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HAP Medicare Explore (PPO)

H2322 - 011 - 0
4 out of 5 stars (4 / 5)

HAP Medicare Explore (PPO) is a Medicare Advantage Plan by HAP Senior Plus (PPO).

This page features plan details for 2025 HAP Medicare Explore (PPO) H2322 – 011 – 0 available in Central, Southwest and Southeast Michigan Counties.

Locations

HAP Medicare Explore (PPO) is offered in the following locations.

Allegan County, Michigan
Arenac County, Michigan
Barry County, Michigan

Click to see more locations

Plan Overview

HAP Medicare Explore (PPO) offers the following coverage and cost-sharing.

Insurer:HAP Senior Plus (PPO)
Health Plan Deductible:$0
MOOP:$5,200 In and Out-of-network
$5,200 In-network
Drugs Covered:Yes

Ready to sign up for HAP Medicare Explore (PPO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

Premium Breakdown

HAP Medicare Explore (PPO) has a monthly premium of $0.00. This amount includes your Part C and D premiums but does not include your Part B premium. The following is a breakdown of your monthly premium with Part B costs included.
Part B Part C Part D Part B Give Back Total
$185.00 $0.00 $0.00 $ $
Please Note:
  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.
  • You may also qualify for “Extra Help” on drug costs. See the Part D Premium Reduction section below for more details.

Drug Info

HAP Medicare Explore (PPO) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Deductible: $300.00
Drug Out-Of-Pocket maximum: $2,000.00
Drug Benefit Type: Enhanced Alternative

Part D Premium Reduction

The Low-Income Subsidy (also known as LIS or “Extra Help”) helps people with Medicare lower the cost of prescription drugs.

The table below shows how the LIS impacts the Part D premium of this plan.

Part DLIS Full
$0.00$0.00

Initial Coverage Phase

After you pay your $300.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $2,000.00. Once you reach that amount, you will enter the next coverage phase.

Catastrophic Coverage Phase

After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $2,000.00, you pay nothing for Medicare Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit. Please note, that this plan has a Enhanced Alternative benefit type.

Additional Benefits

HAP Medicare Explore (PPO) also provides the following benefits.

Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?

    • In-Network: No

Comprehensive Dental

  • Endodontics
    • In-Network: 50 Coins – No Co pay
    • Out-of-Network: No Coins – No Copay
  • Oral and Maxillofacial Surgery
    • In-Network: 0-50 Coins – No Co pay (Limits Apply)
    • Out-of-Network: No Coins – No Copay (Limits Apply)
  • Periodontics
    • In-Network: No Coins – No Co pay
    • Out-of-Network: No Coins – No Copay
  • Restorative Services
    • In-Network: 50 Coins – No Co pay
    • Out-of-Network: No Coins – No Copay

Diagnostic and Preventive Dental

  • Dental X-Rays
    • In-Network: No Coins – No Copay
    • Out-of-Network: No Coins – No Copay
  • Fluoride Treatment
    • In-Network: No Coins – No Copay
    • Out-of-Network: No Coins – No Copay
  • Oral Exams
    • In-Network: No Coins – No Copay
    • Out-of-Network: No Coins – No Copay
  • Prophylaxis (cleaning)
    • In-Network: No Coins – No Copay
    • Out-of-Network: No Coins – No Copay

Diagnostic procedures/lab services/imaging

  • Lab services
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Diagnostic tests and procedures
    • In-Network: $0-180 copay (Authorization Required)
  • Outpatient x-rays
    • In-Network: $35 copay (Authorization Required)
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Diagnostic radiology services (e.g., MRI)
    • In-Network: $0-270 copay (Authorization Required)
  • Diagnostic tests and procedures
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Lab services
    • In-Network: $0 copay (Authorization Required)
  • Diagnostic radiology services (e.g., MRI)
    • Out-of-Network: 40% coinsurance (Authorization Required)

Doctor visits

  • Primary
    • Out-of-Network: 40% coinsurance per visit
  • Specialist
    • In-Network: $45 copay per visit
    • Out-of-Network: 40% coinsurance per visit
  • Primary
    • In-Network: $0 copay

Emergency care/Urgent care

  • Urgent care
    • $0-45 copay per visit (always covered)
  • Emergency
    • $125 copay per visit (always covered)

Foot care (podiatry services)

  • Routine foot care
    • Not covered
  • Foot exams and treatment
    • Out-of-Network: 40% coinsurance
    • In-Network: $0-45 copay

Ground ambulance

    • In-Network: $300 copay
    • Out-of-Network: $300 copay

Health plan deductible

    • $0

Hearing

  • Fitting/evaluation
    • In-Network: $0 copay (Limits Apply)
  • Hearing aids
    • Out-of-Network: $0-1,575 copay (Limits Apply)
    • In-Network: $0-1,575 copay (Limits Apply)
  • Medicare-Covered Hearing Exam
    • In-Network: $0-45 copay
  • Hearing aids OTC
    • Not covered
  • Medicare-Covered Hearing Exam
    • Out-of-Network: 40% coinsurance
  • Fitting/evaluation
    • Out-of-Network: $0 copay (Limits Apply)

