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Healthy Mississippi Premier Advantage (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Healthy Mississippi Premier Advantage (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Healthy Mississippi Premier Advantage (HMO-POS) in 2026, please refer to our full plan details page.
Healthy Mississippi Premier Advantage (HMO-POS) is a HMO-POS plan offered by Singh Holdings LLC available for enrollment in 2025 to people living in Greater Mississippi Area. The overall rating for this plan is not yet available for 2026.
It's important to know that Healthy Mississippi Premier Advantage (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Healthy Mississippi Premier Advantage (HMO-POS).
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 Healthy Mississippi Premier Advantage (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3850.00 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 Healthy Mississippi Premier Advantage (HMO-POS)
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Drug Coverage
The Healthy Mississippi Premier Advantage (HMO-POS) plan features a $0 drug deductible, meaning your prescription drug coverage begins immediately. You will pay no copay for Tier 1 preferred generic drugs across all channels, and you also enjoy no copay on Tier 2 generic, Tier 3 preferred brand, and Tier 4 non-preferred drugs when using preferred pharmacies or preferred mail order services. This makes accessing your daily medications highly affordable when utilizing the plan's preferred network. If you choose to use standard pharmacies or standard mail order, your costs are a $10 copay for Tier 2 generics, a $47 copay for Tier 3 preferred brands, and a $100 copay for Tier 4 non-preferred drugs for a one-month supply. For Tier 5 specialty drugs, you will pay a 33% coinsurance for a one-month supply across all pharmacy and mail order options. This structured pricing helps you manage your healthcare budget effectively by choosing the right pharmacy tier for your prescriptions.
Additional Benefits
The Healthy Mississippi Premier Advantage (HMO-POS) plan offers comprehensive healthcare coverage with minimal out-of-pocket costs, featuring no copays and no coinsurance for inpatient hospital stays, primary care visits, and preventive services. For outpatient hospital services, specialist visits, and diagnostic tests, members will find affordable copays ranging from no copay up to $225, with no coinsurance. Emergency care is covered with a $110 copay that is waived if admitted, while urgent care and ground or air ambulance services carry low to moderate copays and no coinsurance. Routine dental, vision, and hearing benefits are highly accessible, offering no copays or coinsurance alongside generous annual allowances for eyewear, hearing aids, and comprehensive dental care. Additionally, home health care, cardiac rehabilitation, and skilled nursing facility stays for up to 100 days require no copays and no coinsurance. For specialized medical needs like durable medical equipment, dialysis, and select Part B drugs, members can expect no copays and a standard 20% coinsurance.
Inpatient Hospital See details
Healthy Mississippi Premier Advantage (HMO-POS) covers inpatient acute and psychiatric hospital stays with no copay and no coinsurance, though prior authorization is required. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Healthy Mississippi Premier Advantage (HMO-POS) with no coinsurance across all covered services, though prior authorization is required for most. Ambulatory surgical and blood services feature no copay, while outpatient hospital and observation services have a copay of $0 to $225, and outpatient substance abuse sessions range from a $0 to $25 copay.
Partial Hospitalization See details
Partial hospitalization is covered by Healthy Mississippi Premier Advantage (HMO-POS) with a copayment ranging from $55.00 to $70.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Healthy Mississippi Premier Advantage (HMO-POS) covers ground and air ambulance services with a $295 copay and no coinsurance. Transportation services are partially covered, providing up to 48 one-way trips per year to plan-approved locations with no copay or coinsurance, though trips to any health-related location are not covered.
Emergency Services See details
Healthy Mississippi Premier Advantage (HMO-POS) covers emergency services with a $110 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature no coinsurance and a copay ranging from no copay to $40, while worldwide emergency, urgent, and transportation services are covered up to a $10,000 maximum limit with no coinsurance and copays ranging from $40 to $295.
Primary Care See details
Healthy Mississippi Premier Advantage (HMO-POS) provides primary care physician services with no copay and no coinsurance, while specialist visits feature a copay of $0 to $30 and no coinsurance. Additional benefits like physical therapy, mental health, and podiatry are covered with copays up to $30 and no coinsurance, though chiropractic services are not covered and prior authorization is required for most specialty care.
Preventive Services See details
Healthy Mississippi Premier Advantage (HMO-POS) covers preventive services with no copays and no coinsurance, although prior authorization is required. The benefit is partially covered, excluding in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, caregiver support, smoking cessation, enhanced disease management, remote access, and counseling.
Hearing Services See details
Healthy Mississippi Premier Advantage (HMO-POS) offers partially covered hearing services with no copay, no coinsurance, and no deductible for routine exams and fitting evaluations. While prescription hearing aids are covered up to a $1,950 annual maximum with no copay or coinsurance, some services are covered as inner ear, outer ear, and over-the-ear prescription aids are not covered, and over-the-counter (OTC) hearing aids are also excluded.
Vision Services See details
Healthy Mississippi Premier Advantage (HMO-POS) covers routine eye exams and eyewear with no copay, no coinsurance, and no deductible, though other eye exam services are not covered. Covered services include one routine eye exam per year and up to $300 annually for contact lenses or eyeglasses, with prior authorization required.
Dental Services See details
Healthy Mississippi Premier Advantage (HMO-POS) provides partially covered dental services with a $0 to $30 copay and no coinsurance for Medicare-covered dental care, plus a $3,000 annual maximum for other dental services. Preventive and comprehensive services, such as cleanings, exams, and implants, feature no copay and no coinsurance, though orthodontics are not covered.
Home Infusion bundled Services See details
Healthy Mississippi Premier Advantage (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Under this plan, Medicare Part B chemotherapy, radiation, and other drugs require no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin is covered with a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by Healthy Mississippi Premier Advantage (HMO-POS) with no copay and a 20% coinsurance, requiring prior authorization.
Medical Equipment See details
Medical equipment is covered under Healthy Mississippi Premier Advantage (HMO-POS), with durable medical equipment, prosthetics, and medical supplies requiring prior authorization and carrying no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
Healthy Mississippi Premier Advantage (HMO-POS) covers diagnostic and radiological services with no coinsurance, although prior authorization is required. Outpatient diagnostic procedures and tests have a copay of $0 to $50, while lab services, outpatient X-rays, and diagnostic or therapeutic radiological services require no copay.
Home Health Services See details
Home health services are covered under the Healthy Mississippi Premier Advantage (HMO-POS) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with no copay and no coinsurance under Healthy Mississippi Premier Advantage (HMO-POS), though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Healthy Mississippi Premier Advantage (HMO-POS) covers Skilled Nursing Facility (SNF) services for days 1 through 100 with no copay and no coinsurance, although prior authorization is required. This benefit allows for admission without a prior three-day inpatient hospital stay, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Healthy Mississippi Premier Advantage (HMO-POS) partially covers other services, offering over-the-counter items and meal benefits for chronic illnesses with no copay and no coinsurance. Acupuncture is not covered under this plan, and prior authorization is required for the meal benefit.
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