A non-government entity
Paramount Elite Enhanced (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Paramount Elite Enhanced (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Paramount Elite Enhanced (HMO-POS) in 2026, please refer to our full plan details page.
Paramount Elite Enhanced (HMO-POS) is a HMO-POS plan offered by MEDICAL MUTUAL OF OHIO available for enrollment in 2025 to people living in Greater Toledo OH and select SE MI counties. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Paramount Elite Enhanced (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 Paramount Elite Enhanced (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 Paramount Elite Enhanced (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $74.00. 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 a $55.00 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 $3700.00 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 Paramount Elite Enhanced (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 Paramount Elite Enhanced (HMO-POS) Medicare plan features a low annual drug deductible of $55. Under this plan, you will enjoy no copay for both Tier 1 (Preferred Generic) and Tier 2 (Generic) medications when using standard retail pharmacies or standard mail-order services. For higher-tier medications, cost-sharing is based on coinsurance for both standard pharmacies and mail-order options. You will pay a 21% coinsurance for Tier 3 (Preferred Brand) drugs, a 40% coinsurance for Tier 4 (Non-Preferred) drugs, and a 32% coinsurance for Tier 5 (Specialty) drugs.
Additional Benefits
The Paramount Elite Enhanced (HMO-POS) plan offers comprehensive medical coverage with predictable out-of-pocket costs, featuring no copay and no coinsurance for primary care visits, select telehealth, and home health services. Specialist visits and physical therapy require low copays ranging from $25 to $30 with no coinsurance, while inpatient hospital stays cost a $225 daily copay for the first five days and no copay for days six through ninety. Emergency care is covered with a $150 copay, and urgent care visits carry a $35 copay, both with no coinsurance. This plan also provides valuable supplemental benefits, including preventive and comprehensive dental care with no copay and no coinsurance up to a $4,500 annual limit. Routine vision exams, eyewear, and hearing aid fittings are available with no copay, while prescription hearing aids require a copay between $499 and $999. Additionally, members receive a $135 quarterly over-the-counter allowance and up to 24 one-way transportation trips per year to plan-approved locations with no copay.
Inpatient Hospital See details
Paramount Elite Enhanced (HMO-POS) covers inpatient acute and psychiatric hospital services with no coinsurance, requiring a copay of $225 per day for days 1 through 5 and no copay for days 6 through 90. While unlimited additional acute care days are covered with no copay, prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Paramount Elite Enhanced (HMO-POS) covers outpatient services with no coinsurance, featuring a $0 to $225 copay for outpatient hospital services and a $225 copay per stay for observation services. Ambulatory surgical center and blood services have no copay and no coinsurance, while outpatient substance abuse services carry a $30 copay and no coinsurance.
Partial Hospitalization See details
Paramount Elite Enhanced (HMO-POS) covers partial hospitalization services with a $30.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Paramount Elite Enhanced (HMO-POS) covers ground and air ambulance services with a $260 copay and no coinsurance. Transportation services are partially covered with no copay and no coinsurance for up to 24 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
Paramount Elite Enhanced (HMO-POS) covers emergency services with a $150 copay (waived if admitted to the hospital within one day) and urgently needed services with a $35 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with a $150 copay and no coinsurance, up to a maximum plan benefit limit of $25,000.
Primary Care See details
Paramount Elite Enhanced (HMO-POS) covers primary care physician visits and select telehealth services with no copay and no coinsurance. Specialist visits, physical therapy, and mental health services require copays ranging from $25 to $30 with no coinsurance, though routine chiropractic care is not covered.
Preventive Services See details
Paramount Elite Enhanced (HMO-POS) partially covers preventive services with no coinsurance and no copay for most services, though remote access technologies range from no copay to a $30 copay. Sub-services not covered under this plan include in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, telemonitoring, and counseling.
Hearing Services See details
Hearing services are covered by Paramount Elite Enhanced (HMO-POS), including annual routine and Medicare-covered exams for a $30 copay and no coinsurance, and one annual fitting evaluation with no copay and no coinsurance. Prescription hearing aids are partially covered with a $499 to $999 copay and no coinsurance for up to two devices per year, while OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Paramount Elite Enhanced (HMO-POS), offering routine eye exams (one per year) and eyewear with no copay and no coinsurance, subject to a $200 annual combined maximum for contact lenses and eyeglasses. Other eye exam services, individual eyeglass lenses, individual eyeglass frames, and upgrades are not covered by the plan.
Dental Services See details
Dental services are partially covered by Paramount Elite Enhanced (HMO-POS) with no copay and no coinsurance for covered benefits up to a $4,500 annual maximum. While preventive and comprehensive services like cleanings, exams, and select restorative procedures are covered, other diagnostic dental services, other preventive dental services, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Paramount Elite Enhanced (HMO-POS) covers Home Infusion bundled Services with no copay, though prior authorization and step therapy are required. Under this benefit, Medicare Part B chemotherapy and other drugs have no copay and 0% to 20% coinsurance, while insulin is covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Paramount Elite Enhanced (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Paramount Elite Enhanced (HMO-POS) covers medical equipment with no copays, featuring a 0% to 35% coinsurance for durable medical equipment and a 20% coinsurance for prosthetics and medical supplies. Covered diabetic supplies have a 0% to 20% coinsurance, while diabetic therapeutic shoes and inserts require no coinsurance.
Diagnostic and Radiological Services See details
Paramount Elite Enhanced (HMO-POS) partially covers diagnostic and radiological services, as lab services are not covered. Diagnostic procedures and outpatient X-rays require a $10 copay with no coinsurance, diagnostic radiological services have no copay or coinsurance, and therapeutic radiological services carry a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Paramount Elite Enhanced (HMO-POS) with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Paramount Elite Enhanced (HMO-POS) plan. This includes intensive cardiac, pulmonary, and supervised exercise therapy (SET) services, which are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
Paramount Elite Enhanced (HMO-POS) covers skilled nursing facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $218 copay for days 21 through 100. Prior authorization is required, a three-day prior hospital stay is not required, and additional days beyond the standard 100 days are not covered.
Other Services See details
Paramount Elite Enhanced (HMO-POS) partially covers other services, offering a meal benefit for chronic illnesses and up to $135 every three months for over-the-counter items with no copay and no coinsurance. Acupuncture is not covered under this plan, and prior authorization is required for the meal benefit.
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