Inpatient hospital coverage

    • In-Network: $350 per day for days 1 through 5
      $0 per day for days 6 through 90 (Authorization Required)
    • Out-of-Network: 40% per stay (Authorization Required)

Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)

    • $5,200 In and Out-of-network
      $5,200 In-network

Medical equipment/supplies

  • Diabetes supplies
    • Out-of-Network: 40% coinsurance per item
  • Durable medical equipment (e.g., wheelchairs, oxygen)
    • Out-of-Network: 40% coinsurance per item (Authorization Required)
  • Prosthetics (e.g., braces, artificial limbs)
    • Out-of-Network: 40% coinsurance per item (Authorization Required)
  • Durable medical equipment (e.g., wheelchairs, oxygen)
    • In-Network: 20% coinsurance per item (Authorization Required)
  • Prosthetics (e.g., braces, artificial limbs)
    • In-Network: 20% coinsurance per item (Authorization Required)
  • Diabetes supplies
    • In-Network: 0-20% coinsurance per item

Medicare Part B drugs

  • Other Part B drugs
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Chemotherapy
    • Out-of-Network: 40% coinsurance (Authorization Required)
    • In-Network: 0-20% coinsurance (Authorization Required)
  • Other Part B drugs
    • In-Network: 0-20% coinsurance (Authorization Required)

Mental health services

  • Inpatient hospital – psychiatric
    • Out-of-Network: 40% per stay (Authorization Required)
  • Outpatient individual therapy visit
    • Out-of-Network: 40% coinsurance
  • Outpatient individual therapy visit with a psychiatrist
    • In-Network: $15 copay
    • Out-of-Network: 40% coinsurance
  • Inpatient hospital – psychiatric
    • In-Network: $350 per day for days 1 through 5
      $0 per day for days 6 through 90 (Authorization Required)
  • Outpatient group therapy visit with a psychiatrist
    • Out-of-Network: 40% coinsurance
  • Outpatient individual therapy visit
    • In-Network: $15 copay
  • Outpatient group therapy visit
    • In-Network: $15 copay
    • Out-of-Network: 40% coinsurance
  • Outpatient group therapy visit with a psychiatrist
    • In-Network: $15 copay

Optional supplemental benefits

    • Yes

Other health plan deductibles?

    • In-Network: No

Outpatient hospital coverage

    • In-Network: $0-325 copay per visit (Authorization Required)
    • Out-of-Network: 40% coinsurance per visit (Authorization Required)

Preventive care

    • In-Network: $0 copay
    • Out-of-Network: 40% coinsurance

Rehabilitation services

  • Occupational therapy visit
    • Out-of-Network: 40% coinsurance (Authorization Required)
    • In-Network: $20 copay (Authorization Required)
  • Physical therapy and speech and language therapy visit
    • Out-of-Network: 40% coinsurance (Authorization Required)
    • In-Network: $20 copay (Authorization Required)

Skilled Nursing Facility

    • In-Network: $0 per day for days 1 through 20
      $214 per day for days 21 through 100 (Authorization Required)
    • Out-of-Network: 40% per stay (Authorization Required)

Transportation

    • Not covered

Vision

  • Contact lenses
    • Out-of-Network: $0 copay (Limits Apply)
  • Eyeglass frames
    • Out-of-Network: $0 copay (Limits Apply)
  • Routine eye exam
    • Out-of-Network: $0 copay (Limits Apply)
  • Eyeglasses (frames and lenses)
    • In-Network: $0 copay (Limits Apply)
    • Out-of-Network: $0 copay (Limits Apply)
  • Other
    • Not covered
  • Upgrades
    • Not covered
  • Contact lenses
    • In-Network: $0 copay (Limits Apply)
  • Eyeglass lenses
    • In-Network: $0 copay (Limits Apply)
  • Eyeglass frames
    • In-Network: $0 copay (Limits Apply)
  • Eyeglass lenses
    • Out-of-Network: $0 copay (Limits Apply)
  • Routine eye exam
    • In-Network: $0 copay (Limits Apply)

Wellness programs (e.g., fitness, nursing hotline)

    • Covered

Delta Dental Plan 50

Comprehensive Dental

  • Periodontics, Prosthodontics, removable, Implant Services, Prosthodontics, fixed
    • Monthly Premium: $19.90
    • Max Coverage: $2000.00
    • Coverage Periodicity: Every year

Diagnostic and Preventive Dental

  • Other Diagnostic Dental Services
    • Monthly Premium: $19.90
    • Max Coverage: $2000.00
    • Coverage Periodicity: Every year

Ready to sign up for HAP Medicare Explore (PPO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

Table of Contents

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All plan-related information on this site is from CMS.gov and Medicare.gov. We only use data released publicly each year. While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. Contact a plan for a Summary of Benefits.

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