A non-government entity
American Health Advantage of Tennessee (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for American Health Advantage of Tennessee (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 Tennessee (HMO I-SNP) in 2026, please refer to our full plan details page.
American Health Advantage of Tennessee (HMO I-SNP) is a HMO I-SNP plan offered by Mitchell Family Office available for enrollment in 2025 to people living in Tennessee. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that American Health Advantage of Tennessee (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 Tennessee (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 Tennessee (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 Tennessee (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $27.70. 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:
Sign up for American Health Advantage of Tennessee (HMO I-SNP)
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 American Health Advantage of Tennessee (HMO I-SNP) Medicare plan features an annual prescription drug deductible of $615. This deductible represents the amount you must pay out-of-pocket for your covered medications before the plan begins to pay its share. Specific drug coverage tier details, including individual copayments and coinsurance rates for different medication levels, are not currently available for this plan. To understand your exact medication costs, it is recommended to review the plan's comprehensive formulary or contact the provider directly.
Additional Benefits
The American Health Advantage of Tennessee (HMO I-SNP) offers medical coverage featuring no copays and no coinsurance for primary care visits, preventive services, home health care, and skilled nursing facility stays. For outpatient care, emergency services, ambulance transport, and dialysis, members will pay no copay and a 20% coinsurance. Inpatient hospital stays are covered with Medicare-defined copays and no coinsurance, though prior authorizations are required for many services. Specialty benefits like hearing and vision are partially covered, offering a $500 annual allowance per ear for hearing aids and a $350 annual limit on eyewear with no copays. However, the plan does not cover routine dental care, routine transportation, acupuncture, or over-the-counter items. Medicare Part B insulin is available with a $35 copay and no coinsurance, while other Part B drugs require a coinsurance ranging from 0% to 20%.
Inpatient Hospital See details
American Health Advantage of Tennessee (HMO I-SNP) partially covers inpatient acute and psychiatric hospital services with no coinsurance and Medicare-defined copays, subject to prior authorization. Additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
American Health Advantage of Tennessee (HMO I-SNP) covers outpatient services with no copay and a 20% coinsurance for outpatient hospital, observation, ambulatory surgical center, outpatient substance abuse, and outpatient blood services. Prior authorization is required for outpatient hospital, observation, and ambulatory surgical center services, and the deductible is waived for the first three pints of blood.
Partial Hospitalization See details
Partial hospitalization is covered by American Health Advantage of Tennessee (HMO I-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
American Health Advantage of Tennessee (HMO I-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, though prior authorization is required. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by American Health Advantage of Tennessee (HMO I-SNP) with a 20% coinsurance and no copay for both emergency and urgently needed care, with coinsurance waived if admitted to the hospital within one day. For worldwide emergency services, some services are covered, but worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
Primary care services through the American Health Advantage of Tennessee (HMO I-SNP) are covered with no copay and no coinsurance for primary care doctor visits, telehealth, and opioid treatment. Other services like specialist visits, physical therapy, and mental health care have no copay and 0% to 20% coinsurance, though routine and other chiropractic services are not covered.
Preventive Services See details
American Health Advantage of Tennessee (HMO I-SNP) partially covers preventive services with no copay and no coinsurance for covered services, though referrals are required for in-home support. Many supplemental services are not covered, including annual physical exams, fitness benefits, health education, personal emergency response systems, nutritional/dietary benefits, and counseling services.
Hearing Services See details
American Health Advantage of Tennessee (HMO I-SNP) covers hearing services with no deductible, including routine hearing exams with a 20% coinsurance and no copay, and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $500 per ear yearly, though inner ear, outer ear, over-the-ear, and over-the-counter hearing aids are not covered.
Vision Services See details
American Health Advantage of Tennessee (HMO I-SNP) offers partially covered vision services, including one routine eye exam per year with no copay and a 20% coinsurance, though other eye exam services are not covered. Covered eyewear has a $350 annual maximum with no deductible, featuring no copay and no coinsurance for glasses and upgrades, and no copay with a 20% coinsurance for contact lenses.
Dental Services See details
Dental services are partially covered by American Health Advantage of Tennessee (HMO I-SNP), offering Medicare-covered dental services with no copay and a 20% coinsurance. Routine and comprehensive dental services, including oral exams, cleanings, x-rays, fluoride, restorative care, and orthodontics, are not covered.
Home Infusion bundled Services See details
American Health Advantage of Tennessee (HMO I-SNP) covers Home Infusion bundled Services with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs have a coinsurance ranging from 0% to 20%, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered by American Health Advantage of Tennessee (HMO I-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
Medical Equipment is covered by American Health Advantage of Tennessee (HMO I-SNP) with no copay for all covered items. Durable medical equipment and prosthetics or medical supplies require a 20% coinsurance, while diabetic equipment and supplies have no coinsurance. Prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by American Health Advantage of Tennessee (HMO I-SNP), with prior authorization required for all services. Diagnostic procedures and tests require a copay and 20% coinsurance, lab services feature no copay, and radiological services—including x-rays—require 20% coinsurance with no copay.
Home Health Services See details
Home Health Services are covered by American Health Advantage of Tennessee (HMO I-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are provided by the American Health Advantage of Tennessee (HMO I-SNP) with no copay, though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by American Health Advantage of Tennessee (HMO I-SNP) with no copay and no coinsurance for days 1 through 100, and does not require a prior three-day inpatient hospital stay. Prior authorization is required for these services, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are not covered under the American Health Advantage of Tennessee (HMO I-SNP) plan. This means acupuncture, over-the-counter (OTC) items, and meal benefits are all excluded from coverage, and members are responsible for the full cost of these services.
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