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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 2025, 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 East Florida. The overall rating for this plan is not yet available for 2025.
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 $20.30. 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 Florida (HMO I-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay the costs for drugs in each tier until your total drug costs reach $2000. If you qualify for the low-income subsidy (LIS), you may be eligible for a reduced premium. Once your yearly out-of-pocket drug costs reach $2000, you will pay nothing for Medicare Part D covered drugs.
Additional Benefits
The American Health Advantage of Florida (HMO I-SNP) plan offers a range of benefits with varying cost-sharing. Many services have a 20% coinsurance, including outpatient services, ambulance services, emergency services, vision exams, eyewear, and medical equipment. Some services have no copay, such as primary care visits, preventive services, hearing exams, routine eye exams, home health services, diabetic supplies, and lab services. The plan also includes specific copays for certain services, such as a $35 copay for Medicare Part B Insulin Drugs. Prescription hearing aids are covered up to $500 per year with no copay, and transportation services have no copay for up to 24 one-way trips per year. However, some services, such as cardiac rehabilitation services, are not covered by this plan.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, but the cost sharing is not specified. Additional days, non-Medicare-covered stays, and upgrades for Inpatient Hospital-Acute and Additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services include coverage for outpatient hospital services and observation services, each with a 20% coinsurance, and ambulatory surgical center (ASC) services with a 20% coinsurance. Outpatient substance abuse services are covered, and individual and group sessions both have a coinsurance between 20% and 20%. Outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the American Health Advantage of Florida (HMO I-SNP) plan, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services include coverage for ground and air ambulance services with a 20% coinsurance, and transportation services to any health-related location with no copay, up to 24 one-way trips per year. Transportation services to plan-approved health-related locations are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services, are covered under this plan. You will pay 20% coinsurance for both Emergency Services and Urgently Needed Services. Worldwide Emergency Services are not covered.
Primary Care See details
The American Health Advantage of Florida (HMO I-SNP) plan covers primary care physician services with no copay and chiropractic services with 20% coinsurance, but routine chiropractic care is not covered. The plan also covers occupational therapy services with a coinsurance between 0% and 20%, physician specialist services with a coinsurance between 0% and 20%, and mental health specialty services with a coinsurance between 0% and 20%.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, with no copay, as well as additional preventive services, kidney disease education, and other preventive services. 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, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, support for caregivers, 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. In-Home Support Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit have no copay.
Hearing Services See details
Hearing exams are covered, with a coinsurance of at most 20% for routine hearing exams and no copay. Prescription hearing aids are covered up to a maximum of $500 per year, with no copay, but inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision Services include coverage for eye exams and eyewear. Eye exams have a 20% coinsurance, and routine eye exams have no copay. Eyewear, including contact lenses, eyeglasses, eyeglass lenses, eyeglass frames, and upgrades, has a 20% coinsurance; contact lenses, eyeglasses, eyeglass lenses, eyeglass frames, and upgrades have no copay. There is a combined maximum benefit of $300.00 per year for all eyewear.
Dental Services See details
Dental services are partially covered by the American Health Advantage of Florida (HMO I-SNP) plan. Medicare Dental Services are covered with 20% coinsurance, while Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable), Maxillofacial Prosthetics, Implant Services, Prosthodontics (fixed), Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the American Health Advantage of Florida (HMO I-SNP) plan, including Insulin and Medicare Part B drugs. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the American Health Advantage of Florida (HMO I-SNP) plan. You will pay 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. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the American Health Advantage of Florida (HMO I-SNP) plan. 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 Florida (HMO I-SNP) 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 Florida (HMO I-SNP) plan. Prior authorization is required for these services, but the plan does not cover any of the sub-services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the American Health Advantage of Florida (HMO I-SNP) plan, but require prior authorization. There is 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
Other Services are not covered, including acupuncture, over-the-counter items, meal benefits, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services, private duty nursing services, and more. No authorization or referral is required for these services.
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