Select Health Medicare Active (HMO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Select Health Medicare Active (HMO) with no coinsurance, though prior authorization is required. While some services are covered with no copay, specific sub-services including standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered in practice.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Select Health Medicare Active (HMO) with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 to 20 and 56 to 100, a $218 daily copay for days 21 to 55, and additional days beyond the standard Medicare limit are not covered.
Other Services See details
Select Health Medicare Active (HMO) partially covers other services, providing over-the-counter (OTC) items and a meal benefit for chronic illnesses with no copay and no coinsurance. Prior authorization is required for the meal benefit, and acupuncture is not covered.
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