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American Health Advantage of Florida (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for American Health Advantage of Florida (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 Florida (HMO I-SNP) in 2026, please refer to our full plan details page.
American Health Advantage of Florida (HMO I-SNP) is a HMO I-SNP plan offered by Mitchell Family Office available for enrollment in 2025 to people living in Florida (Partial). The overall rating for this plan is not yet available for 2026.
It's important to know that American Health Advantage of Florida (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 Florida (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 Florida (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 Florida (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $4.80. 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 Florida (HMO I-SNP) Medicare plan features an annual drug deductible of $615 for its prescription drug coverage. This deductible represents the amount you must pay out-of-pocket for covered medications before the plan begins to pay its share. Detailed information regarding specific drug coverage tiers, copayments, or coinsurance amounts is currently unavailable for this plan. When considering this Florida HMO I-SNP plan, beneficiaries should factor the $615 deductible into their annual healthcare budget. Because specific tier costs are not detailed, you will want to confirm how your specific prescriptions are covered before enrolling. This ensures you understand your potential out-of-pocket expenses beyond the initial deductible amount.
Additional Benefits
The American Health Advantage of Florida (HMO I-SNP) offers comprehensive medical coverage featuring no copays for inpatient hospital stays, primary care, home health, and up to 100 days in a skilled nursing facility. For outpatient care, specialist visits, emergency services, and diagnostic tests, members generally pay no copay alongside a standard 20% coinsurance. The plan also includes transportation benefits covering up to 24 one-way trips annually to health-related destinations with no copay or coinsurance. Supplemental benefits include routine hearing and vision care, which offer no-copay services but require a 20% coinsurance for exams, alongside annual allowances of $500 per ear for hearing aids and $300 for eyewear. While Medicare-covered dental services and diabetic supplies are available with no copays, routine dental care, over-the-counter items, and meal benefits are not covered. Additionally, Part B insulin is subject to a $35 copay with no coinsurance, while other Part B drugs feature no copay and up to 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by American Health Advantage of Florida (HMO I-SNP) with no copay and no coinsurance, subject to Medicare-defined cost sharing and prior authorization. Additional acute or psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
American Health Advantage of Florida (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
American Health Advantage of Florida (HMO I-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by American Health Advantage of Florida (HMO I-SNP), which requires prior authorization and a 20% coinsurance with no copay for ground and air ambulance services. The plan also covers up to 24 one-way trips per year to any health-related location with no copay and no coinsurance.
Emergency Services See details
American Health Advantage of Florida (HMO I-SNP) covers emergency services with a 20% coinsurance (up to $115 per visit) and no copay, and urgently needed services with a 20% coinsurance (up to $40 per visit) and no copay, both of which count toward the plan-level deductible. Coinsurance is waived if admitted to the hospital within one day, but worldwide emergency, urgent, and transportation services are not covered.
Primary Care See details
American Health Advantage of Florida (HMO I-SNP) provides primary care, telehealth, and opioid treatment services with no copay and no coinsurance. Specialist visits, physical and occupational therapies, mental health, and psychiatric services require no copay and a 0% to 20% coinsurance, while chiropractic services are not covered in practice.
Preventive Services See details
American Health Advantage of Florida (HMO I-SNP) offers partially covered preventive services with no copay and no coinsurance, including Medicare-covered preventive care, kidney disease education, and in-home support. However, annual physical exams and several additional benefits, such as fitness benefits, health education, and nutritional counseling, are not covered.
Hearing Services See details
American Health Advantage of Florida (HMO I-SNP) covers hearing services, offering routine hearing exams once per year with a 20% coinsurance and no copay, and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered up to $500 per ear annually with no copay or coinsurance, while OTC hearing aids and inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
American Health Advantage of Florida (HMO I-SNP) offers partially covered vision services with no deductibles, featuring one routine eye exam per year with no copay and a 20% coinsurance, while other eye exams are not covered. Covered eyewear has a $300 annual limit, offering eyeglasses with no copay and no coinsurance, and contact lenses with no copay and a 20% coinsurance.
Dental Services See details
American Health Advantage of Florida (HMO I-SNP) provides partial coverage for dental services, with Medicare-covered dental care requiring no copay and a 20% coinsurance. Other dental services, including routine cleanings, exams, x-rays, fluoride, restorative services, and orthodontics, are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by American Health Advantage of Florida (HMO I-SNP) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a 0% to 20% coinsurance.
Dialysis Services See details
American Health Advantage of Florida (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 Florida (HMO I-SNP), with durable medical equipment, prosthetics, and medical supplies requiring no copay and a 20% coinsurance. Diabetic equipment, including supplies and therapeutic shoes or inserts, is 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 Florida (HMO I-SNP) with prior authorization, featuring a minimum 20% coinsurance and no copay for radiological, therapeutic, and outpatient X-ray services. Diagnostic procedures and tests require a copayment and a minimum 20% coinsurance, while lab services have no copay but are subject to coinsurance.
Home Health Services See details
Home Health Services are covered by American Health Advantage of Florida (HMO I-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by American Health Advantage of Florida (HMO I-SNP) with no copay and no coinsurance, although prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered in practice and carry a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
American Health Advantage of Florida (HMO I-SNP) provides partially covered Skilled Nursing Facility (SNF) services, as additional days beyond the standard Medicare-covered 100 days are not covered. For the covered 100 days, there is no copay and no coinsurance, though prior authorization is required and a prior three-day inpatient hospital stay is not.
Other Services See details
Other Services are not covered under the American Health Advantage of Florida (HMO I-SNP), as acupuncture, over-the-counter (OTC) items, and meal benefits are all excluded from coverage.
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