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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 2025, 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 4.5 out of 5 stars in 2025.
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 $45.00. 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 $5900.00 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 a variety of benefits, including inpatient hospital stays with a copay, and outpatient services. The plan also covers ambulance services, emergency services, and a range of primary care and specialist visits with copays. Additional benefits include preventive services, hearing and vision care, and dental services. The plan also covers home infusion, dialysis, and medical equipment with varying copays and coinsurance. Other notable services include home health, cardiac rehabilitation, and skilled nursing facility stays.
Inpatient Hospital See details
The Health Plan SecureCare Integrity Plan 2 (HMO) covers inpatient hospital services, including acute and psychiatric care, with a $295 copay for days 1-6, and no copay for days 7-90. Additional days for inpatient hospital-acute are covered with no copay, while non-Medicare-covered stays and upgrades for inpatient hospital-acute, and additional days and non-Medicare-covered stays for inpatient hospital-psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered, including all outpatient hospital services and outpatient substance abuse services. Outpatient hospital services have a copay between $0 and $250, observation services have a $200 copay, and ambulatory surgical center services have a $250 copay. Individual and group sessions for outpatient substance abuse both have a copay of $35. Outpatient blood services are covered, with a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. There is no information about the copay or coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered. Ground ambulance services have a $250 copay, and air ambulance services have a $500 copay, but there is no coinsurance for either. Transportation services to any health-related location are covered for up to 35 round trips per year.
Emergency Services See details
Emergency Services, including urgently needed services, are covered by The Health Plan SecureCare Integrity Plan 2 (HMO) with a $110 copay for emergency services and a $40 copay for urgently needed services; there is no coinsurance. Worldwide Emergency Coverage has a $110 copay, and Worldwide Emergency Transportation has a copay between $250 and $500. Worldwide Urgent Coverage is not covered.
Primary Care See details
The Health Plan SecureCare Integrity Plan 2 (HMO) covers Primary Care Physician Services, Chiropractic Services with a $20 copay, Occupational Therapy Services with a $40 copay, Physician Specialist Services with a $35 copay, Mental Health Specialty Services with a $35 copay, Podiatry Services with a $35 copay, Other Health Care Professional with a $35 copay, Psychiatric Services with a $35 copay, Physical Therapy and Speech-Language Pathology Services with a $40 copay, Additional Telehealth Benefits, and Opioid Treatment Program Services with a $35 copay. Routine Chiropractic Care is not covered.
Preventive Services See details
The Health Plan SecureCare Integrity Plan 2 (HMO) covers preventive services, including Medicare-covered services with prior authorization, annual physical exams, and additional preventive services. The plan also covers health education, Personal Emergency Response System (PERS), Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit, Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit. However, In-Home Safety Assessment, 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, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies, Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
Hearing exams are covered with a $35 copay, including routine hearing exams and fitting/evaluation for hearing aids. Prescription hearing aids (all types) are covered with a copay between $599 and $899 every two years for up to two visits. Prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision Services includes coverage for routine eye exams, eyewear, eyeglass lenses, and eyeglass frames, with no deductible; however, eyeglasses (lenses and frames) and upgrades are not covered. Routine eye exams are covered once per year, and contact lenses are covered with the number of pairs varying on the amount required for annual use. Eyewear has a combined maximum benefit of $200.00 every year.
Dental Services See details
Dental Services are covered, including oral exams with a $35 copay, dental x-rays, prophylaxis, restorative services with a 0%-50% coinsurance, endodontics with a 0%-50% coinsurance, periodontics with a 0%-50% coinsurance, prosthodontics removable with a 0%-50% coinsurance, prosthodontics fixed with a 0%-50% coinsurance, and oral and maxillofacial surgery with a 0%-50% coinsurance. Fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including insulin, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under The Health Plan SecureCare Integrity Plan 2 (HMO). You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. DME has a 20% coinsurance with no copay, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance, while Diabetic Supplies have between 0% and 20% coinsurance, and Medical Supplies have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by The Health Plan SecureCare Integrity Plan 2 (HMO). Diagnostic Procedures/Tests have a $50 copay, while Lab Services are not covered. Diagnostic Radiological Services have no copay, and Therapeutic Radiological Services have 20% coinsurance. Outpatient X-Ray Services have a $50 copay.
Home Health Services See details
Home Health Services are covered by The Health Plan SecureCare Integrity Plan 2 (HMO) with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are generally covered, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required for the services that are covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by The Health Plan SecureCare Integrity Plan 2 (HMO), but require prior authorization. There is no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services include Over-the-Counter (OTC) Items and Meal Benefits, while acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered. The OTC benefit has a maximum coverage amount of $120 every three months. The Meal Benefit requires prior authorization.
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