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 2025, 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 out of 5 stars in 2025.
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 $40.00. 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 $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:
Sign up for American Health Advantage of Tennessee (HMO I-SNP)
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Drug Coverage
The American Health Advantage of Tennessee (HMO I-SNP) plan has a $590 deductible for prescription drugs. If you qualify for the low-income subsidy, your Part D premium will be $40. After you meet your deductible, you'll pay the costs for drugs in each tier until your total drug costs reach $2000. Once you reach $2000 in out-of-pocket drug costs, you will enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The American Health Advantage of Tennessee (HMO I-SNP) plan offers a range of benefits with varying cost-sharing. Many primary care services have no copay, and there are no copays for home health services, skilled nursing facility stays (days 1-100), and some preventive services. The plan also covers hearing exams, with no copay for fitting/evaluation of hearing aids and a maximum of $500 per year for prescription hearing aids. The plan utilizes coinsurance for many services, including outpatient services, ambulance, emergency services, and vision services. You'll also pay a 20% coinsurance for outpatient services, hearing exams, vision exams, and dental services. Some services, such as cardiac rehabilitation services and additional transportation, are not covered by the plan.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, but additional days, non-Medicare covered stays, and upgrades are not covered. You will be responsible for the Medicare-defined cost share for tier 1 services.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services and Observation Services with a 20% coinsurance. Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services are covered with a coinsurance of 20%. Outpatient Blood Services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by American Health Advantage of Tennessee (HMO I-SNP). You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by American Health Advantage of Tennessee (HMO I-SNP). Ground and Air Ambulance Services have a 20% coinsurance, and there is no copay. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the American Health Advantage of Tennessee (HMO I-SNP) plan. Emergency Services and Urgently Needed Services have a 20% coinsurance, while Worldwide Emergency Services are not covered.
Primary Care See details
The American Health Advantage of Tennessee (HMO I-SNP) plan covers primary care physician services with no copay, and chiropractic services with 20% coinsurance. Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Psychiatric Services, and Physical Therapy and Speech-Language Pathology Services are covered with a coinsurance between 0% and 20%. The plan also covers podiatry services, with routine foot care covered by a coinsurance of 0% to 20%, and 8 visits per year. Additional Telehealth benefits are covered with no copay. Opioid Treatment Program Services are covered with no copay.
Preventive Services See details
Preventive services include Medicare-covered services, and additional preventive services, but not annual physical exams. Kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit are covered with no copay. Other services like health education, in-home safety assessments, and more are not covered.
Hearing Services See details
Hearing Services include coverage for hearing exams and prescription hearing aids. Routine hearing exams have no copay and a 20% coinsurance, and fitting/evaluation for hearing aids has no copay and no coinsurance. Prescription hearing aids (all types) have no copay, and coverage is limited to a maximum of $500 per year.
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 has a 20% coinsurance, and contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades have no copay.
Dental Services See details
Dental Services are partially covered, with a 20% coinsurance for Medicare Dental Services, but orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, 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 Tennessee (HMO I-SNP) plan. The plan covers Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the American Health Advantage of Tennessee (HMO I-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered by American Health Advantage of Tennessee (HMO I-SNP), including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, and Prosthetic Devices and Medical Supplies also have a 20% coinsurance; Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with prior authorization required. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Lab Services have no copay. Therapeutic Radiological Services and Outpatient X-Ray Services also have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the American Health Advantage of Tennessee (HMO I-SNP) plan with no copay and no coinsurance; however, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but not in practice. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by American Health Advantage of Tennessee (HMO I-SNP). There is no copay for days 1-100. Additional days beyond Medicare-covered SNF and non-Medicare-covered SNF stays are not covered.
Other Services See details
The "Other Services" benefit for American Health Advantage of Tennessee (HMO I-SNP) does not cover acupuncture, over-the-counter (OTC) items, meal benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, or Self-Directed Personal Assistance Services. No authorization or referral is required for these services.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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