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Georgia Health Advantage Choice (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Georgia Health Advantage Choice (HMO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Georgia Health Advantage Choice (HMO I-SNP) in 2026, please refer to our full plan details page.
Georgia Health Advantage Choice (HMO I-SNP) is a HMO I-SNP plan offered by Mitchell Family Office available for enrollment in 2025 to people living in Georgia. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that Georgia Health Advantage Choice (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:
Georgia Health Advantage Choice (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 Georgia Health Advantage Choice (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 Georgia Health Advantage Choice (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $25.40. 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 Georgia Health Advantage Choice (HMO I-SNP) prescription drug plan has an annual drug deductible of $615. You will need to pay this deductible amount out-of-pocket before the plan begins covering the costs of your prescription medications. Specific drug coverage tier details, including individual copays and coinsurance rates, are not available for this plan. For precise details on how much your specific medications will cost under this plan, you should refer directly to the comprehensive formulary.
Additional Benefits
The Georgia Health Advantage Choice (HMO I-SNP) plan offers comprehensive coverage for essential medical services, often with no copays. Primary care visits, home health services, and up to 100 days in a skilled nursing facility are covered with no copay and no coinsurance, while outpatient care, emergency services, and specialist visits generally feature no copay and a 20% coinsurance. Inpatient hospital stays require Medicare-defined copays but no coinsurance, helping to keep your out-of-pocket costs predictable. This plan also includes valuable supplemental benefits, such as a monthly over-the-counter allowance of $110, $500 per ear annually for prescription hearing aids, and up to $275 yearly for eyewear with no copays. While diabetic supplies and home infusions have no copay or coinsurance, standard medical equipment and Medicare-covered dental services require a 20% coinsurance and no copay. Please note that routine dental cleanings, fitness benefits, and routine transportation are not covered under this plan.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Georgia Health Advantage Choice (HMO I-SNP), requiring prior authorization and Medicare-defined copays with no coinsurance. Additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services under the Georgia Health Advantage Choice (HMO I-SNP) are covered with no copay and a 20% coinsurance for outpatient hospital, observation, ambulatory surgical center, substance abuse, and blood services. Prior authorization is required for ambulatory surgical center, observation, and outpatient hospital services, and there is no deductible for outpatient blood services with the cost waived for the first three pints.
Partial Hospitalization See details
Georgia Health Advantage Choice (HMO I-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required to receive coverage for this benefit.
Ambulance and Transportation Services See details
Georgia Health Advantage Choice (HMO I-SNP) covers Medicare-approved 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
Georgia Health Advantage Choice (HMO I-SNP) covers emergency and urgently needed services with a 20% coinsurance and no copay, with the coinsurance waived if you are admitted to the hospital within one day. Some worldwide emergency services are covered, but worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
Georgia Health Advantage Choice (HMO I-SNP) covers primary care physician services, telehealth, and opioid treatment with no copay and no coinsurance, while chiropractic services are not covered. Specialist visits, mental health, psychiatric, podiatry, and physical, occupational, and speech therapy services are covered with no copay and 0% to 20% coinsurance.
Preventive Services See details
Georgia Health Advantage Choice (HMO I-SNP) partially covers preventive services with no copay and no coinsurance for Medicare-covered preventive services, kidney disease education, glaucoma screenings, diabetes self-management training, digital rectal exams, and EKGs. However, there is no coverage for an annual physical exam or additional services such as health education, fitness benefits, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, additional smoking cessation, disease management, telemonitoring, remote access, bathroom safety modifications, and counseling.
Hearing Services See details
Georgia Health Advantage Choice (HMO I-SNP) offers partially covered hearing services, featuring annual routine exams with a 20% coinsurance and no copay, and unlimited hearing aid fittings with no copay or coinsurance. Prescription hearing aids are covered up to $500 per ear annually with no copay or coinsurance; however, OTC hearing aids, as well as inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision Services See details
Vision services are partially covered by Georgia Health Advantage Choice (HMO I-SNP), excluding other eye exam services, with no deductibles. One routine eye exam per year is covered with no copay and a 20% coinsurance, and eyewear is covered up to $275 annually with no copay, featuring no coinsurance for eyeglasses and frames but a 20% coinsurance for contact lenses.
Dental Services See details
Georgia Health Advantage Choice (HMO I-SNP) partially covers dental services, with coverage limited to Medicare-covered dental services featuring no copay and a 20% coinsurance. Other dental services, including preventive cleanings, oral exams, x-rays, and orthodontic treatments, are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Georgia Health Advantage Choice (HMO I-SNP) with no copay and no coinsurance, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy and other Part B drugs feature no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis services are covered under the Georgia Health Advantage Choice (HMO I-SNP) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Georgia Health Advantage Choice (HMO I-SNP) covers durable medical equipment (DME) and prosthetics with no copay and a 20% coinsurance. Diabetic supplies and therapeutic shoes are covered with no copay and no coinsurance, with prior authorization required for all medical equipment benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Georgia Health Advantage Choice (HMO I-SNP) subject to prior authorization. Lab services feature no copay but require coinsurance, while diagnostic procedures require a copay and 20% minimum coinsurance, and radiological services have no copay but require a 20% minimum coinsurance.
Home Health Services See details
Georgia Health Advantage Choice (HMO I-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Georgia Health Advantage Choice (HMO I-SNP) plan, as all sub-services—including cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation—are excluded from coverage.
Skilled Nursing Facility (SNF) See details
Georgia Health Advantage Choice (HMO I-SNP) covers Medicare-approved Skilled Nursing Facility (SNF) stays for up to 100 days with no copay and no coinsurance, and does not require a prior three-day inpatient hospital stay. Prior authorization is required for these covered services, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Georgia Health Advantage Choice (HMO I-SNP) partially covers other services, offering an over-the-counter (OTC) benefit of up to $110 per month with no copay and no coinsurance. Acupuncture, meal benefits, and other additional services are not covered under this plan.
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