A non-government entity
Trinity Health Plan of Michigan Cash Back (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Trinity Health Plan of Michigan Cash Back (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 Cash Back (HMO) in 2026, please refer to our full plan details page.
Trinity Health Plan of Michigan Cash Back (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 Cash Back (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 Cash Back (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 Cash Back (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 $148.80. 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 $275.00 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 $7500.00 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 Cash Back (HMO) has an annual drug deductible of $275. For Tier 1 preferred generic drugs, you pay no copay for up to a three-month supply at standard pharmacies and through standard mail order. Tier 2 generic drugs also have no copay when filled via standard mail order, whereas standard retail pharmacy fills cost a $5 copay for one month, $10 for two months, and $15 for three months. Higher-tier medications require coinsurance instead of flat copays. Tier 3 preferred brand drugs carry a 25% coinsurance, and Tier 4 non-preferred drugs carry a 35% coinsurance for both standard retail and mail order options. Tier 5 specialty drugs are covered at a 29% coinsurance for a one-month supply through standard retail and mail order.
Additional Benefits
The Trinity Health Plan of Michigan Cash Back (HMO) provides comprehensive medical coverage featuring no copays for primary care visits, home health services, and preventive care. Specialist visits and urgent care require a $40 copay, while emergency room visits carry a $115 copay, all with no coinsurance. For inpatient hospital stays, members pay daily copays for the first five days and no copay for subsequent days. Routine dental and vision exams are covered with no copay, though dental restorative services require a 50% coinsurance up to a $1,000 annual maximum. Skilled nursing facility care features no copay for the first 20 days, while durable medical equipment requires a 20% coinsurance with no copay. Members also benefit from a quarterly over-the-counter allowance with no copay or coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Trinity Health Plan of Michigan Cash Back (HMO) with no coinsurance, requiring prior authorization. Acute stays require a $450 copay per day for days 1 to 5 and no copay for day 6 and beyond, while psychiatric stays cost a $415 copay per day for days 1 to 5 and no copay for days 6 to 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Trinity Health Plan of Michigan Cash Back (HMO) covers outpatient services with no coinsurance, featuring outpatient hospital copays from $0 to $425 and observation services at $405 per stay. Ambulatory surgical center services require a $425 copay, outpatient substance abuse sessions carry a $40 copay, and outpatient blood services are covered with no copay, coinsurance, or deductible.
Partial Hospitalization See details
Partial hospitalization is covered under the Trinity Health Plan of Michigan Cash Back (HMO) with a $55.00 copay and no coinsurance.
Ambulance and Transportation Services See details
Trinity Health Plan of Michigan Cash Back (HMO) covers ambulance services with no coinsurance, requiring a $250 copay for ground transport and a $300 copay for air transport, with prior authorization required. Transportation services to health-related locations are not covered.
Emergency Services See details
Trinity Health Plan of Michigan Cash Back (HMO) covers emergency services with a $115 copay (waived if admitted within 48 hours) and urgently needed services with a $40 copay, with no coinsurance required for either service. Worldwide emergency and urgent care are also covered with a $115 copay, while worldwide emergency transportation has a copay of $250 to $300, both featuring no coinsurance.
Primary Care See details
Trinity Health Plan of Michigan Cash Back (HMO) covers primary care physician services with no copay and no coinsurance, while specialist visits and mental health services require a $40 copay with no coinsurance. Physical, occupational, and speech therapies have a $35 copay and no coinsurance, but chiropractic and podiatry services are not covered.
Preventive Services See details
Trinity Health Plan of Michigan Cash Back (HMO) partially covers preventive services, offering covered benefits like annual physical exams, kidney disease education, fitness benefits, and glaucoma screenings with no copay and no coinsurance. However, several supplemental options are not covered, including health education, weight management programs, in-home safety assessments, and counseling services.
Hearing Services See details
Trinity Health Plan of Michigan Cash Back (HMO) covers hearing exams with no coinsurance, requiring a $40 copay for Medicare-covered exams and no copay for routine exams and fitting evaluations. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $599 to $899, but OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Trinity Health Plan of Michigan Cash Back (HMO), offering eye exams with a $0 to $40 copay and eyewear with no copay up to a $125 annual limit, both with no coinsurance or deductibles. While routine eye exams and standard eyewear are covered, other eye exam services and eyewear upgrades are not covered.
Dental Services See details
Trinity Health Plan of Michigan Cash Back (HMO) partially covers dental services up to a $1,000 annual maximum, offering preventive benefits like cleanings and exams with no copay and no coinsurance, while restorative services and oral surgery have no copay and a 50% coinsurance. Medicare-covered dental services require a $40 copay and no coinsurance, but other preventive services, endodontics, periodontics, prosthodontics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Trinity Health Plan of Michigan Cash Back (HMO) with no copay, requiring prior authorization. Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have a coinsurance of 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by the Trinity Health Plan of Michigan Cash Back (HMO) with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is covered under the Trinity Health Plan of Michigan Cash Back (HMO) with a 20% coinsurance and no copay for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes or inserts carry a 20% coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Trinity Health Plan of Michigan Cash Back (HMO) with no coinsurance. Under this plan, lab services have no copay, outpatient X-rays and diagnostic tests have a $40 copay, therapeutic radiological services start at a $60 copay, and diagnostic radiological services start at a $425 copay.
Home Health Services See details
Trinity Health Plan of Michigan Cash Back (HMO) covers home health services with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Trinity Health Plan of Michigan Cash Back (HMO).
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) care is covered by the Trinity Health Plan of Michigan Cash Back (HMO) with no coinsurance, featuring no copay for days 1 to 20 and 61 to 100, and a $218 daily copay for days 21 to 60. No prior three-day inpatient hospital stay is required for admission, though additional days beyond the standard 100-day Medicare benefit period are not covered.
Other Services See details
Other services covered under the Trinity Health Plan of Michigan Cash Back (HMO) include acupuncture, which requires a $20.00 copay and no coinsurance for up to 6 treatments per year. Additionally, the plan covers chronic illness meals and over-the-counter (OTC) items with no copay and no coinsurance, including up to $25.00 in OTC benefits every three months.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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