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American Health Advantage of Oklahoma (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for American Health Advantage of Oklahoma (HMO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on American Health Advantage of Oklahoma (HMO I-SNP) in 2026, please refer to our full plan details page.
American Health Advantage of Oklahoma (HMO I-SNP) is a HMO I-SNP plan offered by Mitchell Family Office available for enrollment in 2025 to people living in Central and East Oklahoma. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that American Health Advantage of Oklahoma (HMO I-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
American Health Advantage of Oklahoma (HMO I-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about American Health Advantage of Oklahoma (HMO I-SNP).
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 American Health Advantage of Oklahoma (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $28.20. 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 $615.00 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 $9250.00 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:
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Drug Coverage
The American Health Advantage of Oklahoma (HMO I-SNP) Medicare plan features an annual prescription drug deductible of $615. This deductible represents the amount you must pay out-of-pocket for your covered medications before the plan begins to pay its share of the costs. Specific drug tier details, including exact copayments and coinsurance rates for individual medications, are not currently available for this plan. To determine your actual out-of-pocket prescription costs, it is recommended to verify your specific medication list directly with the plan's formulary.
Additional Benefits
The American Health Advantage of Oklahoma (HMO I-SNP) offers robust medical coverage with many essential services featuring no copays. You will pay no copay and no coinsurance for primary care doctor visits, home health services, and skilled nursing facility stays up to 100 days. Outpatient hospital care, emergency services, and ambulance transport generally require no copay and a 20% coinsurance. Additional benefits include up to 32 free one-way transportation trips per month to plan-approved locations. While routine dental care is not covered, the plan provides coverage for routine vision and hearing exams with no copay and a 20% coinsurance, as well as allowances for eyewear and prescription hearing aids. Durable medical equipment and dialysis are also covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
American Health Advantage of Oklahoma (HMO I-SNP) partially covers inpatient acute and psychiatric hospital services, requiring prior authorization and Medicare-defined copayments with no coinsurance. Additional hospital days, non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
American Health Advantage of Oklahoma (HMO I-SNP) covers outpatient services, including outpatient hospital, ambulatory surgical center, substance abuse, and blood services, with no copay and a 20% coinsurance. Prior authorization is required for outpatient hospital, observation, and ambulatory surgical center services.
Partial Hospitalization See details
American Health Advantage of Oklahoma (HMO I-SNP) covers partial hospitalization with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by American Health Advantage of Oklahoma (HMO I-SNP), with ground and air ambulance services requiring a 20% coinsurance and no copay. Transportation services are partially covered with no copay and no coinsurance for up to 32 one-way trips per month to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
American Health Advantage of Oklahoma (HMO I-SNP) covers emergency and urgently needed services with a 20% coinsurance and no copay, with costs counting toward your plan-level deductible. The coinsurance is waived if you are admitted to the hospital within one day, but worldwide emergency, urgent, and transportation services are not covered.
Primary Care See details
American Health Advantage of Oklahoma (HMO I-SNP) covers primary care physician services, telehealth, and opioid treatment with no copay and no coinsurance. Specialist visits, physical and occupational therapies, mental health services, and podiatry are covered with no copay and 0% to 20% coinsurance, while chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by American Health Advantage of Oklahoma (HMO I-SNP), featuring no copay and no coinsurance for covered options like kidney disease education, in-home support, glaucoma screenings, and diabetes self-management training. Specific services not covered under this plan include annual physical exams, fitness benefits, health education, and in-home safety assessments.
Hearing Services See details
American Health Advantage of Oklahoma (HMO I-SNP) covers hearing services with no deductible, offering routine exams with a 20% coinsurance and no copay, and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to a $500 annual maximum per ear, but OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
American Health Advantage of Oklahoma (HMO I-SNP) offers partially covered vision services, including one annual routine eye exam with no copay and 20% coinsurance, while other eye exam services are not covered. Eyewear is covered up to a $300 annual maximum with no copay and 20% coinsurance for contact lenses, and no copay and no coinsurance for eyeglasses, lenses, frames, and upgrades.
Dental Services See details
American Health Advantage of Oklahoma (HMO I-SNP) partially covers dental services, offering coverage only for Medicare-covered dental benefits with no copay and a 20% coinsurance. Routine and comprehensive dental services, including preventive care like oral exams, cleanings, and x-rays, as well as restorative services, endodontics, periodontics, and orthodontics, are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by American Health Advantage of Oklahoma (HMO I-SNP) with no copay, though prior authorization is required. Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the American Health Advantage of Oklahoma (HMO I-SNP) plan with no copay and a 20% coinsurance.
Medical Equipment See details
American Health Advantage of Oklahoma (HMO I-SNP) covers durable medical equipment, prosthetics, and medical supplies with no copay and 20% coinsurance. Diabetic equipment, supplies, and therapeutic shoes or inserts are also covered with no copay and no coinsurance, though prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by American Health Advantage of Oklahoma (HMO I-SNP) subject to prior authorization. Outpatient diagnostic procedures and tests require a copayment and a minimum 20% coinsurance, lab services feature no copay, and radiological, therapeutic, and X-ray services carry a minimum 20% coinsurance with no copay.
Home Health Services See details
Home Health Services are covered under the American Health Advantage of Oklahoma (HMO I-SNP) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by American Health Advantage of Oklahoma (HMO I-SNP) with no copay and require prior authorization. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
American Health Advantage of Oklahoma (HMO I-SNP) covers Skilled Nursing Facility (SNF) services for days 1 through 100 with no copay and no coinsurance, though prior authorization is required. A prior three-day inpatient hospital stay is not required for admission, but additional days beyond the standard 100-day Medicare limit are not covered.
Other Services See details
Other Services are covered under the American Health Advantage of Oklahoma (HMO I-SNP), but in practice, some services are covered while acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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