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eternalHealth Valor Give Back (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for eternalHealth Valor Give Back (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on eternalHealth Valor Give Back (HMO-POS) in 2025, please refer to our full plan details page.
eternalHealth Valor Give Back (HMO-POS) is a HMO-POS plan offered by Eternal Health of Delaware, Inc. available for enrollment in 2025 to people living in Maricopa and Pima County. The overall rating for this plan is not yet available for 2025.
It's important to know that eternalHealth Valor Give Back (HMO-POS) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about eternalHealth Valor Give Back (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 eternalHealth Valor Give Back (HMO-POS), 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 $100.00. 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.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $9000.00 (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 $9000.00 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:
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Drug Coverage
Prescription drugs are not covered by eternalHealth Valor Give Back (HMO-POS).
Additional Benefits
The eternalHealth Valor Give Back (HMO-POS) plan offers a variety of benefits, including coverage for inpatient and outpatient services, with coinsurance costs typically around 20%. The plan covers primary care, preventive services, hearing, vision, and dental services, with varying copays and coinsurance depending on the service. Additional benefits include ambulance and transportation services, emergency services, home infusion, and medical equipment, all with coinsurance requirements. The plan also covers skilled nursing facility services and offers other services like acupuncture, OTC items, and a meal benefit.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered, but the copay information is not available. Additional Days for Inpatient Hospital-Acute are covered, but Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, and Additional Days for Inpatient Hospital Psychiatric and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient hospital and observation services have a 20% coinsurance, while outpatient blood services have a 20% coinsurance, and outpatient substance abuse services have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered under the eternalHealth Valor Give Back (HMO-POS) plan, with a 20% coinsurance.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the eternalHealth Valor Give Back (HMO-POS) plan. Ground and air ambulance services have a 20% coinsurance, with no copay, while transportation services to a plan-approved health-related location are covered for 24 one-way trips per year with no copay.
Emergency Services See details
Emergency Services, including Urgently Needed Services, are covered by eternalHealth Valor Give Back (HMO-POS) with a 20% coinsurance and no copay. Worldwide Emergency Services are covered with a 20% coinsurance for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, with a maximum benefit coverage of $25,000.
Primary Care See details
The eternalHealth Valor Give Back (HMO-POS) plan covers primary care, including chiropractic, occupational therapy, physician specialist, mental health specialty, psychiatric, physical therapy, telehealth, and opioid treatment program services. Chiropractic services have a $20 copay, and routine chiropractic care has a $25 copay for up to 20 visits per year. Occupational therapy has a $30 copay, and physical therapy has a $30 copay. Mental health, psychiatric, and opioid treatment program services have 20% coinsurance.
Preventive Services See details
The eternalHealth Valor Give Back (HMO-POS) plan covers preventive services, including an annual physical exam and other services not usually covered by Medicare. Kidney Disease Education Services have a 20% coinsurance, and Fitness Benefit is covered. The plan does not cover Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), 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, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), Home and Bathroom Safety Devices and Modifications, and Counseling Services.
Hearing Services See details
Hearing Services include routine hearing exams with a coinsurance of at most 20% and fitting/evaluation for hearing aids. Prescription hearing aids (all types) are covered with a copay between $595 and $895, while inner ear, outer ear, and over the ear prescription hearing aids are not covered; OTC hearing aids are also not covered.
Vision Services See details
The eternalHealth Valor Give Back (HMO-POS) plan covers vision services, including eye exams with a 20% coinsurance. The plan also covers eyewear, including contact lenses, eyeglasses, eyeglass lenses, and eyeglass frames, with a 20% coinsurance and a combined maximum benefit of $200 per year; upgrades are not covered.
Dental Services See details
Dental services are covered under the eternalHealth Valor Give Back (HMO-POS) plan, with a 20% coinsurance for Medicare dental services, and a maximum plan benefit of $2,500.00 per year for other dental services. 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), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are also covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are covered with coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the eternalHealth Valor Give Back (HMO-POS) plan. The coinsurance for these services is between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits are covered by the eternalHealth Valor Give Back (HMO-POS) plan. Durable Medical Equipment has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetics and Medical Supplies, including Medicare-covered prosthetic devices and medical supplies, have a 20% coinsurance. Diabetic Equipment, including Medicare-covered Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services, are covered. There is no copay for these services, but you pay at most 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the eternalHealth Valor Give Back (HMO-POS) plan with no copay and no coinsurance, but authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the eternalHealth Valor Give Back (HMO-POS) plan. The plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but the plan does not cover additional days beyond Medicare coverage or non-Medicare covered stays. You will pay the Medicare-defined cost share for tier 1, and prior authorization is required.
Other Services See details
The eternalHealth Valor Give Back (HMO-POS) plan covers acupuncture with a $25 copay, over-the-counter (OTC) items up to $50 every three months, and a meal benefit for a chronic illness. This plan does not cover Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and other services.
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