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Elevate Medicare Select (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Elevate Medicare Select (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Elevate Medicare Select (HMO) in 2025, please refer to our full plan details page.
Elevate Medicare Select (HMO) is a HMO plan offered by Denver Health and Hospital Authority available for enrollment in 2025 to people living in Adams, Arapahoe, Denver and Jefferson Counties. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Elevate Medicare Select (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 Elevate Medicare Select (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 Elevate Medicare Select (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 $6750.00 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 Elevate Medicare Select (HMO) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you'll pay a copay for your prescriptions. For example, preferred generic drugs have a $9 copay at preferred pharmacies, while standard generic drugs have a $45 copay. For non-preferred drugs, you'll pay 33% coinsurance. The plan offers no copay for specialty tier drugs. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The Elevate Medicare Select (HMO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services have copays that vary depending on the service. Emergency services and primary care visits also have copays. This plan also includes coverage for preventive services with no copay, plus additional vision, hearing, and dental benefits. The plan also offers coverage for home health services, and skilled nursing facilities, and provides benefits for medical equipment.
Inpatient Hospital See details
Inpatient Hospital benefits are covered under the Elevate Medicare Select (HMO) plan. For Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, you will pay a copay of $350 for days 1-5, and a copay of $0 for days 6-90. Additional days for Inpatient Hospital-Acute, Non-Medicare-covered stays for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, Additional days for Inpatient Hospital Psychiatric, and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a copay between $0 and $275, observation services with a $275 copay, and ambulatory surgical center services with no copay. Individual and group sessions for outpatient substance abuse have a copay of $20, while outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Elevate Medicare Select (HMO) plan with a $55 copay.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a $250 copay, which is waived if admitted to the hospital. Transportation Services to a plan-approved health-related location are covered with no copay or coinsurance, but transportation to any other health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Elevate Medicare Select (HMO) plan. Emergency Services have a $110 copay, and Urgently Needed Services have a $40 copay, both with no coinsurance. Worldwide Emergency Services are not covered.
Primary Care See details
The Elevate Medicare Select (HMO) plan covers Primary Care Physician Services, Chiropractic Services with a $20 copay, Occupational Therapy Services with a $35 copay, Physician Specialist Services with a $15-$35 copay, Mental Health Specialty Services with a $20 copay for individual and group sessions, Physical Therapy and Speech-Language Pathology Services with a $25 copay, Additional Telehealth Benefits with a $0-$40 copay, and Opioid Treatment Program Services with a $20 copay. Routine Chiropractic Care and Podiatry Services are not covered.
Preventive Services See details
Elevate Medicare Select (HMO) covers Medicare-covered preventive services with no copay, but does not cover annual physical exams. This plan also covers additional preventive services, including Nutritional/Dietary Benefit, Fitness Benefit (Memory Fitness), Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit.
Hearing Services See details
Hearing services include hearing exams, routine hearing exams, and fitting/evaluation for hearing aids. Routine hearing exams are limited to one exam every three years. Prescription hearing aids are covered up to a maximum of $1,500 every three years, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision Services include coverage for routine eye exams, with one exam covered every year, and eyewear with a combined maximum benefit of $220 every year. Contact lenses and eyeglasses (lenses and frames) are covered, while eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services include coverage for Medicare dental services with a $15 copay, and other dental services. The plan covers oral exams (2 visits per year), dental x-rays, other diagnostic dental services (2 visits per year), prophylaxis (cleaning) (2 visits per year), fluoride treatments (1 per year), and other preventative dental services. Restorative services are covered for 2 fillings per year. Orthodontic services are covered under Diagnostic and Preventive Dental. Adjunctive General Services, Endodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, Oral and Maxillofacial Surgery, and Orthodontics are not covered. The plan has a maximum benefit of $2,000 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Elevate Medicare Select (HMO) plan, with a coinsurance of 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies, which have 20% coinsurance for Medicare-covered devices and supplies, but does not cover Durable Medical Equipment for use outside the home, Diabetic Supplies, or Diabetic Therapeutic Shoes/Inserts.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are partially covered under the Elevate Medicare Select (HMO) plan. Diagnostic Radiological Services have a copay of at most $160.00, and Therapeutic Radiological Services have a copay of at most $60.00, while Outpatient X-Ray Services have a copay of $35.00; Diagnostic Procedures/Tests and Lab Services are not covered.
Home Health Services See details
Home Health Services are covered by the Elevate Medicare Select (HMO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the specific services of Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD are not covered. The copay for covered services is listed below.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Elevate Medicare Select (HMO) plan. There is no copay for days 1-20 and days 45-100, but there is a $188 copay for days 21-44; this plan does not cover additional days beyond Medicare-covered stays, or non-Medicare-covered stays.
Other Services See details
The Elevate Medicare Select (HMO) plan does not cover acupuncture, meal benefits, or Dual Eligible SNPs with Highly Integrated Services. Over-the-Counter (OTC) Items are covered with a maximum benefit of $130.00 every three months, and the plan offers Nicotine Replacement Therapy (NRT) as a Part C OTC benefit. All other services listed are not covered.
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