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American Health Advantage of Indiana (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for American Health Advantage of Indiana (HMO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on American Health Advantage of Indiana (HMO I-SNP) in 2026, please refer to our full plan details page.
American Health Advantage of Indiana (HMO I-SNP) is a HMO I-SNP plan offered by Mitchell Family Office available for enrollment in 2025 to people living in Indiana. The overall rating for this plan is not yet available for 2026.
It's important to know that American Health Advantage of Indiana (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:
American Health Advantage of Indiana (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 American Health Advantage of Indiana (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 American Health Advantage of Indiana (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $38.40. 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 American Health Advantage of Indiana (HMO I-SNP) prescription drug coverage includes an annual drug deductible of $615. This deductible is the amount you must pay out-of-pocket for your medications before the plan's coverage kicks in. Detailed information regarding drug tiers, copays, and coinsurance is not available for this plan. To fully understand your potential out-of-pocket expenses, you should consult the plan's specific drug formulary to see how your medications are classified and covered.
Additional Benefits
The American Health Advantage of Indiana (HMO I-SNP) plan offers comprehensive coverage with no copay and no coinsurance for primary care, home health services, diabetic supplies, and skilled nursing facility stays up to 100 days. For many other key services, including outpatient hospital care, ambulance transport, dialysis, and durable medical equipment, members will pay no copay and a 20% coinsurance. Routine hearing and vision services are also covered with no copay and a 20% coinsurance, alongside annual allowances for hearing aids and eyewear. While Medicare-covered dental and emergency services are available, routine dental care, fitness benefits, and over-the-counter items are not covered under this plan. Additionally, several services, such as inpatient hospital stays, outpatient procedures, and medical equipment, require prior authorization before care is received. Overall, this plan minimizes copay costs for essential medical services while utilizing coinsurance for specialized and outpatient care.
Inpatient Hospital See details
Inpatient hospital services are partially covered by American Health Advantage of Indiana (HMO I-SNP) with Medicare-defined copays and no coinsurance, requiring prior authorization for acute and psychiatric stays. Additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
American Health Advantage of Indiana (HMO I-SNP) covers outpatient services, including outpatient hospital, observation, ambulatory surgical center, substance abuse, and blood services, with no copay and 20% coinsurance. Prior authorization is required for outpatient hospital, observation, and ambulatory surgical center services, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
Partial hospitalization services are covered by American Health Advantage of Indiana (HMO I-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
American Health Advantage of Indiana (HMO I-SNP) covers ambulance services with a 20% coinsurance and no copay for both ground and air transport, subject to prior authorization. Transportation services are partially covered, offering up to 36 one-way trips per year to plan-approved health-related locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
American Health Advantage of Indiana (HMO I-SNP) covers emergency and urgently needed services with a 20% coinsurance, no copay, and cost-sharing that counts toward the plan-level deductible. Coinsurance is waived if you are admitted to the hospital within one day, with maximum visit costs capped at $115 for emergency services and $40 for urgent care. For worldwide emergency services, some services are covered, but worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
American Health Advantage of Indiana (HMO I-SNP) covers primary care, telehealth, and opioid treatment services with no copay and no coinsurance. Specialist visits, mental health, psychiatry, routine podiatry, and physical, occupational, and speech therapies are covered with no copay and 0% to 20% coinsurance, while chiropractic services are not covered in practice.
Preventive Services See details
American Health Advantage of Indiana (HMO I-SNP) preventive services are partially covered, featuring no copay and no coinsurance for Medicare-covered preventive care, kidney disease education, glaucoma screenings, and in-home support services, though some services require a referral. Several additional services are not covered under this benefit, including annual physical exams, fitness benefits, health education, and personal emergency response systems.
Hearing Services See details
American Health Advantage of Indiana (HMO I-SNP) covers routine hearing exams with a 20% coinsurance and no copay, as well as fitting evaluations and prescription hearing aids with no copay or coinsurance up to $500 per ear annually. OTC hearing aids and inner ear, outer ear, or over the ear prescription hearing aids are not covered.
Vision Services See details
American Health Advantage of Indiana (HMO I-SNP) offers partially covered vision services, with other eye exam services excluded from coverage. Routine eye exams are covered once annually with no copay and 20% coinsurance, while covered eyewear—including eyeglasses and contact lenses—features no copay, 20% coinsurance on contact lenses, and no deductible, up to a $300 yearly maximum.
Dental Services See details
Dental services are partially covered by American Health Advantage of Indiana (HMO I-SNP), which offers Medicare-covered dental care with no copay and a 20% coinsurance. Routine and preventive dental services, such as cleanings, oral exams, and x-rays, as well as comprehensive orthodontic and restorative services, are not covered.
Home Infusion bundled Services See details
American Health Advantage of Indiana (HMO I-SNP) covers Home Infusion bundled Services with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs carry no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the American Health Advantage of Indiana (HMO I-SNP) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is covered by American Health Advantage of Indiana (HMO I-SNP), with durable medical equipment and prosthetics requiring no copay and 20% coinsurance. Diabetic equipment and supplies are covered with no copay and no coinsurance, with prior authorization required for all of these benefits.
Diagnostic and Radiological Services See details
American Health Advantage of Indiana (HMO I-SNP) covers diagnostic and radiological services subject to prior authorization. Outpatient diagnostic procedures and tests require a copay and a minimum 20% coinsurance, while lab services require no copay. Radiological services, including X-rays, diagnostic, and therapeutic services, have no copay and require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by American Health Advantage of Indiana (HMO I-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services under the American Health Advantage of Indiana (HMO I-SNP) are offered with no copay and require prior authorization, but only some services are covered. Standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
American Health Advantage of Indiana (HMO I-SNP) covers Skilled Nursing Facility (SNF) services for days 1 through 100 with no copay and no coinsurance, and does not require a prior three-day inpatient hospital stay. Prior authorization is required, and additional days beyond the standard 100-day Medicare limit are not covered.
Other Services See details
Other services are not covered under the American Health Advantage of Indiana (HMO I-SNP), as acupuncture, over-the-counter (OTC) items, and meal benefits are all excluded from coverage.
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