A non-government entity
HAP Senior Plus (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HAP Senior Plus (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HAP Senior Plus (HMO-POS) in 2025, please refer to our full plan details page.
HAP Senior Plus (HMO-POS) is a HMO-POS plan offered by Henry Ford Health System available for enrollment in 2025 to people living in Mid and Southeast Michigan Counties. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that HAP Senior Plus (HMO-POS) 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 HAP Senior Plus (HMO-POS).
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 HAP Senior Plus (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $105.00. 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 $4500.00 (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 $4500.00 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 HAP Senior Plus (HMO-POS)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The HAP Senior Plus (HMO-POS) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you will pay a copay or coinsurance depending on the drug tier and the pharmacy you use. For example, you will pay a $9 copay for preferred generic drugs at a preferred pharmacy for a 30-day supply. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you will pay nothing for Medicare Part D covered drugs. However, you may still have to pay for excluded drugs covered under any enhanced benefit.
Additional Benefits
The HAP Senior Plus (HMO-POS) plan offers a range of benefits, including inpatient hospital stays with a $300 copay for the first five days, and no copay for days 6-90. The plan also covers outpatient services with copays ranging from $0 to $225, and includes coverage for ambulance services with a $250 copay. Additionally, the plan offers primary care services with a $10 copay, preventive services, hearing exams with a $10 copay, and vision services like eye exams and eyewear. This plan provides dental services with a $2,000 maximum benefit, home infusion services, and dialysis services with a 20% coinsurance. Durable medical equipment and prosthetics are covered with a 20% coinsurance, and home health services are covered with no copay. The plan also covers skilled nursing facility stays with no copay for the first 20 days and a $214 copay for days 21-100.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, the copay is $300 for days 1-5, and no copay for days 6-90, while for Inpatient Hospital Psychiatric, the copay is also $300 for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, and Additional days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including hospital and observation services, are covered by the HAP Senior Plus (HMO-POS) plan, with copays ranging from $0 to $225. Ambulatory Surgical Center (ASC) Services have no copay, while Outpatient Substance Abuse Services are not covered, and Outpatient Blood Services are covered.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay, and requires prior authorization.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a $250 copay for both ground and air ambulance services. Transportation Services to a plan-approved health-related location are covered for up to 12 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the HAP Senior Plus (HMO-POS) plan. Emergency Services have a $125 copay, and Urgently Needed Services have a copay between $10 and $45. Worldwide Emergency Coverage has a $125 copay, Worldwide Urgent Coverage has a $45 copay, and Worldwide Emergency Transportation has a $250 copay.
Primary Care See details
The HAP Senior Plus (HMO-POS) plan covers primary care physician services, chiropractic services, occupational therapy, physician specialist services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services have a $10 copay, chiropractic services have a $20 copay, occupational therapy has a $10 copay, physician specialist services have a $35 copay, physical therapy and speech-language pathology services have a $10 copay, and additional telehealth benefits have a $10-$45 copay. Mental health specialty services, podiatry services, and psychiatric services are not covered.
Preventive Services See details
Preventive services are covered, including Medicare-covered zero-dollar preventive services, annual physical exams, and additional preventive services like Nutritional/Dietary Benefits, Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit, Remote Access Technologies, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit. However, services such as Health Education, In-Home Safety Assessment, Personal Emergency Response System, Medical Nutrition Therapy, Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Enhanced Disease Management, Telemonitoring Services, Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
Hearing services include hearing exams with a $10 copay. Prescription hearing aids (all types) are covered with a copay between $0 and $1575, while hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
The HAP Senior Plus (HMO-POS) plan covers vision services, including routine eye exams with a copay of $10-$35, and eyewear with a combined maximum benefit of $150 per year. Contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames are also covered, while upgrades are not covered.
Dental Services See details
Dental Services include coverage for Medicare dental services with a $10-$35 copay, and other dental services with a $2,000 maximum benefit per year. Oral exams, dental x-rays, prophylaxis (cleaning), and fluoride treatments are covered, with some limitations on the number of visits and x-rays. Restorative services and endodontics have a 50% coinsurance, while oral and maxillofacial surgery has a 0%-50% coinsurance. Orthodontics and adjunctive general services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the HAP Senior Plus (HMO-POS) plan and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the HAP Senior Plus (HMO-POS) plan, with a coinsurance of 20%.
Medical Equipment See details
Medical equipment is covered by HAP Senior Plus (HMO-POS), including Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetics/Medical Supplies with a 20% coinsurance, but Durable Medical Equipment for use outside the home and Diabetic Therapeutic Shoes/Inserts are not covered. Diabetic Supplies have a coinsurance between 0% and 20%.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the HAP Senior Plus (HMO-POS) plan. Diagnostic Procedures/Tests have a maximum copay of $150, while Lab Services are not covered. Diagnostic Radiological Services have a maximum copay of $200, Therapeutic Radiological Services have a copay of $35 or more, and Outpatient X-Ray Services have a copay of $35.
Home Health Services See details
Home Health Services are covered by the HAP Senior Plus (HMO-POS) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the HAP Senior Plus (HMO-POS) plan. This includes Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the HAP Senior Plus (HMO-POS) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The HAP Senior Plus (HMO-POS) plan covers over-the-counter items with a maximum benefit of $90 every three months, and also provides a meal benefit for chronic illnesses. 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 are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
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.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved