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The Health Plan SecureCare Integrity Plan 2 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for The Health Plan SecureCare Integrity Plan 2 (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on The Health Plan SecureCare Integrity Plan 2 (HMO) in 2026, please refer to our full plan details page.
The Health Plan SecureCare Integrity Plan 2 (HMO) is a HMO plan offered by The Health Plan of West Virginia, Inc. available for enrollment in 2025 to people living in Kanawha and Surrounding Counties. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that The Health Plan SecureCare Integrity Plan 2 (HMO) 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 The Health Plan SecureCare Integrity Plan 2 (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 The Health Plan SecureCare Integrity Plan 2 (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 $75.00. 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 Maximum Out-Of-Pocket cost of $6700.00 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 The Health Plan SecureCare Integrity Plan 2 (HMO)
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Drug Coverage
Prescription drugs are not covered by The Health Plan SecureCare Integrity Plan 2 (HMO).
Additional Benefits
The Health Plan SecureCare Integrity Plan 2 (HMO) offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, preventive services, and home health care. Specialist visits require a $45 copay, while inpatient hospital stays carry a $345 daily copay for days one through six and no copay for subsequent days. Emergency room visits have a $115 copay, and outpatient hospital services range from no copay up to a $325 copay with no coinsurance. For extra benefits, routine vision exams and preventive dental care are covered with no copay, and the plan includes a $200 annual eyewear allowance and up to $1,500 for comprehensive dental services. Routine hearing exams require a $20 copay, whereas major medical needs like durable medical equipment and dialysis services require a 20% coinsurance with no copay. Members also receive over-the-counter items and chronic illness meals with no copay and no coinsurance.
Inpatient Hospital See details
Inpatient hospital services are covered by The Health Plan SecureCare Integrity Plan 2 (HMO) with no coinsurance, though prior authorization is required. For acute stays, there is a $345 copay per day for days 1 through 6 and no copay for day 7 and beyond, while psychiatric stays require a $300 copay per day for days 1 through 6 and no copay for days 7 through 90. Please note that upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
The Health Plan SecureCare Integrity Plan 2 (HMO) covers outpatient services with no coinsurance, featuring copays of $0 to $325 for outpatient hospital services and $325 per stay for observation services. Ambulatory surgical center services require a $300 copay with no coinsurance, outpatient substance abuse sessions have a $45 copay with no coinsurance, and outpatient blood services are provided with no copay or coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by The Health Plan SecureCare Integrity Plan 2 (HMO) with no copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
The Health Plan SecureCare Integrity Plan 2 (HMO) covers ambulance services with no coinsurance, requiring a $275 copay for ground transport and a $500 copay for air transport, with prior authorization required. Transportation services are not covered under this plan.
Emergency Services See details
The Health Plan SecureCare Integrity Plan 2 (HMO) covers emergency services with a $115 copay and no coinsurance, and urgently needed services with a $40 copay and no coinsurance. Worldwide emergency services are partially covered up to a $25,000 limit with no coinsurance, featuring a $115 copay for emergency care and a $275 to $500 copay for emergency transportation, while worldwide urgent care is not covered.
Primary Care See details
The Health Plan SecureCare Integrity Plan 2 (HMO) provides primary care and telehealth services with no copay and no coinsurance. Specialist visits, mental health sessions, and podiatry care require a $45 copay, while physical and occupational therapy require a $40 copay, all with no coinsurance; chiropractic services are not covered.
Preventive Services See details
Preventive services under The Health Plan SecureCare Integrity Plan 2 (HMO) are covered with no copay and no coinsurance, including annual physical exams, kidney disease education, and various screenings. Additional preventive benefits are partially covered with no copay and no coinsurance, but do not cover in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, remote access, home safety modifications, or counseling.
Hearing Services See details
Hearing services are covered by The Health Plan SecureCare Integrity Plan 2 (HMO), including annual routine hearing exams for a $20 copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $399 to $899 for up to two devices every two years, while inner ear, outer ear, over the ear, and over-the-counter (OTC) hearing aids are not covered.
Vision Services See details
The Health Plan SecureCare Integrity Plan 2 (HMO) offers partially covered vision services with no copay and no coinsurance, featuring one routine eye exam per year and a $200 annual allowance for eyewear including lenses, frames, and contact lenses. Other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services covered by The Health Plan SecureCare Integrity Plan 2 (HMO) include Medicare-covered dental for a $45 copay and no coinsurance, alongside preventive cleanings, exams, and x-rays for no copay and no coinsurance. Comprehensive services like restorative, endodontics, periodontics, prosthodontics, and oral surgery are covered up to $1,500 annually with no copay and 0% to 50% coinsurance, though fluoride, implants, orthodontics, maxillofacial prosthetics, adjunctive general, and other diagnostic or preventive services are not covered.
Home Infusion bundled Services See details
The Health Plan SecureCare Integrity Plan 2 (HMO) covers Home Infusion bundled Services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs have no copay and a coinsurance ranging from 0% to 20%, while Part B insulin drugs require a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered under The Health Plan SecureCare Integrity Plan 2 (HMO) with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment benefits under The Health Plan SecureCare Integrity Plan 2 (HMO) are covered with no copays, though prior authorization is required. Durable medical equipment, prosthetics, 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 covered by The Health Plan SecureCare Integrity Plan 2 (HMO), though diagnostic services are only partially covered because lab services are not covered. Under this plan, diagnostic procedures require a $50 copay and no coinsurance, while radiological services require prior authorization and range from no copay or coinsurance for diagnostic radiology to a $50 copay for X-rays and a 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are fully covered under The Health Plan SecureCare Integrity Plan 2 (HMO) with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
The Health Plan SecureCare Integrity Plan 2 (HMO) technically offers Cardiac Rehabilitation Services with no copay and no coinsurance, but the benefit is not covered in practice. Specifically, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by The Health Plan SecureCare Integrity Plan 2 (HMO) with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
The Health Plan SecureCare Integrity Plan 2 (HMO) partially covers Other Services, which feature over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan.
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