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American Health Advantage of Missouri Choice (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for American Health Advantage of Missouri Choice (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 Missouri Choice (HMO I-SNP) in 2026, please refer to our full plan details page.
American Health Advantage of Missouri Choice (HMO I-SNP) is a HMO I-SNP plan offered by Mitchell Family Office available for enrollment in 2025 to people living in Missouri (partial). This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that American Health Advantage of Missouri Choice (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 Missouri Choice (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 Missouri Choice (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 Missouri Choice (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $43.00. 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 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 Missouri Choice (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. Detailed drug tier coverage details, including specific copayments and coinsurance rates, are currently not available for this plan. When evaluating this HMO I-SNP plan, you should factor the $615 deductible into your overall estimated annual prescription costs. To determine how your specific medications are covered after meeting this deductible, you will need to consult the plan's formulary directly.
Additional Benefits
The American Health Advantage of Missouri Choice (HMO I-SNP) offers robust coverage for core medical needs, featuring no copay and no coinsurance for primary care, telehealth, home health, and skilled nursing facility stays up to 100 days. Outpatient services, dialysis, durable medical equipment, and emergency care are covered with no copay and a standard 20% coinsurance. Inpatient hospital stays are covered with Medicare-defined copays and no coinsurance, though prior authorization is required for many of these services. For supplemental care, the plan provides a monthly allowance of up to $95 for over-the-counter items with no copay or coinsurance. Vision and hearing benefits are partially covered, offering up to $250 annually for eyewear and up to $500 per ear for hearing aids with no copays, alongside routine exams that require a 20% coinsurance. However, routine dental services, annual physical exams, and transportation are not covered under this plan.
Inpatient Hospital See details
American Health Advantage of Missouri Choice (HMO I-SNP) covers inpatient acute and psychiatric hospital services with Medicare-defined copays and no coinsurance, subject to prior authorization. This benefit is partially covered, as upgrades, additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
American Health Advantage of Missouri Choice (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
Partial hospitalization is covered by American Health Advantage of Missouri Choice (HMO I-SNP) with no copay and a 20% coinsurance. Prior authorization is required for this service.
Ambulance and Transportation Services See details
American Health Advantage of Missouri Choice (HMO I-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services to plan-approved or other health-related locations are not covered under this plan.
Emergency Services See details
Emergency services and urgently needed services under the American Health Advantage of Missouri Choice (HMO I-SNP) are covered with a 20% coinsurance and no copay (up to $115 and $40 per visit, respectively), which counts toward the plan-level deductible and is waived if admitted to the hospital within one day. Worldwide emergency, urgent, and transportation services are not covered.
Primary Care See details
American Health Advantage of Missouri Choice (HMO I-SNP) covers primary care, telehealth, and opioid treatment with no copay and no coinsurance, but chiropractic services are not covered. Other services, including specialist visits, physical, occupational, and speech therapies, psychiatric care, and podiatry, are covered with no copay and a 0% to 20% coinsurance.
Preventive Services See details
Preventive services are partially covered by American Health Advantage of Missouri Choice (HMO I-SNP) with no copay and no coinsurance for covered benefits like kidney disease education, in-home support, and glaucoma screenings. However, annual physical exams are not covered, along with health education, fitness benefits, telemonitoring, counseling, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, home-based palliative care, caregiver support, smoking cessation, enhanced disease management, remote access, and home safety modifications.
Hearing Services See details
Hearing services are covered by American Health Advantage of Missouri Choice (HMO I-SNP), including fitting evaluations with no copay or coinsurance and annual routine hearing exams with no copay and a 20% coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $500 per ear annually, but OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by American Health Advantage of Missouri Choice (HMO I-SNP), with other eye exam services excluded. One routine eye exam is covered annually with no copay and 20% coinsurance, and eyewear is covered up to $250 per year with no copays, requiring 20% coinsurance for contact lenses and no coinsurance for eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered by American Health Advantage of Missouri Choice (HMO I-SNP), which offers Medicare-covered dental services with no copay and a 20% coinsurance. Routine, preventive, and orthodontic dental services—including oral exams, cleanings, x-rays, and restorative procedures—are not covered.
Home Infusion bundled Services See details
American Health Advantage of Missouri Choice (HMO I-SNP) covers Home Infusion bundled Services with no copay, subject to prior authorization. Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs feature no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
American Health Advantage of Missouri Choice (HMO I-SNP) covers Dialysis Services with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is covered by American Health Advantage of Missouri Choice (HMO I-SNP), offering durable medical equipment and prosthetics with no copay and 20% coinsurance. Diabetic equipment and supplies 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 Missouri Choice (HMO I-SNP), though prior authorization is required. Diagnostic procedures and tests require a copay and a minimum 20% coinsurance, whereas lab services have no copay, and radiological services—including X-rays—feature no copay and a minimum 20% coinsurance.
Home Health Services See details
American Health Advantage of Missouri Choice (HMO I-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive these covered services.
Cardiac Rehabilitation Services See details
American Health Advantage of Missouri Choice (HMO I-SNP) covers some Cardiac Rehabilitation Services with no copay, but standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
American Health Advantage of Missouri Choice (HMO I-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance for days 1 through 100, though prior authorization is required and admission does not require a prior three-day hospital stay. Additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
American Health Advantage of Missouri Choice (HMO I-SNP) partially covers other services, offering over-the-counter (OTC) items with no copay and no coinsurance up to a maximum of $95 per month. Acupuncture, meal benefits, and other additional services are not covered under this plan.
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