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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 2025, 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 2025.
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 $49.80. 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 $590.00 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 $9350.00 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 American Health Advantage of Oklahoma (HMO I-SNP)
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Drug Coverage
The American Health Advantage of Oklahoma (HMO I-SNP) plan has a $590 deductible for prescription drugs. After meeting the deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000, at which point you enter the next coverage phase. This plan's premium may be reduced if you qualify for the low-income subsidy. The plan does not provide information on the costs associated with each drug tier. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The American Health Advantage of Oklahoma (HMO I-SNP) plan offers a range of benefits with varying cost-sharing options. Many services have no copay, including primary care visits, preventive services, hearing exams, and home health services. The plan also covers a variety of services with coinsurance, such as outpatient, partial hospitalization, ambulance, emergency, and vision services, as well as home infusion bundled services. This plan provides coverage for hospital stays, outpatient services, and skilled nursing facilities. Other key benefits include hearing, vision, and dental services, with specific copays and coinsurance amounts depending on the service. Be aware that some services, such as Cardiac Rehabilitation Services and many "other services" are not covered by this plan.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered, but Additional Days, Non-Medicare-covered Stays, and Upgrades for Acute are not covered. For Acute and Psychiatric, you will pay the Medicare-defined cost share for tier 1, and the copay information is provided separately.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services and Observation Services with a 20% coinsurance, Ambulatory Surgical Center (ASC) Services, and Outpatient Substance Abuse Services with 20% coinsurance for both individual and group sessions; however, Outpatient Blood Services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by American Health Advantage of Oklahoma (HMO I-SNP). The plan has a 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by American Health Advantage of Oklahoma (HMO I-SNP), including ground and air ambulance services with a 20% coinsurance, and transportation services to plan-approved health-related locations with no copay for up to 34 one-way trips per month. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered by American Health Advantage of Oklahoma (HMO I-SNP) with a 20% coinsurance, but no copay. Urgently Needed Services are also covered with a 20% coinsurance, but no copay. Worldwide Emergency Services are not covered.
Primary Care See details
The American Health Advantage of Oklahoma (HMO I-SNP) plan covers primary care physician services with no copay, and chiropractic services with 20% coinsurance. Occupational therapy services are covered, with a coinsurance that can range from 0% to 20%. Physician specialist services, mental health specialty services, and psychiatric services are covered with a coinsurance that can range from 0% to 20%, while podiatry services have a coinsurance that can range from 0% to 20% and no copay. Physical therapy and speech-language pathology services are covered with a coinsurance that can range from 0% to 20%. The plan also covers additional telehealth benefits with no copay, and opioid treatment program services with no copay.
Preventive Services See details
Preventive Services are covered, including Medicare-covered zero dollar services, with no copay. Annual physical exams, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, 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 benefits, home-based palliative care, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, fitness benefits, 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 and prescription hearing aids are covered. Routine hearing exams have no copay and a 20% coinsurance, and fitting/evaluation for hearing aids has no copay and no coinsurance. Prescription hearing aids (all types) have no copay and are limited to 2 per year, but prescription hearing aids for the inner ear, outer ear, and over-the-ear are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services include coverage for eye exams and eyewear. Eye exams have a 20% coinsurance for routine eye exams, and no copay. Eyewear has a 20% coinsurance, and a $0 copay for contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, with a combined maximum benefit of $300 per year.
Dental Services See details
Dental Services are partially covered by the American Health Advantage of Oklahoma (HMO I-SNP) plan, with a 20% coinsurance for Medicare Dental Services. Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics, Maxillofacial Prosthetics, Implant Services, Prosthodontics, fixed, Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with coinsurance between 0% and 20%. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered, with a coinsurance of 20%.
Medical Equipment See details
Medical Equipment benefits include coverage for Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, and Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies have a 20% coinsurance for Medicare-covered devices and supplies. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services. Diagnostic Procedures/Tests, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have a coinsurance of at most 20%, while Lab Services have no copay.
Home Health Services See details
Home Health Services are covered by the American Health Advantage of Oklahoma (HMO I-SNP) with no copay and no coinsurance, though additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the American Health Advantage of Oklahoma (HMO I-SNP) plan. Prior authorization is required for these services, but the plan does not cover the services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the American Health Advantage of Oklahoma (HMO I-SNP) plan, with prior authorization required. There is no copay for days 1-100 of SNF services, and additional days beyond Medicare-covered SNF stays are not covered.
Other Services See details
Other Services are not covered, including acupuncture, over-the-counter items, meal benefits, 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. Dual Eligible SNPs with Highly Integrated Services are also not covered.
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