The Health Plan SecureChoice Optimum (PPO)

THP INSURANCE COMPANY · 2027 plan year

Plan ID H8604-014-001

Local PPO★ 3 CMS Stars
MOOP (in-network)
$7,000
MOOP (combined)
$9,550
Monthly premium
$45/mo
Part C $4.50 + Part D $40.50, before Extra Help
Prescription drugs
Included

This plan in 2026

Plan information

Contract / Plan / Segment
H8604-014-001
Medical deductible
$0 — no deductible
Part D premium
$40.50/mo (part of the monthly premium above)Before Extra Help, which can lower or remove it for people with limited income.
Part D deductible
$425/yr
Also owed
Your Medicare Part B premium, paid separately

Other segments for this plan:

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — Acute$395/day for days 1–6, $0 after
Inpatient Hospital — Additional Days (Acute)No charge
Inpatient Hospital — Psychiatric$375/day for days 1–5, $0 after

Pharmacy

BenefitIn-network
Part B DrugsSee plan details
Chemotherapy & Radiation Drugs (Part B)0%-20% coinsurance
Other Part B Drugs0%-20% coinsurance

Mental Health

BenefitIn-network
Mental Health — Individual Sessions$45
Mental Health — Group Sessions$45
Supplemental Health BenefitsSee plan details
Mental Health Specialty ServicesSee plan details

Other

BenefitIn-network
Cardiac & Pulmonary RehabilitationSee plan details
Skilled Nursing Facility (SNF)$0/day for days 1–20, $221/day for days 21–100
Cardiac Rehabilitation — Additional Sessions$5
Intensive Cardiac Rehabilitation — Additional Sessions$5
Pulmonary Rehabilitation — Additional Sessions$5
Supervised Exercise Therapy (SET)$20
Emergency Services$130
Urgently Needed Services$40
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$130
Worldwide Emergency Transportation$250-$500
Partial Hospitalization Program$35
Intensive Outpatient Program (IOP)$35
Home Health ServicesNo charge
Primary Care Physician Services$10
Chiropractic Services$15
Occupational Therapy Services$35
Physician Specialist Services$45
Podiatry Services$45
Podiatry Services$45
Other Health Care Professional Services$45
Psychiatric ServicesSee plan details
Psychiatric Services — Individual Sessions$45
Psychiatric Services — Group Sessions$45
Physical Therapy & Speech-Language Pathology$40
Additional Telehealth Services (Part B)No charge
Opioid Treatment Program Services$40
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & Tests$50
Laboratory ServicesNo charge
Radiological ServicesSee plan details
Diagnostic Radiology$0-$250
Therapeutic Radiology20% coinsurance
X-Ray Services$95
Outpatient Hospital Services$0-$750
Hospital Observation Services$750 per stay
Ambulatory Surgical Center (ASC)$500
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$45
Substance Abuse — Group Sessions$45
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground Ambulance$250
Air Ambulance$500
Durable Medical Equipment (DME)20% coinsurance
Prosthetics & OrthoticsSee plan details
Prosthetic Devices20% coinsurance
Medical Supplies20% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic Supplies0%-20% coinsurance
Diabetic Therapeutic Shoes & Inserts20% coinsurance
Diabetic Monitors0%-20% coinsurance
Dialysis Services20% coinsurance
Medicare-Covered Preventive ServicesSee plan details
Welcome to Medicare EKGNo charge
Annual Physical ExamNo charge
Health EducationNo charge
Smoking & Tobacco Cessation CounselingNo charge
Fitness BenefitNo charge
Kidney Disease Education ServicesNo charge
Glaucoma ScreeningNo charge
Diabetes Self-Management TrainingNo charge
Digital Rectal ExamsNo charge
Insulin (Part B)$35
Dental — Medicare-Covered Services$45
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge
Dental — Prophylaxis (Cleaning)No charge
Dental — ComprehensiveSee plan details
Dental — Restorative ServicesNo charge
Dental — Endodontics (Root Canal)No charge
Dental — Periodontics (Gum Care)No charge
Dental — Removable Prosthodontics (Dentures)No charge
Dental — Fixed Prosthodontics (Bridges)No charge
Dental — Oral & Maxillofacial SurgeryNo charge
Vision — Eye ExamsNo charge
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — EyewearNo charge
Vision — EyewearSee plan details
Vision — Contact LensesNo charge
Vision — Eyeglass LensesNo charge
Vision — Eyeglass FramesNo charge
Hearing — Exams$20
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge
Hearing — Fitting & Evaluation for Hearing AidNo charge
Hearing — Prescription Hearing AidsSee plan details
Hearing — Hearing Aids (All Types)$399-$899

Service area

  • OH: 77 counties

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