A non-government entity
New Hanover Health Advantage Select (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for New Hanover Health Advantage Select (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on New Hanover Health Advantage Select (HMO-POS) in 2025, please refer to our full plan details page.
New Hanover Health Advantage Select (HMO-POS) is a HMO-POS plan offered by The Carle Foundation available for enrollment in 2025 to people living in New Hanover, Pender, and Brunswick counties. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that New Hanover Health Advantage Select (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 New Hanover Health Advantage Select (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.
For New Hanover Health Advantage Select (HMO-POS), 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 a $100.00 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 combined Maximum Out-Of-Pocket cost of $8950.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $8950.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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:
Sign up for New Hanover Health Advantage Select (HMO-POS)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The New Hanover Health Advantage Select (HMO-POS) plan has a $100 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance for your prescriptions depending on the drug tier and the pharmacy you use. For example, in the initial coverage phase, you may pay a $0 copay for preferred generic drugs at a standard pharmacy, or 25% coinsurance for standard generic drugs at a standard or mail-order pharmacy. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The New Hanover Health Advantage Select (HMO-POS) plan offers a variety of benefits, including coverage for inpatient and outpatient services, with varying copays depending on the service. The plan also covers primary care, preventive services, hearing, vision, and dental services, with specific copays and coinsurance amounts detailed for each. This plan includes coverage for ambulance and transportation, emergency services, and home health services. Additional benefits include coverage for medical equipment and home infusion services, as well as access to acupuncture and an over-the-counter (OTC) allowance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you'll pay a $295 copay for days 1-6, and no copay for days 7-90; for Inpatient Hospital Psychiatric, you'll pay a $160 copay for days 1-10, and no copay for days 11-90.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services and Observation Services with a copay of $265, Ambulatory Surgical Center (ASC) Services with a copay of $215, and Individual and Group Sessions for Outpatient Substance Abuse with a copay between $35.00 and $35.00. Outpatient Blood Services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay a $50 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the New Hanover Health Advantage Select (HMO-POS) plan. Ground and air ambulance services have a copay of $265, with no coinsurance. Transportation Services to a plan-approved health-related location are covered for up to 26 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the New Hanover Health Advantage Select (HMO-POS) plan. Emergency Services has a $140 copay, Urgently Needed Services has a $40 copay, Worldwide Emergency Coverage has a $140 copay, Worldwide Urgent Coverage has a $40 copay, and Worldwide Emergency Transportation has a $265 copay.
Primary Care See details
The New Hanover Health Advantage Select (HMO-POS) plan covers primary care physician services, physician specialist services, occupational therapy, mental health specialty services, psychiatric services, physical therapy and speech-language pathology services, and opioid treatment program services. Chiropractic services are covered with a $20 copay, and routine chiropractic care is not covered. Individual and group sessions for mental health and psychiatric services have a copay between $35.00 and $35.00. Other health care professional visits have a copay between $15.00 and $15.00. Physical therapy and speech-language pathology services have a $30 copay. Additional telehealth benefits have a copay between $0 and $35.00.
Preventive Services See details
The New Hanover Health Advantage Select (HMO-POS) plan covers preventive services, including Medicare-covered services, annual physical exams, and additional services, though health education, in-home safety assessments, 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 benefit, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications, and counseling services are not covered. Additionally, the plan covers Personal Emergency Response System (PERS), Fitness Benefit, Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, EKG following Welcome Visit, and Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline).
Hearing Services See details
Hearing Services include routine hearing exams with a $35 copay, and fitting/evaluation for hearing aids, each covered once per year. Prescription hearing aids are covered with a maximum benefit of $750 per year, while prescription hearing aids - inner ear, outer ear, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams with a copay of $0-$35, and eyewear with 20% coinsurance for contact lenses. This plan also covers eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades. The plan has a combined maximum benefit of $300 per year for all eyewear.
Dental Services See details
Dental services include coverage for Medicare Dental Services with a $35 copay, and Other Dental Services with 0-30% coinsurance. Additionally, this plan covers Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), and Other Preventive Dental Services. The plan does not cover Fluoride Treatment or Orthodontics, and has a maximum benefit of $3,000 per year. Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable, fixed), Maxillofacial Prosthetics, Implant Services, and Oral and Maxillofacial Surgery are covered with a $35 copay and 30-50% coinsurance.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. The plan covers Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and other Medicare Part B drugs with 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the New Hanover Health Advantage Select (HMO-POS) plan. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment coverage includes Durable Medical Equipment, Prosthetics/Medical Supplies, and Diabetic Equipment. Durable Medical Equipment has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies have a 20% coinsurance for Medicare-covered devices and supplies, and Diabetic Supplies have a coinsurance between 0% and 20% while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by New Hanover Health Advantage Select (HMO-POS). Diagnostic Procedures/Tests have a copay between $0 and $85, while Lab Services have no copay; Diagnostic Radiological Services have a copay of at most $275, and Therapeutic Radiological Services have a copay of at most $35 and a coinsurance of at least 20%.
Home Health Services See details
Home Health Services are covered by the New Hanover Health Advantage Select (HMO-POS) 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 New Hanover Health Advantage Select (HMO-POS) plan. This includes Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the New Hanover Health Advantage Select (HMO-POS) plan, but require prior authorization. There is no copay for days 1-20, a $214 copay for days 21-41, and no copay for days 42-100. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The New Hanover Health Advantage Select (HMO-POS) plan covers acupuncture with a $35 copay and covers OTC items up to $100 every three months. This plan also offers a meal benefit for chronic or medical conditions. Additional services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and others are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved