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Trinity Health Plan of Michigan Glory No RX (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Trinity Health Plan of Michigan Glory No RX (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 Glory No RX (HMO) in 2025, please refer to our full plan details page.
Trinity Health Plan of Michigan Glory No RX (HMO) is a HMO plan offered by Trinity Health Corporation available for enrollment in 2025 to people living in Select Counties in Michigan. The overall rating for this plan is not yet available for 2025.
It's important to know that Trinity Health Plan of Michigan Glory No RX (HMO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Trinity Health Plan of Michigan Glory No RX (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 Glory No RX (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 $100.00. 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.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $5500.00 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
Prescription drugs are not covered by Trinity Health Plan of Michigan Glory No RX (HMO).
Additional Benefits
The Trinity Health Plan of Michigan Glory No RX (HMO) plan offers a range of benefits with varying costs. You can expect no copay for services like primary care visits, outpatient observation, and many preventive services, along with coverage for dental, vision, and hearing services, although some of these have associated copays or coinsurance. Hospital stays have a copay, while ambulance services and emergency care have copays. The plan also includes coverage for outpatient services, mental health, and substance abuse, but with copays for many of these services. Additional benefits include home health services and medical equipment, but some services like cardiac rehabilitation are not covered. There is a $100 allowance every three months for over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a copay of $275 for days 1-7, and no copay for days 8-90. Additional days for Inpatient Hospital-Acute are covered with no copay, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered.
Outpatient Services See details
Outpatient services include coverage for outpatient hospital services with a copay between $0 and $275, observation services with no copay, ambulatory surgical center services with a $275 copay, outpatient substance abuse services with a $40 copay for both individual and group sessions, and outpatient blood services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by this plan with a $55 copay.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Trinity Health Plan of Michigan Glory No RX (HMO) plan. Ground ambulance services have a $275 copay, and air ambulance services have a $325 copay, with no coinsurance. 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 Trinity Health Plan of Michigan Glory No RX (HMO). Emergency Services and Worldwide Emergency Coverage have a $110 copay, Urgently Needed Services has a $35 copay, and Worldwide Emergency Transportation has a copay between $275 and $325. There is no coinsurance for any of these services.
Primary Care See details
The Trinity Health Plan of Michigan Glory No RX (HMO) plan covers Primary Care Physician Services with no copay, Chiropractic Services with a $10 copay, Occupational Therapy Services with a $20 copay, and Physician Specialist Services with a $30 copay. Mental Health and Psychiatric Services have a $30 copay for individual and group sessions, while Physical Therapy and Speech-Language Pathology Services have a $20 copay. Additional Telehealth Benefits have a copay between $0 and $30, and Opioid Treatment Program Services have a $30 copay.
Preventive Services See details
Preventive Services include coverage for a yearly physical exam with no copay, as well as additional preventive services, kidney disease education services, and other preventive services. Additional preventive services, kidney disease education services, and other preventive services have varying copays. Health education, in-home safety assessment, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications, and counseling services are not covered. Glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit have no copay.
Hearing Services See details
Hearing services include hearing exams, routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids. Hearing exams have a $30 copay, and routine hearing exams and fitting/evaluation for hearing aids have no copay. Prescription hearing aids (all types) have a copay between $599 and $899, while prescription hearing aids for the inner, outer, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
The Trinity Health Plan of Michigan Glory No RX (HMO) plan covers vision services, including eye exams with a copay between $0 and $30, and eyewear with a $0 copay for contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames, up to a combined maximum of $225 per year. Upgrades are not covered.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with a $30 copay, and Other Dental Services with no copay. Restorative Services and Oral and Maxillofacial Surgery have a 50% coinsurance, Endodontics and Periodontics have a 70% coinsurance.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are covered with a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Trinity Health Plan of Michigan Glory No RX (HMO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment benefits are covered by the Trinity Health Plan of Michigan Glory No RX (HMO) plan, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment. Durable Medical Equipment has a 20% coinsurance, while Prosthetic Devices and Medical Supplies have a 20% coinsurance. Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures and tests, are covered with a $30 copay, while lab services have no copay. Diagnostic Radiological Services have a copay of at most $250, Therapeutic Radiological Services have a copay of at most $60, and Outpatient X-Ray Services have a $30 copay.
Home Health Services See details
Home Health Services are covered by the Trinity Health Plan of Michigan Glory No RX (HMO) 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 not covered by the Trinity Health Plan of Michigan Glory No RX (HMO). While the plan states that cardiac rehabilitation services are covered, all of the specific services listed within this benefit are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Trinity Health Plan of Michigan Glory No RX (HMO) plan, with a $0 copay for days 1-20 and days 56-100, and a $214 copay for days 21-55. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include acupuncture, over-the-counter (OTC) items, and a meal benefit. Acupuncture has a $20 copay and requires prior authorization, while OTC items have no copay and a maximum benefit coverage amount of $100 every three months. The meal benefit also has no copay. Several other services are not covered, including 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, and others.
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