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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 Colorado Front Range. 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.
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 combined Maximum Out-Of-Pocket cost of $8900.00 (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 $8900.00 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 with no deductible. During the initial coverage phase, you will pay varying copays or coinsurance amounts depending on the drug tier and pharmacy type. For example, you may pay an $8 copay at a standard pharmacy for a Tier 1 drug, or a 33% coinsurance for a Tier 4 drug. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy (LIS), you will pay $0.00 for Part D drugs.
Additional Benefits
The Select Health Medicare Choice (PPO) plan offers comprehensive coverage, including inpatient hospital stays with a copay, outpatient services, and emergency services. Primary care, preventive services, hearing, vision, and dental services are also covered, with varying copays depending on the service. The plan also covers home health, skilled nursing facility, and medical equipment services with copays or coinsurance. Additional benefits include ambulance services, partial hospitalization, and home infusion services. This plan also covers dialysis services and diagnostic services with coinsurance requirements. Other services include OTC items and meal benefits, and offers additional benefits like Naloxone.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a $310 copay for days 1-5, and no copay for days 6-90. Additional days for inpatient hospital-acute are covered with no copay, but non-Medicare covered stays and upgrades are not covered. Inpatient Hospital Psychiatric benefits are covered, with a $310 copay for days 1-5, and no copay for days 6-90, however additional days and non-Medicare covered stays are not covered.
Outpatient Services See details
Outpatient Services includes coverage for outpatient hospital services with a $35-$300 copay and 20% coinsurance, observation services with a $320 copay, ambulatory surgical center (ASC) services with a $200 copay, and outpatient substance abuse services with a $15-$25 copay for individual and group sessions. Outpatient blood services are also covered, including a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered by the Select Health Medicare Choice (PPO) plan, but requires prior authorization. You will have a $105 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Select Health Medicare Choice (PPO) plan. Ground and air ambulance services each have a $250 copay, and there is no coinsurance. Transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $125 copay, while Urgently Needed Services have a $45 copay, and Worldwide Emergency Services have various copays depending on the service: $125 for Worldwide Emergency Coverage, $45 for Worldwide Urgent Coverage, and $250 for Worldwide Emergency Transportation.
Primary Care See details
The Select Health Medicare Choice (PPO) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Chiropractic services have a $20 copay, physician specialist services have a $35 copay, individual mental health and psychiatric sessions have a $25 copay, group mental health and psychiatric sessions have a $15 copay, podiatry services and other health care professional services have a copay between $0 and $35, physical therapy and speech-language pathology services have a $30 copay, additional telehealth benefits have a copay between $0 and $35, and opioid treatment program services have 10% coinsurance. Routine chiropractic care is not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered preventive services with no copay, annual physical exams, health education, in-home safety assessments, medical nutrition therapy, weight management programs, nutritional/dietary benefits, in-home support services, fitness benefits, remote access technologies, home and bathroom safety devices, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit. Personal emergency response systems, post discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss, alternative therapies, therapeutic massage, adult day health services, home-based palliative care, support for caregivers, additional sessions of smoking cessation, enhanced disease management, telemonitoring services, and counseling services are not covered.
Hearing Services See details
Hearing services include routine hearing exams with a $35 copay, and fitting/evaluation for hearing aids. Prescription hearing aids (all types) are covered with a copay between $325 and $1799, but 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 include coverage for eye exams with a $35 copay and eyewear, including contact lenses and eyeglasses (lenses and frames). Eyeglass lenses and frames are not covered. The plan covers one routine eye exam and one other eye exam service per year. There is a $300 combined maximum plan benefit for all eyewear every year.
Dental Services See details
Dental Services are covered under the Select Health Medicare Choice (PPO) plan. Medicare Dental Services have a $35 copay and require prior authorization, while other services include 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, all of which are covered. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Select Health Medicare Choice (PPO) plan, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%, while for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance ranges from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by the Select Health Medicare Choice (PPO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits are covered by the Select Health Medicare Choice (PPO) plan, including Durable Medical Equipment (DME) with a coinsurance between 0% and 20%, and Prosthetics/Medical Supplies and Diabetic Therapeutic Shoes/Inserts each with a 20% coinsurance. Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
The Select Health Medicare Choice (PPO) plan covers Diagnostic and Radiological Services. Diagnostic Procedures/Tests have a maximum copay of $35 and a coinsurance of up to 20%, while Lab Services are not covered. Diagnostic Radiological Services have a maximum copay of $180, and Therapeutic Radiological Services have a coinsurance of up to 20%. Outpatient X-Ray Services are not covered.
Home Health Services See details
Home Health Services are covered by the Select Health Medicare Choice (PPO) plan with no copay or coinsurance, but prior authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Select Health Medicare Choice (PPO) plan. For days 1-20, there is no copay, for days 21-55, the copay is $214, and for days 56-100, there is no copay; additional days beyond Medicare coverage and non-Medicare-covered stays are not covered.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items, and Meal Benefits, but does not cover Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, 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, and Self-Directed Personal Assistance Services. This plan offers OTC items as a supplemental benefit and covers Naloxone.
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