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eternalHealth Grand Give Back (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for eternalHealth Grand Give Back (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on eternalHealth Grand Give Back (HMO) in 2026, please refer to our full plan details page.
eternalHealth Grand Give Back (HMO) is a HMO plan offered by Eternal Health of Delaware, Inc. available for enrollment in 2025 to people living in Maricopa, Pima, Pinal and Graham Counties. The overall rating for this plan is not yet available for 2026.
It's important to know that eternalHealth Grand Give Back (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 eternalHealth Grand Give Back (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 eternalHealth Grand Give Back (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 $65.00. 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 a $400.00 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 $4550.00 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:
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Drug Coverage
The eternalHealth Grand Give Back (HMO) plan features an Enhanced Alternative drug benefit with an annual prescription drug deductible of $400.00. After meeting this deductible, you will pay a $5.00 copay for Tier 1 preferred generics and a $47.00 copay for Tier 2 standard generics when using standard retail or standard mail services. For higher-tier medications, the plan charges a 35% coinsurance for Tier 3 preferred brands and a 28% coinsurance for Tier 4 non-preferred drugs. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase where you pay nothing for covered Part D prescription drugs. Additionally, those who qualify for the Extra Help low-income subsidy will pay nothing for their Part D premium.
Additional Benefits
The eternalHealth Grand Give Back (HMO) plan offers comprehensive coverage for core medical services, frequently featuring no coinsurance and set copays. Inpatient hospital stays require a $325 daily copay for the first five days and no copay for days six through 90, while primary care visits feature copays ranging from no copay up to $30. Emergency care is covered with a $120 copay that is waived upon admission, and outpatient hospital services carry copays ranging from no copay up to $225. Members also receive extensive supplemental benefits, including up to $2,500 in annual dental coverage and a $200 yearly allowance for eyewear with no copay. Routine vision and hearing exams both require a $35 copay, while up to two prescription hearing aids are covered annually with copays between $595 and $895. Other notable perks include 24 one-way transportation trips to approved locations, acupuncture treatments with a $25 copay, and a $75 quarterly over-the-counter reimbursement.
Inpatient Hospital See details
Inpatient Hospital benefits under the eternalHealth Grand Give Back (HMO) are partially covered and require prior authorization, featuring a $325 copay per day for days 1 through 5 and no copay or coinsurance for days 6 through 90. While unlimited additional days for acute care are covered, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
eternalHealth Grand Give Back (HMO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center services and no deductible for outpatient blood services. Patients will pay a copay of $0 to $225 for outpatient hospital services, $185 per stay for observation services, and $20 per session for outpatient substance abuse services.
Partial Hospitalization See details
Partial hospitalization benefits are covered by the eternalHealth Grand Give Back (HMO) plan with a $25.00 copay and no coinsurance.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by eternalHealth Grand Give Back (HMO), as transportation to any health-related location is not covered. Ground and air ambulance services require prior authorization and have a $270 copay with no coinsurance, while up to 24 one-way trips per year to plan-approved locations are covered.
Emergency Services See details
eternalHealth Grand Give Back (HMO) covers emergency services with a $120 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require no copay to a $25 copay, while worldwide emergency services are covered up to a $25,000 maximum with copays ranging from no copay to $270; both of these benefits also feature no coinsurance.
Primary Care See details
eternalHealth Grand Give Back (HMO) provides partially covered primary care benefits with no coinsurance, though podiatry services are not covered. Covered services feature copays ranging from no copay up to $30, including a $15 copay for specialists and $30 copays for physical, occupational, and speech therapies.
Preventive Services See details
Preventive services are covered by eternalHealth Grand Give Back (HMO) with no copay or coinsurance for Medicare-covered zero-dollar preventive services, annual physicals, kidney disease education, and select screenings. Additional preventive benefits are partially covered, providing fitness benefits and personal emergency response systems, while sub-services like health education, alternative therapies, and weight management programs are not covered.
Hearing Services See details
Hearing services are partially covered by the eternalHealth Grand Give Back (HMO) plan, featuring a $35 copay and no coinsurance for annual routine hearing exams, and no copay or coinsurance for hearing aid fittings. Up to two prescription hearing aids of all types are covered per year with a $595 to $895 copay and no coinsurance, though OTC hearing aids and prescription aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
eternalHealth Grand Give Back (HMO) provides partially covered vision services, including one annual routine eye exam for a $35 copay and no coinsurance. The plan also covers contact lenses and eyeglasses with no copay, no coinsurance, and no deductible up to a $200 yearly limit, though eyewear upgrades are not covered.
Dental Services See details
Dental services are covered by eternalHealth Grand Give Back (HMO), which provides up to $2,500 in annual coverage for preventive and comprehensive dental care. Medicare-covered dental services require a $35 copay and no coinsurance, while other covered services, such as exams, cleanings, and restorative treatments, require no copay and no coinsurance.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by eternalHealth Grand Give Back (HMO) with prior authorization required. Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance, while chemotherapy and other Part B drugs have no copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the eternalHealth Grand Give Back (HMO) plan with a 20% coinsurance and no copay.
Medical Equipment See details
Medical Equipment benefits are covered by eternalHealth Grand Give Back (HMO) with no copays, although prior authorization is required. Durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes carry a 20% coinsurance, while diabetic supplies range from no coinsurance to 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are partially covered by eternalHealth Grand Give Back (HMO), as lab services and outpatient X-ray services are not covered. Covered services require prior authorization and carry no coinsurance, with copays ranging from no copay to $60 for diagnostic tests, no copay to $225 for diagnostic radiology, and a flat $60 copay for therapeutic radiology.
Home Health Services See details
Home Health Services are covered by the eternalHealth Grand Give Back (HMO) plan. Specific copay and coinsurance details are not provided in the plan benefits summary.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the eternalHealth Grand Give Back (HMO) plan, as no copay or coinsurance coverage is provided for cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services.
Skilled Nursing Facility (SNF) See details
eternalHealth Grand Give Back (HMO) provides partially covered Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $203 daily copay for days 21 through 100. Prior authorization is required, and additional days beyond Medicare-covered SNF services are not covered.
Other Services See details
Other Services are partially covered by eternalHealth Grand Give Back (HMO), which features acupuncture with a $25 copay and no coinsurance for up to 20 treatments per year. The plan also includes chronic illness meal benefits and a $75 quarterly over-the-counter reimbursement allowance with no copay or coinsurance, though Dual Eligible SNPs with Highly Integrated Services are not covered.
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