Health New England Medicare Compass (PPO)

H2737 - 001 - 0
3.5 out of 5 stars (3.5 / 5)

Health New England Medicare Compass (PPO) is a Medicare Advantage Plan by Health New England Medicare Advantage Plans.

This page features plan details for 2025 Health New England Medicare Compass (PPO) H2737 – 001 – 0 available in Hampden, Hampshire, Franklin, Berkshire Counties.

Locations

Health New England Medicare Compass (PPO) is offered in the following locations.

Plan Overview

Health New England Medicare Compass (PPO) offers the following coverage and cost-sharing.

Insurer:Health New England Medicare Advantage Plans
Health Plan Deductible:$0
MOOP:$6,750 In and Out-of-network
$6,750 In-network
Drugs Covered:Yes

Ready to sign up for Health New England Medicare Compass (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

Health New England Medicare Compass (PPO) has a monthly premium of $19.00. 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 $19.00 $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

Health New England Medicare Compass (PPO) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Deductible: $490.00
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 $490.00 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

Health New England Medicare Compass (PPO) also provides the following benefits.

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

    • In-Network: No

Comprehensive Dental

  • Adjunctive General Services
    • In-Network: No Coins – No Co pay (Limits Apply)
    • Out-of-Network: No Coins – No Copay (Limits Apply)
  • Endodontics
    • In-Network: No Coins – No Co pay (Limits Apply)
    • Out-of-Network: No Coins – No Copay (Limits Apply)
  • Implant Services
    • In-Network: No Coins – No Co pay (Limits Apply)
    • Out-of-Network: No Coins – No Copay (Limits Apply)
  • Maxillofacial Prosthetics
    • Out-of-Network: No Coins – No Copay (Limits Apply)
  • Maxillofacial Prosthetics
    • In-Network: No Coins – No Co pay (Limits Apply)
  • Oral and Maxillofacial Surgery
    • In-Network: No Coins – No Co pay (Limits Apply)
    • Out-of-Network: No Coins – No Copay (Limits Apply)
  • Orthodontics
    • In-Network: No Coins – No Co pay (Limits Apply)
    • Out-of-Network: No Coins – No Copay (Limits Apply)
  • Periodontics
    • In-Network: No Coins – No Co pay (Limits Apply)
    • Out-of-Network: No Coins – No Copay (Limits Apply)
  • Prosthodontics, fixed
    • In-Network: No Coins – No Co pay (Limits Apply)
    • Out-of-Network: No Coins – No Copay (Limits Apply)
  • Prosthodontics, removable
    • In-Network: No Coins – No Co pay (Limits Apply)
    • Out-of-Network: No Coins – No Copay (Limits Apply)
  • Restorative Services
    • In-Network: No Coins – No Co pay (Limits Apply)
    • Out-of-Network: No Coins – No Copay (Limits Apply)

Diagnostic and Preventive Dental

  • Dental X-Rays
    • In-Network: No Coins – No Copay (Limits Apply)
    • Out-of-Network: No Coins – No Copay (Limits Apply)
  • Fluoride Treatment
    • In-Network: No Coins – No Copay (Limits Apply)
    • Out-of-Network: No Coins – No Copay (Limits Apply)
  • Oral Exams
    • In-Network: No Coins – No Copay (Limits Apply)
    • Out-of-Network: No Coins – No Copay (Limits Apply)
  • Other Diagnostic Dental Services
    • In-Network: No Coins – No Copay (Limits Apply)
    • Out-of-Network: No Coins – No Copay (Limits Apply)
  • Other Preventive Dental Services
    • In-Network: No Coins – No Copay (Limits Apply)
    • Out-of-Network: No Coins – No Copay (Limits Apply)
  • Prophylaxis (cleaning)
    • In-Network: No Coins – No Copay (Limits Apply)
    • Out-of-Network: No Coins – No Copay (Limits Apply)

Diagnostic procedures/lab services/imaging

  • Diagnostic tests and procedures
    • In-Network: $25 copay (Authorization Required)
  • Lab services
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Diagnostic radiology services (e.g., MRI)
    • In-Network: $0-300 copay (Authorization Required)
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Outpatient x-rays
    • In-Network: $35 copay (Authorization Required)
  • Diagnostic tests and procedures
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Lab services
    • In-Network: $25 copay (Authorization Required)
  • Outpatient x-rays
    • Out-of-Network: 40% coinsurance (Authorization Required)

