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DrPlus-B (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DrPlus-B (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DrPlus-B (HMO D-SNP) in 2025, please refer to our full plan details page.
DrPlus-B (HMO D-SNP) is a HMO D-SNP plan offered by DOCTORS HEALTHCARE PLANS, INC. available for enrollment in 2025 to people living in Broward County. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that DrPlus-B (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
DrPlus-B (HMO D-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 DrPlus-B (HMO D-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 DrPlus-B (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $13.70. 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 $3750.00 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 DrPlus-B (HMO D-SNP) plan has a deductible of $590.00. During the initial coverage phase, after you meet your deductible, you will pay 25% coinsurance for most drugs depending on the pharmacy. For specialty tier drugs, you will have no copay. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The DrPlus-B (HMO D-SNP) plan offers a wide range of benefits, including coverage for inpatient and outpatient services, emergency services, primary care, preventive services, hearing, vision, and dental. The plan also covers ambulance and transportation services, with a $50 copay for ground ambulance and 20% coinsurance for air ambulance. This plan provides no copay for many services, including routine hearing exams, and fitting/evaluation for hearing aids, and home health services. The plan does include copays for ground ambulance services ($50) and emergency services ($100). Some services require prior authorization, and some services may include coinsurance between 0% and 20%.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. Additional Days for Inpatient Hospital-Acute and Upgrades for Inpatient Hospital-Acute are covered, but Non-Medicare-covered Stay for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered by the DrPlus-B (HMO D-SNP) plan, including outpatient hospital services, observation services, ambulatory surgical center services, and outpatient blood services. Outpatient substance abuse services are partially covered, but individual and group sessions are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the DrPlus-B (HMO D-SNP) plan, but requires prior authorization. The plan does not specify the cost of this benefit, including copay and coinsurance.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by DrPlus-B (HMO D-SNP), including ground ambulance services with a $50 copay, and air ambulance services with 20% coinsurance. Transportation Services to a plan-approved health-related location are covered, and transportation to any other health-related location is not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services and Worldwide Emergency Services, are covered by the DrPlus-B (HMO D-SNP) plan. Emergency Services have a $100 copay, while Urgently Needed Services have no copay, and Worldwide Emergency Services are covered up to $50,000. Worldwide Emergency Transportation is not covered.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered, but Individual and Group Sessions for Mental Health Specialty Services, Individual and Group Sessions for Psychiatric Services are not covered. Routine Chiropractic Care is limited to 12 visits per year.
Preventive Services See details
The DrPlus-B (HMO D-SNP) plan covers preventive services, including health education, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit. Some services are not covered, including the annual physical exam, in-home safety assessments, and more.
Hearing Services See details
Hearing Services includes coverage for routine hearing exams and fitting/evaluation for hearing aids, with no copay or coinsurance. Prescription hearing aids are covered up to $1500 every two years, but inner ear, outer ear, and over-the-ear hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision Services includes coverage for eye exams, with one routine eye exam covered every year, and eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades. The plan offers a combined maximum benefit of $350 per year for all eyewear.
Dental Services See details
The DrPlus-B (HMO D-SNP) plan covers a range of dental services, including oral exams, dental x-rays, prophylaxis (cleaning), and fluoride treatments, with specific limits on the number of visits per year or the number of x-rays. Restorative services, endodontics, periodontics, prosthodontics (removable), implant services, and oral and maxillofacial surgery are also covered, however, adjunctive general services, maxillofacial prosthetics, prosthodontics (fixed), and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the DrPlus-B (HMO D-SNP) plan, with prior authorization required. For Medicare Part B insulin drugs, there is a $35 copay with a coinsurance between 0% and 20%. Other Medicare Part B drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization and a doctor referral. You will pay a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a coinsurance between 0% and 20%, prosthetics with a coinsurance between 0% and 20%, and diabetic supplies with a coinsurance between 0% and 20%. Durable Medical Equipment for use outside the home and medical supplies are not covered, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are not covered by the DrPlus-B (HMO D-SNP) plan. While the plan states that these services are covered, none of the sub-services are covered, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services.
Home Health Services See details
Home Health Services are covered by the DrPlus-B (HMO D-SNP) plan with no copay and no coinsurance, though authorization and a referral are required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization and a doctor referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. Prior authorization is required.
Other Services See details
Other Services are partially covered by DrPlus-B (HMO D-SNP), but acupuncture, over-the-counter items, 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 plan provides a meal benefit for a chronic illness, but requires prior authorization and a doctor's referral.
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