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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 2025, 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 2025.
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 $51.00. 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 $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:
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Drug Coverage
The American Health Advantage of Missouri Choice (HMO I-SNP) plan has a $590 deductible for prescription drugs. After meeting your deductible, you will pay the costs for your drugs based on the tier and pharmacy you use, until your total drug costs reach $2,000. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs. If you qualify for the low-income subsidy, you will pay $51.00 per month for your Part D coverage.
Additional Benefits
The American Health Advantage of Missouri Choice (HMO I-SNP) plan offers a variety of benefits with differing cost structures. Many services, such as primary care, telehealth, and home health services, have no copay. However, many other services, including outpatient services, emergency services, hearing exams, vision exams, and dental services, have a 20% coinsurance. The plan covers inpatient and outpatient services, and also offers benefits for hearing, vision, and dental. Additionally, the plan provides coverage for medical equipment, home infusion, and dialysis services. The plan also includes coverage for over-the-counter items, with a monthly maximum benefit.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered, but additional days, non-Medicare-covered stays, and upgrades are not covered. The plan utilizes the Medicare-defined cost share for tier 1 services, and requires prior authorization.
Outpatient Services See details
Outpatient services are covered, including outpatient hospital services and observation services with a 20% coinsurance, and outpatient substance abuse services. Ambulatory Surgical Center (ASC) services are covered with a coinsurance between 20% and 20%. Outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the American Health Advantage of Missouri Choice (HMO I-SNP) plan. You will pay 20% coinsurance for this benefit, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the American Health Advantage of Missouri Choice (HMO I-SNP) plan. Ground and Air Ambulance Services have a 20% coinsurance, and there is no copay. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered, with a 20% coinsurance, and no copay. Urgently Needed Services are covered, with a 20% coinsurance, and no copay. Worldwide Emergency Services are not covered.
Primary Care See details
The American Health Advantage of Missouri Choice (HMO I-SNP) plan covers primary care physician services with no copay, chiropractic services with 20% coinsurance, and occupational therapy services with 0-20% coinsurance. The plan also covers physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits with no copay, and opioid treatment program services with no copay. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered zero dollar preventive services, kidney disease education services, and other preventive services, with no copay for services like glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit. 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 by the American Health Advantage of Missouri Choice (HMO I-SNP) plan, with a 20% coinsurance for routine hearing exams and no copay for fitting/evaluation for hearing aids. Prescription hearing aids have a maximum plan benefit coverage of $500 per ear every year with no copay. OTC hearing aids, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have a 20% coinsurance, and routine eye exams have no copay. Eyewear has a 20% coinsurance, and contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades have no copay; there is a combined maximum benefit of $250 every year for eyewear.
Dental Services See details
Dental Services are covered, but orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, and oral and maxillofacial surgery are not. For covered services, you pay 20% coinsurance.
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.
Dialysis Services See details
Dialysis Services are covered by the American Health Advantage of Missouri Choice (HMO I-SNP) plan. There is a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment with no copay for Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests and 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 Missouri Choice (HMO I-SNP) plan with no copay and no coinsurance. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the American Health Advantage of Missouri Choice (HMO I-SNP) plan. Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are also not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, with no copay for days 1-100. Additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays for SNF are not covered.
Other Services See details
The American Health Advantage of Missouri Choice (HMO I-SNP) plan covers over-the-counter items with no copay, up to a maximum of $95.00 per month. Acupuncture, meal benefits, dual eligible SNPs with highly integrated services, and several other additional services are not covered.
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