A non-government entity
American Health Advantage of Mississippi (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for American Health Advantage of Mississippi (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 Mississippi (HMO I-SNP) in 2025, please refer to our full plan details page.
American Health Advantage of Mississippi (HMO I-SNP) is a HMO I-SNP plan offered by Mitchell Family Office available for enrollment in 2025 to people living in Mississippi. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that American Health Advantage of Mississippi (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 Mississippi (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 Mississippi (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 Mississippi (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $47.30. 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 $590.00 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 $9350.00 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 Mississippi (HMO I-SNP) plan has a $590 deductible for prescription drugs. Once you meet your deductible, you will pay the costs for your drugs in each tier until your total drug costs reach $2000, at which point you enter the next coverage phase. If you qualify for the low-income subsidy, you may have a reduced premium. This plan does not provide specific cost-sharing details for drugs in each tier.
Additional Benefits
The American Health Advantage of Mississippi (HMO I-SNP) plan offers a range of benefits with varying cost-sharing. You'll find no copay for primary care visits, home health services, and skilled nursing facility stays for the first 100 days. The plan also offers no copay for preventive services like glaucoma screening, and hearing exams, while services like outpatient and emergency services, and ambulance services have a 20% coinsurance. This plan provides coverage for inpatient and outpatient services, with some services requiring prior authorization. Additional benefits include coverage for hearing aids, vision services, and some dental services, all with varying cost-sharing. However, it's important to note that some services like cardiac rehabilitation and certain other services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. Prior authorization is required, and you are responsible for the Medicare-defined cost share for tier 1.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services and Observation Services with a 20% coinsurance, as well as Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services. The plan does not cover Outpatient Blood Services.
Partial Hospitalization See details
Partial Hospitalization is covered by the American Health Advantage of Mississippi (HMO I-SNP) plan. You will pay 20% coinsurance for this benefit, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by American Health Advantage of Mississippi (HMO I-SNP). Ground and air ambulance services are covered with a 20% coinsurance, and there is no copay. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered under the American Health Advantage of Mississippi (HMO I-SNP) plan, with a 20% coinsurance, but no copay. Worldwide emergency services, including coverage, urgent coverage, and transportation, are not covered.
Primary Care See details
The American Health Advantage of Mississippi (HMO I-SNP) plan covers primary care physician services with no copay. Chiropractic services have a 20% coinsurance, while occupational therapy services have a 0-20% coinsurance. Physician specialist services and physical therapy/speech-language pathology services have a 0-20% coinsurance. Mental health and psychiatric services have a 0-20% coinsurance. Additional telehealth benefits have no copay. Opioid treatment program services have no copay. Podiatry services are not covered.
Preventive Services See details
Preventive services are covered, with no copay for glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit. Annual physical exams, health education, in-home safety assessments, personal emergency response systems (PERS), medical nutrition therapy (MNT), post-discharge in-home medication reconciliation, readmission 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, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, fitness benefits, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services are not covered. Additionally, additional preventive services require a doctor referral, and In-Home Support Services are covered with no copay.
Hearing Services See details
Hearing services include hearing exams and prescription hearing aids. Hearing exams have no copay and a coinsurance of 20% for routine hearing exams, while prescription hearing aids have no copay and a maximum benefit of $500 per year. Prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have a 20% coinsurance, while routine eye exams have no copay. Eyewear has a 20% coinsurance, with contact lenses having no copay and eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades all having no copay, up to a combined maximum of $300 per year.
Dental Services See details
Dental Services are partially covered under the American Health Advantage of Mississippi (HMO I-SNP) plan, with a 20% coinsurance for Medicare Dental Services. Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics, Maxillofacial Prosthetics, Implant Services, Prosthodontics, fixed, Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the American Health Advantage of Mississippi (HMO I-SNP) plan. You will pay a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay, while Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including Diagnostic Procedures/Tests, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services, are covered by this plan. Diagnostic Procedures/Tests, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have a coinsurance of at most 20%, while Lab Services have no copay.
Home Health Services See details
Home Health Services are covered by American Health Advantage of Mississippi (HMO I-SNP) 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 American Health Advantage of Mississippi (HMO I-SNP) plan. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by American Health Advantage of Mississippi (HMO I-SNP) with prior authorization required. There is no copay for days 1-100.
Other Services See details
Other Services, including acupuncture, over-the-counter items, meal benefits, and other services are not covered. Additional services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services, private duty nursing services, and several others are also not covered.
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