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Univera SeniorChoice Secure (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Univera SeniorChoice Secure (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Univera SeniorChoice Secure (HMO-POS) in 2026, please refer to our full plan details page.
Univera SeniorChoice Secure (HMO-POS) is a HMO-POS plan offered by Lifetime Healthcare, Inc. available for enrollment in 2025 to people living in Western New York. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Univera SeniorChoice Secure (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 Univera SeniorChoice Secure (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 Univera SeniorChoice Secure (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $83.20. 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 a $250.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6000.00 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 Univera SeniorChoice Secure (HMO-POS)
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Drug Coverage
The Univera SeniorChoice Secure (HMO-POS) Medicare plan features an annual drug deductible of $250. For Tier 1 preferred generic drugs, there is no copay when using a preferred pharmacy or preferred mail order service, while standard options require a $5 copay for a one-month supply. Tier 2 generic medications cost a $5 copay at preferred pharmacies and a $10 copay at standard pharmacies for a one-month supply. For higher-tier medications, cost-sharing transitions to coinsurance. Tier 3 preferred brand drugs require a 20% coinsurance, and Tier 5 specialty drugs require a 30% coinsurance regardless of the pharmacy type used. Tier 4 non-preferred drugs cost 33% coinsurance at preferred pharmacies and mail order, or 50% coinsurance at standard pharmacies and mail order.
Additional Benefits
The Univera SeniorChoice Secure (HMO-POS) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, home health services, and routine preventive care. For hospital services, members pay a $225 daily copay for the first five days of inpatient stays, while outpatient hospital services require a $200 copay. Specialist visits and routine hearing exams carry a $25 copay with no coinsurance, while routine eye exams require no copay. Additional perks include dental coverage with no copay or coinsurance up to a $1,000 yearly limit, alongside a $200 annual eyewear allowance with a $25 copay. Emergency care is covered with a $115 copay, which is waived if admitted, and urgent care has a $50 copay. Members also receive up to 12 one-way transportation trips per year and a $30 over-the-counter allowance every three months with no copay.
Inpatient Hospital See details
Inpatient Hospital care is partially covered by Univera SeniorChoice Secure (HMO-POS) with no coinsurance and a copay of $225 per day for days 1 through 5, and no copay for days 6 through 90. Unlimited additional acute care days are covered with no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Univera SeniorChoice Secure (HMO-POS) covers outpatient hospital and ambulatory surgical center services with a $200 copay and no coinsurance. Outpatient substance abuse services are covered with no copay and a 20% coinsurance, while outpatient blood services have no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
Univera SeniorChoice Secure (HMO-POS) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Univera SeniorChoice Secure (HMO-POS) covers ground and air ambulance services with a $100 copay and no coinsurance. Transportation services are partially covered, offering up to 12 one-way trips per year to any health-related location with no copay and no coinsurance, though transportation to plan-approved health-related locations is not covered.
Emergency Services See details
Univera SeniorChoice Secure (HMO-POS) covers emergency services with a $115 copay, which is waived if admitted within 23 hours, and urgently needed services with a $50 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no coinsurance and copays of $115, $50, and $100 respectively.
Primary Care See details
Univera SeniorChoice Secure (HMO-POS) offers primary care physician services with no copay and no coinsurance, while specialist visits and outpatient therapy services require a $25 copay and no coinsurance. Mental health, psychiatric, and opioid treatment services are covered with no copay and a 20% coinsurance, though chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services under Univera SeniorChoice Secure (HMO-POS) are covered with no copay and no coinsurance, including annual physical exams, kidney disease education, and various screenings. Additional preventive services are partially covered with no copay and no coinsurance, providing memory fitness and remote access technologies, while excluding services like health education, in-home safety assessments, and personal emergency response systems.
Hearing Services See details
Univera SeniorChoice Secure (HMO-POS) hearing services are partially covered, featuring routine hearing exams with a $25 copay and no coinsurance. Prescription hearing aids are also partially covered with no coinsurance and copays ranging from $499 to $799, but OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Univera SeniorChoice Secure (HMO-POS) covers routine eye exams (one per year) with no copay and no coinsurance, though other eye exam services are not covered. Eyewear is partially covered up to a $200 annual limit with a $25 copay and no coinsurance, which covers contact lenses and eyeglasses (lenses and frames) but excludes individual lenses, frames, and upgrades.
Dental Services See details
Univera SeniorChoice Secure (HMO-POS) covers Medicare dental services with a $25 copay and no coinsurance, alongside preventive and comprehensive services with no copay or coinsurance up to a $1,000 yearly limit. Some services are not covered, including fluoride treatments, implants, orthodontics, maxillofacial prosthetics, and other diagnostic or preventive dental services.
Home Infusion bundled Services See details
Univera SeniorChoice Secure (HMO-POS) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin drugs are covered with a $35 copay and no coinsurance, while Medicare Part B chemotherapy, radiation, and other Part B drugs require a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Univera SeniorChoice Secure (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Univera SeniorChoice Secure (HMO-POS) covers durable medical equipment, prosthetics, and medical supplies with no copay and 20% coinsurance, subject to prior authorization. Diabetic supplies from specified manufacturers are covered with a $5 copay, while diabetic therapeutic shoes and inserts require 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered under Univera SeniorChoice Secure (HMO-POS), as diagnostic procedures, tests, and lab services are not covered. Covered diagnostic services have no copay and no coinsurance, while radiological services require a $40 copay for outpatient X-rays, a minimum $150 copay for diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiology, with prior authorization required for all.
Home Health Services See details
Home health services are covered under the Univera SeniorChoice Secure (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Univera SeniorChoice Secure (HMO-POS) covers some cardiac rehabilitation services with no coinsurance and a $15 copayment. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Univera SeniorChoice Secure (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Univera SeniorChoice Secure (HMO-POS) covers other services, including acupuncture with no copay and 50% coinsurance for up to 10 treatments per year. Over-the-counter (OTC) items and meal benefits for chronic illnesses are also covered with no copay and no coinsurance, featuring a $30 allowance for OTC items every three months.
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