Doctor visits

  • Specialist
    • In-Network: $50 copay per visit
    • Out-of-Network: $30-70 copay per visit
  • Primary
    • In-Network: $25 copay per visit
    • Out-of-Network: $30-70 copay per visit

Emergency care/Urgent care

  • Urgent care
    • $55 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
    • In-Network: $50 copay
    • Out-of-Network: 40% coinsurance

Ground ambulance

    • Out-of-Network: 40% coinsurance
    • In-Network: $300 copay

Health plan deductible

    • $0

Hearing

  • Fitting/evaluation
    • Out-of-Network: $0 copay
  • Hearing aids
    • Out-of-Network: $499-999 copay (Limits Apply)
    • In-Network: $499-999 copay (Limits Apply)
  • Hearing aids OTC
    • Not covered
  • Medicare-Covered Hearing Exam
    • In-Network: $50 copay
    • Out-of-Network: 40% coinsurance
  • Fitting/evaluation
    • In-Network: $0 copay

Inpatient hospital coverage

    • In-Network: $375 per day for days 1 through 6
      $0 per day for days 7 through 90
    • Out-of-Network: 40% per stay

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

    • $6,750 In and Out-of-network
      $6,750 In-network

Medical equipment/supplies

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

Medicare Part B drugs

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

Mental health services

  • Inpatient hospital – psychiatric
    • In-Network: $375 per day for days 1 through 6
      $0 per day for days 7 through 90
  • Outpatient group therapy visit
    • In-Network: $50 copay
  • Outpatient group therapy visit with a psychiatrist
    • Out-of-Network: 40% coinsurance
  • Outpatient individual therapy visit
    • In-Network: $50 copay
  • Outpatient group therapy visit
    • Out-of-Network: 40% coinsurance
  • Outpatient group therapy visit with a psychiatrist
    • In-Network: $45 copay
  • Outpatient individual therapy visit
    • Out-of-Network: 40% coinsurance
  • Inpatient hospital – psychiatric
    • Out-of-Network: 40% per stay
  • Outpatient individual therapy visit with a psychiatrist
    • In-Network: $45 copay
    • Out-of-Network: 40% coinsurance

Optional supplemental benefits

    • No

Other health plan deductibles?

    • In-Network: No

Outpatient hospital coverage

    • In-Network: $0-450 copay per visit (Authorization Required)
    • Out-of-Network: 40% coinsurance per visit (Authorization Required)

Preventive care

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

Rehabilitation services

  • Occupational therapy visit
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Physical therapy and speech and language therapy visit
    • Out-of-Network: 40% coinsurance (Authorization Required)
    • In-Network: $45 copay (Authorization Required)
  • Occupational therapy visit
    • In-Network: $45 copay (Authorization Required)

Skilled Nursing Facility

    • Out-of-Network: 40% per stay (Authorization Required)
    • In-Network: $10 per day for days 1 through 20
      $200 per day for days 21 through 50
      $0 per day for days 51 through 100 (Authorization Required)

Transportation

    • Not covered

Vision

  • Eyeglasses (frames and lenses)
    • Out-of-Network: $0 copay (Limits Apply)
  • Other
    • Out-of-Network: 40% coinsurance (Limits Apply)
  • Upgrades
    • In-Network: $0 copay (Limits Apply)
  • Contact lenses
    • In-Network: $0 copay (Limits Apply)
    • Out-of-Network: $0 copay (Limits Apply)
  • Eyeglass frames
    • In-Network: $0 copay (Limits Apply)
  • Eyeglass lenses
    • In-Network: $0 copay (Limits Apply)
    • Out-of-Network: $0 copay (Limits Apply)
  • Routine eye exam
    • In-Network: $0 copay (Limits Apply)
  • Upgrades
    • Out-of-Network: $0 copay (Limits Apply)
  • Eyeglass frames
    • Out-of-Network: $0 copay (Limits Apply)
  • Other
    • In-Network: $0 copay (Limits Apply)
  • Eyeglasses (frames and lenses)
    • In-Network: $0 copay (Limits Apply)
  • Routine eye exam
    • Out-of-Network: 40% coinsurance (Limits Apply)

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

    • Covered

Ready to sign up for Health New England Medicare Compass (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

Need more information on Health New England Medicare Compass (PPO)? See 2025 Health New England Medicare Compass (PPO) at MedicareAdvantageRX.com.

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