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DrSelect-CFL (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DrSelect-CFL (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DrSelect-CFL (HMO) in 2026, please refer to our full plan details page.
DrSelect-CFL (HMO) is a HMO plan offered by DOCTORS HEALTHCARE PLANS, INC. available for enrollment in 2026 to people living in Counties: HSB, ORG, OSC, PSC, PLK, SEM. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that DrSelect-CFL (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-CFL (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-CFL (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.
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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3500.00 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-CFL (HMO) Medicare plan features a $0 drug deductible, meaning your prescription coverage begins immediately without any upfront out-of-pocket costs. Under this plan, you will pay no copay for Tier 1 preferred generics, Tier 2 generics, Tier 3 preferred brands, and Tier 6 supplemental drugs filled at standard pharmacies or through mail order. This exceptional benefit applies to one-month, two-month, and three-month supplies, offering significant savings on a wide variety of medications. For higher-tier medications, Tier 4 non-preferred drugs require a copay of $55 for a one-month supply, $110 for a two-month supply, and $165 for a three-month supply. Tier 5 specialty drugs are subject to a 33% coinsurance for a one-month supply through standard pharmacies and mail order. This clear cost structure helps DrSelect-CFL (HMO) members easily estimate and manage their monthly prescription expenses.
Additional Benefits
The DrSelect-CFL (HMO) plan offers comprehensive medical coverage with no copay or coinsurance for primary care visits, specialist consultations, telehealth, and home health services. For hospital stays, members pay no copay for inpatient days 1 through 3 and 12 through 90, alongside a daily copay of $125 for days 4 through 11. Outpatient hospital services require a $150 copay, while emergency care features a $125 copay, both with no coinsurance. This plan also includes valuable supplemental benefits, such as routine dental, vision, and hearing services with no copays or coinsurance, though certain exclusions and benefit limits apply. Members can also take advantage of up to 24 free one-way transportation trips per year and a quarterly $75 over-the-counter item allowance with no copay. Additionally, covered preventive services and partial hospitalizations are available with no copay or coinsurance.
Inpatient Hospital See details
Inpatient hospital services are covered by DrSelect-CFL (HMO) with no coinsurance, though prior authorization is required. Both acute and psychiatric stays feature no copay for days 1 to 3 and 12 to 90, and a $125 daily copay for days 4 to 11. Non-Medicare-covered stays are not covered, and unlimited additional days are covered only for acute care.
Outpatient Services See details
DrSelect-CFL (HMO) covers outpatient services with no coinsurance, featuring a $150 copay for outpatient hospital services, a $50 copay for ambulatory surgical center services, and no copay for blood services. Outpatient substance abuse services are also covered with no coinsurance, requiring a $25 copay for individual sessions and a $10 copay for group sessions.
Partial Hospitalization See details
DrSelect-CFL (HMO) covers partial hospitalization services with no copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
DrSelect-CFL (HMO) covers ambulance services with a $250 copay and coinsurance for ground transport, and a 20% coinsurance and copay for air transport. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved locations with no copay and no coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
DrSelect-CFL (HMO) covers emergency services with a $125 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, while urgently needed services have no copay or coinsurance. Worldwide emergency services are partially covered up to a $10,000 maximum with no coinsurance, requiring a $250 copay for emergency care and a $50 copay for urgent care, though worldwide emergency transportation is not covered.
Primary Care See details
DrSelect-CFL (HMO) covers primary care, specialist visits, telehealth, and opioid treatment with no copay and no coinsurance. Physical, occupational, mental health, and podiatry therapies require copays ranging from $10 to $25 and no coinsurance, while chiropractic benefits are only partially covered because other chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by DrSelect-CFL (HMO) with no copay and no coinsurance for covered benefits like Medicare-covered zero dollar preventive services, fitness benefits, and kidney disease education. However, several sub-services are not covered under this plan, including annual physical exams, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and nutritional/dietary benefits.
Hearing Services See details
Hearing Services are partially covered by DrSelect-CFL (HMO), offering no copay and no coinsurance for routine hearing exams and prescription hearing aids, with a maximum benefit of $1,500 every two years. OTC hearing aids, as well as inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision Services See details
Vision services are partially covered by DrSelect-CFL (HMO), featuring one routine eye exam and eyewear annually with no copay, no coinsurance, and no deductible, while other eye exam services are not covered. Eyewear, including contacts, lenses, frames, and upgrades, is covered up to a combined maximum benefit of $350 per year.
Dental Services See details
Dental services are partially covered by DrSelect-CFL (HMO) with no copay and no coinsurance for covered benefits, though prior authorization is required for certain treatments. Excluded services include other diagnostic dental, other preventive dental, adjunctive general, maxillofacial prosthetics, fixed prosthodontics, and orthodontics.
Home Infusion bundled Services See details
DrSelect-CFL (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, insulin, and other drugs carry a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered by DrSelect-CFL (HMO) with no copay and a 20% coinsurance, though prior authorization and a referral are required.
Medical Equipment See details
DrSelect-CFL (HMO) covers durable medical equipment, prosthetic devices, and diabetic supplies with no copay and coinsurance ranging from no coinsurance to 20%, with prior authorization required. This medical equipment benefit is partially covered, as medical supplies and diabetic therapeutic shoes or inserts are not covered under the plan.
Diagnostic and Radiological Services See details
DrSelect-CFL (HMO) partially covers diagnostic and radiological services, as laboratory services are not covered. Diagnostic procedures have no coinsurance and a copay ranging from no copay to $75, while radiological services feature no copays for diagnostic radiology or x-rays, coinsurance for x-rays, and a 20% coinsurance for therapeutic services.
Home Health Services See details
DrSelect-CFL (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the DrSelect-CFL (HMO) plan, as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all listed as not covered. These services carry a $15 copay and no coinsurance, and require both prior authorization and a referral.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) care is covered by DrSelect-CFL (HMO) with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $160 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by DrSelect-CFL (HMO), offering over-the-counter items and chronic illness meal benefits with no copay and no coinsurance, while acupuncture is not covered. The over-the-counter benefit provides up to $75 every three months, and the meal benefit requires prior authorization and a referral.
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