A non-government entity
DrSelect (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DrSelect (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DrSelect (HMO) in 2026, please refer to our full plan details page.
DrSelect (HMO) is a HMO plan offered by DOCTORS HEALTHCARE PLANS, INC. available for enrollment in 2025 to people living in Miami Dade and Broward County. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that DrSelect (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about DrSelect (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 DrSelect (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 $10.00. 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.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3000.00 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 DrSelect (HMO) Medicare plan offers a $0 drug deductible, allowing your prescription coverage to begin immediately without any upfront out-of-pocket deductible costs. There is no copay for Tier 1 preferred generics, Tier 2 generics, Tier 3 preferred brand drugs, and Tier 6 supplemental drugs when using standard pharmacies or standard mail order services. This zero-cost benefit applies to one-month, two-month, and three-month supplies. For Tier 4 non-preferred drugs, standard pharmacy and mail order copays are $55 for a one-month supply, $110 for a two-month supply, and $165 for a three-month supply. Tier 5 specialty drugs require a 33% coinsurance for a one-month supply through standard pharmacies or standard mail order.
Additional Benefits
DrSelect (HMO) offers robust medical coverage with no copays or coinsurance for inpatient hospital stays, primary care visits, specialist consultations, and home health services. Outpatient services are highly affordable, featuring a $75 copay for hospital visits, a $50 copay for ambulatory surgical centers, and a $100 copay for emergency room visits which is waived upon admission. Urgent care, routine preventive care, and cardiac rehabilitation are also covered with no copays or coinsurance. Supplemental benefits include dental, vision, and hearing care with no copays, featuring a $400 annual eyewear allowance and a $1,350 hearing aid benefit every two years. Members also enjoy unlimited free transportation to plan-approved health locations and skilled nursing facility care with no copay for the first 20 days.
Inpatient Hospital See details
DrSelect (HMO) covers inpatient acute and psychiatric hospital services with no copay and no coinsurance, although prior authorization is required. This benefit is partially covered, as unlimited additional days are included for acute care, but non-Medicare-covered stays and additional psychiatric days are not covered.
Outpatient Services See details
DrSelect (HMO) covers outpatient hospital services with a $75 copay and ambulatory surgical center services with a $50 copay, both with no coinsurance. Outpatient blood services are covered with no copay and no coinsurance, and while some outpatient substance abuse services are covered with no copay or coinsurance, individual and group sessions are not covered.
Partial Hospitalization See details
Partial hospitalization services are covered by DrSelect (HMO) with no copay and no coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
DrSelect (HMO) covers ambulance services with prior authorization, requiring a $125 copay for ground ambulance and a 20% coinsurance for air ambulance. Transportation services are partially covered, offering unlimited round trips to plan-approved health-related locations with no copay or coinsurance, though trips to any other health-related locations are not covered.
Emergency Services See details
DrSelect (HMO) covers emergency services with a $100 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours, and urgently needed services with no copay and no coinsurance. Worldwide emergency services are partially covered up to a $50,000 maximum benefit with no coinsurance, featuring a $125 copay for emergency care and a $25 copay for urgent care, though worldwide emergency transportation is not covered.
Primary Care See details
DrSelect (HMO) covers primary care, specialist, therapy, and podiatry services with no copay and no coinsurance, though chiropractic care is only partially covered as other chiropractic services are excluded. For mental health and psychiatric benefits, some services are covered, but individual and group sessions are not covered.
Preventive Services See details
Preventive services are partially covered by DrSelect (HMO) with no copay and no coinsurance for covered benefits like Medicare-covered zero-dollar services, kidney disease education, health education, and fitness benefits. However, several sub-services are not covered under this plan, including annual physical exams, in-home safety assessments, personal emergency response systems, and medical nutrition therapy.
Hearing Services See details
Hearing Services are covered by DrSelect (HMO) with no copay, no coinsurance, and no deductible for routine exams and prescription hearing aids, which feature a $1,350 maximum benefit limit every two years. This benefit is partially covered, as OTC hearing aids, as well as inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered.
Vision Services See details
DrSelect (HMO) vision services are partially covered with no copay, no coinsurance, and no deductible, though other eye exam services are not covered. Covered benefits include one routine eye exam per year and up to $400 annually for eyewear, including contacts, frames, lenses, and upgrades, at no copay or coinsurance.
Dental Services See details
DrSelect (HMO) dental services are partially covered with no copay and no coinsurance for covered benefits, though prior authorization is required for certain services. Sub-services that are not covered include other diagnostic dental, other preventive dental, adjunctive general, maxillofacial prosthetics, fixed prosthodontics, and orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by DrSelect (HMO) with no copay, though prior authorization and step therapy may apply. Associated Medicare Part B chemotherapy and other drugs have a coinsurance of 0% to 20%, while Part B insulin is covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by DrSelect (HMO) with no copay and a 20% coinsurance, though prior authorization and a referral are required.
Medical Equipment See details
Medical Equipment is partially covered under the DrSelect (HMO) plan, featuring no copay and coinsurance ranging from no coinsurance up to 20% for covered items, with prior authorization required. While durable medical equipment, prosthetic devices, and diabetic supplies are covered, medical supplies and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered under DrSelect (HMO), with diagnostic services requiring a referral and having no copay or coinsurance, though lab services and diagnostic procedures or tests are not covered. Radiological services require referrals and prior authorization, offering diagnostic radiological services with no copay and therapeutic radiological services with a 20% coinsurance, while outpatient X-ray services are not covered.
Home Health Services See details
Home health services are fully covered under the DrSelect (HMO) plan with no copay and no coinsurance, although prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by DrSelect (HMO) with no copay and no coinsurance, though prior authorization and a referral are required. While some services are covered, Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
DrSelect (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $60 daily copay for days 21 through 100. Prior authorization is required, though a prior three-day inpatient hospital stay is not.
Other Services See details
DrSelect (HMO) partially covers other services, offering acupuncture for up to 20 treatments per year and chronic illness meal benefits with no copay and no coinsurance, though prior authorization and referrals are required. Over-the-counter (OTC) items are not covered under this plan.
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