Essence Advantage Choice (PPO)

ESSENCE HEALTHCARE PPO, INC. · 2027 plan year

Plan ID H6200-004-000

Showing AR · also offered in: MO

Local PPO★ 4 CMS Stars
MOOP (in-network)
$8,200
MOOP (combined)
$10,200
Monthly premium
$0/mo
Part C $0 + Part D $0
Prescription drugs
Included

This plan in 2026

Plan information

Contract / Plan / Segment
H6200-004-000
Medical deductible
$260
Part D premium
$0/mo (part of the monthly premium above)
Part D deductible
$700/yr
Also owed
Your Medicare Part B premium, paid separately

More ESSENCE HEALTHCARE PPO, INC. plans in AR

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — Psychiatric$298/day for days 1–7, $0 after
Inpatient Hospital — Additional Days (Psychiatric)No charge
Worldwide Urgent Care Coverage$115
Inpatient Hospital — Acute$298/day for days 1–7, $0 after
Inpatient Hospital — Additional Days (Acute)No charge

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 Specialty ServicesSee plan details
Mental Health — Individual Sessions$25
Mental Health — Group Sessions$20
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Skilled Nursing Facility (SNF)$0/day for days 1–20, $220/day for days 21–100
Cardiac Rehabilitation — Additional Sessions$20
Intensive Cardiac Rehabilitation — Additional Sessions$20
Pulmonary Rehabilitation — Additional Sessions$20
Supervised Exercise Therapy (SET)$20
Emergency Services$115
Urgently Needed Services$40
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$115
Partial Hospitalization Program$45
Intensive Outpatient Program (IOP)$45
Psychiatric Services — Individual Sessions$25
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic Services$15
Occupational Therapy Services$35
Physician Specialist Services$30
Podiatry Services$30
Other Health Care Professional Services$30
Psychiatric ServicesSee plan details
Psychiatric Services — Group Sessions$20
Physical Therapy & Speech-Language Pathology$35
Additional Telehealth Services (Part B)$0-$45
Opioid Treatment Program Services$25
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & Tests$0-$35
Laboratory ServicesNo charge
Radiological ServicesSee plan details
Diagnostic Radiology$0-$200
Therapeutic Radiology20% coinsurance
X-Ray Services$20
Outpatient Hospital Services$325
Hospital Observation Services$325 per stay
Ambulatory Surgical Center (ASC)$225
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$25
Substance Abuse — Group Sessions$20
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground Ambulance$240
Air Ambulance$240
Durable Medical Equipment (DME)20% coinsurance
Prosthetic Devices20% coinsurance
Medical Supplies20% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic SuppliesNo charge
Diabetic Therapeutic Shoes & Inserts20% coinsurance
Diabetic MonitorsNo charge
Dialysis Services20% coinsurance
Medicare-Covered Preventive ServicesSee plan details
Annual Physical ExamNo charge
Fitness BenefitNo charge
Kidney Disease Education ServicesNo charge
Glaucoma ScreeningNo charge
Diabetes Self-Management TrainingNo charge
Digital Rectal ExamsNo charge
Welcome to Medicare EKGNo charge
Insulin (Part B)0%-20% coinsurance (max $35)
Dental — Medicare-Covered Services$30
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge
Dental — Diagnostic ServicesNo charge
Dental — Prophylaxis (Cleaning)No charge
Dental — Fluoride TreatmentNo charge
Dental — Other Preventive ServicesNo 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 — Maxillofacial ProstheticsNo charge
Dental — Implant ServicesNo charge
Dental — Fixed Prosthodontics (Bridges)No charge
Dental — Oral & Maxillofacial SurgeryNo charge
Dental — OrthodonticsNo charge
Dental — Adjunctive General ServicesNo charge
Vision — Eye Exams$30
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — EyewearNo charge
Vision — EyewearSee plan details
Vision — Contact LensesNo charge
Vision — Eyeglasses (Lenses & Frames)No charge
Vision — Eyeglass LensesNo charge
Vision — Eyeglass FramesNo charge
Hearing — Exams$20
Hearing — ExamsSee plan details
Hearing — Routine Exams$20
Hearing — Fitting & Evaluation for Hearing AidNo charge
Hearing — Prescription Hearing AidsSee plan details
Cardiac & Pulmonary RehabilitationSee plan details
Prosthetics & OrthoticsSee plan details
Hearing — Hearing Aids (All Types)No charge

Service area

  • AR: 10 counties

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