Martin's Point Generations Advantage Prime (HMO-POS)

Martin's Point Generations Advantage Prime (HMO-POS) is a HMO-POS plan offered by Martin's Point Generations Advantage, Inc. available for the 2026 plan year to people living in Southern Maine: Andr, Cumb, Kenn, Saga, York. This plan received an overall rating of 4 out of 5 stars in 2026.

It's important to know that Martin's Point Generations Advantage Prime (HMO-POS) 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 Martin's Point Generations Advantage Prime (HMO-POS).

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.

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:

Drug Coverage

The Martin's Point Generations Advantage Prime (HMO-POS) plan features a $300 annual drug deductible. You will pay no copay for Tier 1 preferred generics and Tier 6 select care drugs when filled at a preferred pharmacy or through standard mail order. For Tier 2 generics, copays range from $5 at preferred pharmacies to $10 at standard pharmacies for a one-month supply. For higher-tier medications, Tier 3 preferred brands require a 25% coinsurance at both preferred and standard pharmacies. Tier 4 non-preferred drugs carry a 30% coinsurance at preferred pharmacies and 32% coinsurance at standard pharmacies or standard mail order. Tier 5 specialty drugs require a 29% coinsurance for a one-month supply across all available pharmacy options.

Additional Benefits

The Martin's Point Generations Advantage Prime (HMO-POS) plan offers comprehensive medical coverage with predictable costs, featuring no copay and no coinsurance for primary care visits and home health services. Specialist visits require a $40 copay, while inpatient hospital stays incur a $350 daily copay for the first five days with no copay thereafter. Emergency care is covered with a $115 copay, which is waived if you are admitted to the hospital within 24 hours. For supplemental care, the plan provides routine dental cleanings and exams with no copay or coinsurance up to a $1,000 annual maximum, along with yearly routine eye exams ranging from no copay to a $40 copay. Prescription hearing aids are covered up to $500 per ear annually with no copay, while durable medical equipment requires a 20% coinsurance with no copay. Skilled nursing facility stays are also covered with no copay for the first 20 days and a $150 daily copay for days 21 through 100.

Plan Providers

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpring^SM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.