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Generations Valor (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Generations Valor (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Generations Valor (HMO-POS) in 2025, please refer to our full plan details page.
Generations Valor (HMO-POS) is a HMO-POS plan offered by MHH Healthcare, L.P. available for enrollment in 2025 to people living in Oklahoma (Partial). This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Generations Valor (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 Generations Valor (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 Generations Valor (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 $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 combined Maximum Out-Of-Pocket cost of $4900.00 (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 $4900.00 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 Generations Valor (HMO-POS).
Additional Benefits
The Generations Valor (HMO-POS) plan offers a variety of benefits including inpatient and outpatient hospital services, with copays varying by service. Emergency, urgent, and primary care services are covered with copays, and preventive services are available with no copay. This plan includes coverage for hearing, vision, and dental services, with specific copays and maximum benefits for each. Additionally, it provides coverage for ambulance and transportation services, along with home health, skilled nursing, and home infusion services, subject to certain conditions.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you will pay a $295 copay for days 1-7, and no copay for days 8-90, while for Inpatient Hospital Psychiatric, you will pay a $295 copay for days 1-7 and no copay for days 8-90. Additional days for Inpatient Hospital-Acute are covered, and Non-Medicare-covered stays and Upgrades for Inpatient Hospital-Acute are not covered, while additional days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered by Generations Valor (HMO-POS), with copays ranging from $15 to $320 for Outpatient Hospital Services, a $300 copay for Observation Services, and a $250 copay for Ambulatory Surgical Center Services. Outpatient Substance Abuse services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by Generations Valor (HMO-POS) with a $55 copay, but requires prior authorization and a doctor referral.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered. Ground ambulance services have a $240 copay, while air ambulance services have a 20% coinsurance. Transportation services to a plan-approved health-related location are covered for up to 24 one-way trips per year, but transportation services to any other health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered by Generations Valor (HMO-POS), each with a copay of $90, $15, and $90, respectively, and no coinsurance. Worldwide Emergency Transportation is not covered.
Primary Care See details
The Generations Valor (HMO-POS) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, other health care professional services, physical therapy, and speech-language pathology services. Chiropractic services have a $20 copay, while occupational therapy services, and physical therapy and speech-language pathology services have a $20 copay. Physician specialist services have a $35 copay. Individual and group sessions for mental health specialty services, routine chiropractic care, individual and group sessions for psychiatric services, and podiatry services are not covered.
Preventive Services See details
The Generations Valor (HMO-POS) plan covers preventive services, including Medicare-covered services with no copay. Additional preventive services such as Personal Emergency Response System (PERS), Fitness Benefit, In-Home Support Services, Remote Access Technologies, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are covered. Health Education, 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, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
Hearing Services includes hearing exams with no copay, and prescription hearing aids with a maximum benefit of $1,000 per year for all types, but does not cover OTC hearing aids, or prescription hearing aids for the inner or outer ear. Routine hearing exams and fitting/evaluation for hearing aids are covered once per year.
Vision Services See details
The Generations Valor (HMO-POS) plan covers vision services, including eye exams and eyewear. Eyewear has a combined maximum benefit of $300 every year, and contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames are unlimited. However, upgrades are not covered.
Dental Services See details
The Generations Valor (HMO-POS) plan covers dental services, including oral exams with a $35 copay, dental x-rays, other diagnostic dental services, prophylaxis (cleaning) and fluoride treatment. Restorative services have 0% - 20% coinsurance, and endodontics, prosthodontics, maxillofacial prosthetics, prosthodontics, fixed, and oral and maxillofacial surgery have 20% coinsurance. Implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Generations Valor (HMO-POS) plan, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay and between 0-20% coinsurance, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have between 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Generations Valor (HMO-POS) plan, but require prior authorization and a doctor's referral. The coinsurance for this service is between 0% and 20%.
Medical Equipment See details
Medical Equipment benefits for Generations Valor (HMO-POS) include Durable Medical Equipment (DME) with 20% coinsurance and no copay, Prosthetics/Medical Supplies with 0-20% coinsurance and no copay, and Diabetic Equipment, with no copay. Durable Medical Equipment for use outside the home, and Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for Diagnostic Procedures/Tests with a copay between $0 and $100, and Lab Services with a $5 copay. Diagnostic Radiological Services have a copay of at most $250, and Therapeutic Radiological Services have a copay of at most $50, with a minimum copay of $50. Outpatient X-Ray Services are not covered.
Home Health Services See details
Home Health Services are covered by the Generations Valor (HMO-POS) plan with no copay and no coinsurance, but require both authorization and a referral. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but all sub-services including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization and a doctor referral are required for the covered services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Generations Valor (HMO-POS), with a doctor referral and prior authorization required. There is no copay for days 1-20, and a $184 copay for days 21-100.
Other Services See details
The Generations Valor (HMO-POS) plan covers Over-the-Counter (OTC) items with a maximum benefit of $100 every three months, and also covers meal benefits requiring prior authorization. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered.
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