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Trinity Health Plan of Michigan No Premium (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Trinity Health Plan of Michigan No Premium (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Trinity Health Plan of Michigan No Premium (HMO) in 2026, please refer to our full plan details page.
Trinity Health Plan of Michigan No Premium (HMO) is a HMO plan offered by Trinity Health Corporation available for enrollment in 2025 to people living in Select Counties in Michigan. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Trinity Health Plan of Michigan No Premium (HMO) 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 Trinity Health Plan of Michigan No Premium (HMO).
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 Trinity Health Plan of Michigan No Premium (HMO), 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. Additionally, this plan comes with a Part B Premium reduction of $7.00. You must continue to pay paying your reduced 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 $100.00 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 $4500.00 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 Trinity Health Plan of Michigan No Premium (HMO) features an annual drug deductible of $100. Under this plan, there is no copay for Tier 1 preferred generic and Tier 2 generic drugs, whether you use a standard retail pharmacy or standard mail-order services for up to a three-month supply. This cost-sharing structure makes everyday maintenance medications highly affordable for plan members. For brand-name and specialty medications, your out-of-pocket costs are determined by a percentage of the drug cost. Tier 3 preferred brand drugs require a 25% coinsurance, while Tier 4 non-preferred drugs carry a 45% coinsurance for both standard pharmacy and mail-order fills. Tier 5 specialty drugs are covered with a 31% coinsurance for a one-month supply.
Additional Benefits
The Trinity Health Plan of Michigan No Premium (HMO) offers comprehensive medical coverage with no copay for primary care visits and a $30 copay for specialists, with no coinsurance for either. Inpatient hospital stays require a $325 daily copay for the first six days and no copay for days 7 through 90, while outpatient hospital services range from no copay up to a $275 copay. Emergency room visits feature a $130 copay, which is waived if you are admitted to the hospital within 48 hours. Members also receive excellent supplemental benefits, including routine eye exams, routine hearing exams, and preventive dental services with no copay. Prescription hearing aids require a copay of $599 to $899, while durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay. Additionally, the plan features home health services and an over-the-counter allowance of $75 every three months with no copay.
Inpatient Hospital See details
Trinity Health Plan of Michigan No Premium (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $325 daily copay for days 1 through 6 and no copay for days 7 through 90. Prior authorization is required, and while unlimited additional acute care days are covered with no copay, additional psychiatric days, room upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Trinity Health Plan of Michigan No Premium (HMO) covers outpatient services with no coinsurance, featuring outpatient hospital copays ranging from no copay up to $275 and observation services at a $315 copay per stay. Ambulatory surgical center services require a $275 copay, outpatient substance abuse sessions have a $20 copay, and outpatient blood services are covered with no copay or deductible.
Partial Hospitalization See details
Trinity Health Plan of Michigan No Premium (HMO) covers partial hospitalization services with a $55.00 copay and no coinsurance.
Ambulance and Transportation Services See details
Trinity Health Plan of Michigan No Premium (HMO) covers ambulance services with no coinsurance, requiring a $250 copay for ground ambulance and a $300 copay for air ambulance services. While some transportation services are covered, transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
Emergency services are covered under the Trinity Health Plan of Michigan No Premium (HMO) with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 48 hours. Urgently needed services require a $35 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no coinsurance and copays ranging from $130 to $300.
Primary Care See details
Trinity Health Plan of Michigan No Premium (HMO) offers primary care physician services with no copay and no coinsurance, and specialist visits with a $30 copay and no coinsurance. Covered physical, occupational, speech, mental health, psychiatric, and opioid treatment therapies require a $20 copay with no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
Trinity Health Plan of Michigan No Premium (HMO) partially covers preventive services with no copay and no coinsurance for covered benefits like annual physical exams, fitness benefits, and kidney disease education. However, several supplemental services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, alternative therapies, and counseling.
Hearing Services See details
Hearing services are covered by Trinity Health Plan of Michigan No Premium (HMO), featuring Medicare-covered exams for a $30 copay and no coinsurance, and annual routine exams and fittings with no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and a copay of $599 to $899 for up to two aids per year, though OTC hearing aids and inner ear, outer ear, and over the ear prescription devices are not covered.
Vision Services See details
Vision services are partially covered by Trinity Health Plan of Michigan No Premium (HMO), offering routine eye exams and eyewear with no copay and no coinsurance. Routine exams are limited to one per year, and eyewear has a $225 annual combined maximum, though other eye exam services and eyewear upgrades are not covered.
Dental Services See details
Dental Services are partially covered by Trinity Health Plan of Michigan No Premium (HMO), which offers Medicare-covered dental for a $30 copay and no coinsurance, and preventive dental services with no copay and no coinsurance up to a $1,000 annual maximum. Comprehensive services feature no copay with coinsurance between 0% and 70% depending on the service, though maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Trinity Health Plan of Michigan No Premium (HMO) covers home infusion bundled services with no copay, subject to prior authorization. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have a coinsurance of 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by Trinity Health Plan of Michigan No Premium (HMO) with no copay and a 20% coinsurance.
Medical Equipment See details
Trinity Health Plan of Michigan No Premium (HMO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance, requiring prior authorization. Diabetic supplies are available with no copay from specified manufacturers, while diabetic therapeutic shoes and inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the Trinity Health Plan of Michigan No Premium (HMO) with no coinsurance. Members pay no copay for lab services, a $20 copay for outpatient x-rays, a $30 copay for diagnostic procedures and tests, a $60 minimum copay for therapeutic radiological services, and a $175 minimum copay for diagnostic radiological services.
Home Health Services See details
Home health services are covered by the Trinity Health Plan of Michigan No Premium (HMO) with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with no coinsurance under the Trinity Health Plan of Michigan No Premium (HMO), though only some services are covered. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered, carrying copays between $15 and $20.
Skilled Nursing Facility (SNF) See details
Trinity Health Plan of Michigan No Premium (HMO) covers Skilled Nursing Facility (SNF) services for up to 100 days with no coinsurance and no prior three-day hospital stay requirement. There is no copay for days 1 through 20 and days 61 through 100, a $218 daily copay for days 21 through 60, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Trinity Health Plan of Michigan No Premium (HMO) covers acupuncture with a $20 copay and no coinsurance, up to 12 treatments per year with prior authorization. The plan also covers a chronic illness meal benefit and up to $75 every three months for over-the-counter items, both with no copay and no coinsurance.
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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.
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