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Select Health Medicare Choice (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Select Health Medicare Choice (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Select Health Medicare Choice (PPO) in 2025, please refer to our full plan details page.
Select Health Medicare Choice (PPO) is a PPO plan offered by Intermountain Health Care, Inc. available for enrollment in 2025 to people living in Clark and Nye Counties. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Select Health Medicare Choice (PPO) 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 Choice (PPO).
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 Choice (PPO), 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 $3.00. 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.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $8950.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $8950.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 Choice (PPO)
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Drug Coverage
The Select Health Medicare Choice (PPO) plan has an enhanced alternative drug benefit. This plan has no deductible for prescription drugs. During the initial coverage phase, you will pay a copay for your prescriptions, depending on the drug tier and pharmacy. For example, the copay for a standard generic drug is $10.00. After your yearly out-of-pocket drug costs reach $2000.00, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Select Health Medicare Choice (PPO) plan offers a range of benefits, including coverage for inpatient hospital stays with a copay, outpatient services with varying copays, and ambulance services. The plan also provides coverage for primary care, preventive services, hearing, vision, and dental services, each with specific copays and limitations. Additional benefits include home health services with no copay, skilled nursing facility care with a copay, and coverage for medical equipment and home infusion services with coinsurance. However, some services like acupuncture, private duty nursing, and certain dental and vision services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you will pay a $295 copay for days 1-5, and no copay for days 6-90. For Inpatient Hospital Psychiatric, you will pay a $295 copay for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered, but Non-Medicare-covered stay and Upgrades for Inpatient Hospital-Acute are not covered. Additional days and Non-Medicare-covered stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services are covered by Select Health Medicare Choice (PPO), including outpatient hospital services with a copay of $35-$275, observation services with a copay of $275, ambulatory surgical center services with a copay of $175, outpatient substance abuse services with a copay of $20-$25, and outpatient blood services with a waived deductible for three pints.
Partial Hospitalization See details
Partial Hospitalization is covered by the Select Health Medicare Choice (PPO) plan. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Select Health Medicare Choice (PPO). Ground and air ambulance services have a copay of $270, while transportation services to a plan-approved health-related location are covered for up to 24 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Select Health Medicare Choice (PPO) plan. Emergency Services have a $125 copay, Urgently Needed Services have a $40 copay, Worldwide Emergency Coverage has a $125 copay, Worldwide Urgent Coverage has a $40 copay, and Worldwide Emergency Transportation has a $270 copay; all services have no coinsurance.
Primary Care See details
The Select Health Medicare Choice (PPO) plan covers Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Chiropractic Services, Individual Sessions for Mental Health Specialty Services, Group Sessions for Mental Health Specialty Services, Individual Sessions for Psychiatric Services, and Group Sessions for Psychiatric Services have a $20, $25, $20, $25, and $20 copay, respectively. Physical Therapy and Speech-Language Pathology Services have a $20 copay. Physician Specialist Services have a $35 copay. Podiatry Services and Opioid Treatment Program Services have a $35 and $40 copay, respectively. Additional Telehealth Benefits have a copay between $0 and $35.
Preventive Services See details
Preventive Services are covered, including Medicare-covered zero dollar preventive services and annual physical exams. Health education, medical nutrition therapy, weight management programs, nutritional/dietary benefits, in-home support services, fitness benefits, remote access technologies, home and bathroom safety devices, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit are also covered. Some services, like in-home safety assessments, personal emergency response systems, post discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, alternative therapies, therapeutic massage, adult day health services, home-based palliative care, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, and counseling services, are not covered.
Hearing Services See details
Hearing Services includes routine hearing exams with a $35 copay, and fitting/evaluation for hearing aids with a $35 copay. Prescription hearing aids (all types) are covered with a copay between $699 and $999. Prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision Services includes coverage for eye exams with a $35 copay, as well as coverage for contact lenses, eyeglasses (lenses and frames), and upgrades. Eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental services with the Select Health Medicare Choice (PPO) plan include a $35 copay for Medicare dental services, and other dental services are covered with a $2,500 maximum benefit per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery are covered; however, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Select Health Medicare Choice (PPO) plan, with a coinsurance of 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance, however Durable Medical Equipment for use outside the home is not covered. Diabetic Equipment benefits include Diabetic Therapeutic Shoes/Inserts with 20% coinsurance, but Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a coinsurance of at most 20% and a copay of at most $35, and Diagnostic Radiological Services with a copay of at most $150. Lab Services are not covered, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Select Health Medicare Choice (PPO) plan, with no copay and no coinsurance; however, additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the specific services of Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Select Health Medicare Choice (PPO) plan, but require prior authorization. There is no copay for days 1-20, a $214 copay for days 21-35, and no copay for days 36-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Select Health Medicare Choice (PPO) plan does not cover acupuncture, Dual Eligible SNPs, EPSDT services, private duty nursing services, case management (long term care), institution for mental disease services, services in an intermediate care facility, case management, tobacco cessation counseling for pregnant women, freestanding birth center services, respiratory care services, family planning services, nursing home services, home and community based services, personal care services, or self-directed personal assistance services. Over-the-counter (OTC) items and meal benefits are covered, but the meal benefit requires prior authorization.
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