Independent Health's Encompass 65 RED 045 (HMO)

INDEPENDENT HEALTH ASSOCIATION, INC. · 2027 plan year

Plan ID H3362-045-000

HMO★ 4.5 CMS StarsNew for 2027
MOOP (in-network)
$7,000
MOOP (combined)
—
Monthly premium
$286/mo
Part C $73.40 + Part D $212.60, before Extra Help
Prescription drugs
Included

Plan information

Contract / Plan / Segment
H3362-045-000
Medical deductible
$150
Part D premium
$212.60/mo (part of the monthly premium above)Before Extra Help, which can lower or remove it for people with limited income.
Part D deductible
$375/yr
Also owed
Your Medicare Part B premium, paid separately

More INDEPENDENT HEALTH ASSOCIATION, INC. plans in NY

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — Additional Days (Acute)No charge
Inpatient Hospital — Psychiatric$350/day for days 1–4, $0 after
Inpatient Hospital — Acute$300/day for days 1–6, $0 after
Worldwide Urgent Care Coverage$40

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$20
Mental Health — Group Sessions$20
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Skilled Nursing Facility (SNF)$0/day for days 1–20, $221/day for days 21–100
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional SessionsNo charge
Intensive Cardiac Rehabilitation — Additional SessionsNo charge
Pulmonary Rehabilitation — Additional SessionsNo charge
Supervised Exercise Therapy (SET)$20
Emergency Services$115
Urgently Needed Services$40
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$115
Substance Abuse — Group Sessions$40
Partial Hospitalization Program$55
Intensive Outpatient Program (IOP)$55
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic Services$15
Chiropractic — Other Services$15
Occupational Therapy Services$10
Physician Specialist Services$25
Podiatry Services$25
Other Health Care Professional Services$25
Psychiatric ServicesSee plan details
Psychiatric Services — Individual Sessions$20
Psychiatric Services — Group Sessions$20
Physical Therapy & Speech-Language Pathology$10
Additional Telehealth Services (Part B)$0-$40
Opioid Treatment Program Services$40
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & Tests$0-$25
Laboratory Services0%-20% coinsurance
Radiological ServicesSee plan details
Diagnostic Radiology$150
Therapeutic Radiology20% coinsurance
X-Ray Services$30
Outpatient Hospital Services$375
Hospital Observation Services$300 per stay
Ambulatory Surgical Center (ASC)$325
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$40
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground Ambulance$240
Air Ambulance20% coinsurance
Durable Medical Equipment (DME)10%-20% coinsurance
Prosthetics & OrthoticsSee plan details
Prosthetic Devices20% coinsurance
Medical SuppliesNo charge
Diabetic Supplies & ServicesSee plan details
Diabetic Supplies0%-20% coinsurance
Diabetic Therapeutic Shoes & InsertsNo charge
Diabetic MonitorsNo charge
Dialysis Services20% coinsurance
Medicare-Covered Preventive ServicesSee plan details
Annual Physical ExamNo charge
Health Education$0-$20
Vision — EyewearNo charge
Fitness BenefitNo charge
Remote Access TechnologiesNo charge
Personal Emergency Response System (PERS)No 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)$35
Dental — Medicare-Covered Services$25-$375
Vision — EyewearSee plan details
Dental — PreventiveNo charge per office visit (combined preventive services)
Dental — Oral ExamsSee plan details
Dental — X-RaysSee plan details
Dental — Prophylaxis (Cleaning)See plan details
Dental — Fluoride TreatmentSee plan details
Dental — ComprehensiveSee plan details
Dental — Restorative Services50% coinsurance
Dental — Endodontics (Root Canal)50% coinsurance
Dental — Periodontics (Gum Care)50% coinsurance
Dental — Removable Prosthodontics (Dentures)50% coinsurance
Dental — Oral & Maxillofacial Surgery50% coinsurance
Dental — Adjunctive General Services50% coinsurance
Vision — Eye Exams$0-$25
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — Contact LensesNo charge
Worldwide Emergency Transportation$240 copay + 20% coinsurance
Chiropractic ServicesSee plan details
Vision — Eyeglasses (Lenses & Frames)No charge
Hearing — Exams$0-$25
Hearing — ExamsSee plan details
Hearing — Routine Exams$0-$25
Hearing — Fitting & Evaluation for Hearing Aid$45
Hearing — Prescription Hearing AidsSee plan details
Hearing — Hearing Aids (All Types)$499-$1,949

Service area

  • NY: 8 counties

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