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Select Health Medicare Flex (HMO)

H1994 - 031 - 0
4 out of 5 stars (4 / 5)

select-health medicare provider logo

Select Health Medicare Flex (HMO) is a Medicare Advantage Plan by Select Health.

This page features plan details for 2025 Select Health Medicare Flex (HMO) H1994 – 031 – 0 available in Colorado Front Range and Western Slope.

Locations

Select Health Medicare Flex (HMO) is offered in the following locations.

Adams County, Colorado
Arapahoe County, Colorado
Boulder County, Colorado

Click to see more locations

Plan Overview

Select Health Medicare Flex (HMO) offers the following coverage and cost-sharing.

Insurer:Select Health
Health Plan Deductible:$0
MOOP:$4,900 In-network
Drugs Covered:Yes

Ready to sign up for Select Health Medicare Flex (HMO) ?

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

Select Health Medicare Flex (HMO) 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

Select Health Medicare Flex (HMO) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Deductible: $200.00
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 $200.00 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

Select Health Medicare Flex (HMO) 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)
  • Endodontics
    • In-Network: No Coins – No Co pay (Limits Apply)
  • Implant Services
    • In-Network: No Coins – No Co pay (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)
  • Orthodontics
    • In-Network: No Coins – No Co pay (Limits Apply)
  • Periodontics
    • In-Network: No Coins – No Co pay (Limits Apply)
  • Prosthodontics, fixed
    • In-Network: No Coins – No Co pay (Limits Apply)
  • Prosthodontics, removable
    • In-Network: No Coins – No Co pay (Limits Apply)
  • Restorative Services
    • In-Network: No Coins – No Co pay (Limits Apply)

Diagnostic and Preventive Dental

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

Diagnostic procedures/lab services/imaging

  • Diagnostic radiology services (e.g., MRI)
    • $0-150 copay (Authorization Required)
  • Outpatient x-rays
    • $0 copay (Authorization Required)
  • Lab services
    • $0 copay (Authorization Required)
  • Diagnostic tests and procedures
    • $0-25 copay or 0-20% coinsurance (Authorization Required)

Doctor visits

  • Primary
    • $0 copay
  • Specialist
    • $25 copay per visit

Emergency care/Urgent care

  • Urgent care
    • $40 copay per visit (always covered)
  • Emergency
    • $125 copay per visit (always covered)

Foot care (podiatry services)

  • Routine foot care
    • $25 copay (Limits Apply)
  • Foot exams and treatment
    • $25 copay

Ground ambulance

    • $275 copay

Health plan deductible

    • $0

Hearing

  • Fitting/evaluation
    • $0 copay (Limits Apply)
  • Hearing aids OTC
    • Not covered
  • Hearing aids
    • $0 copay
  • Medicare-Covered Hearing Exam
    • $25 copay

Inpatient hospital coverage

    • $300 per day for days 1 through 5
      $0 per day for days 6 through 90 (Authorization Required)

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

    • $4,900 In-network

Medical equipment/supplies

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

Medicare Part B drugs

  • Chemotherapy
    • 0-20% coinsurance (Authorization Required)
  • Other Part B drugs
    • 0-20% coinsurance (Authorization Required)

Mental health services

  • Outpatient group therapy visit
    • $20 copay
  • Outpatient individual therapy visit
    • $30 copay
  • Outpatient group therapy visit with a psychiatrist
    • $20 copay
  • Outpatient individual therapy visit with a psychiatrist
    • $30 copay
  • Inpatient hospital – psychiatric
    • $300 per day for days 1 through 5
      $0 per day for days 6 through 90 (Authorization Required)

Optional supplemental benefits

    • No

Other health plan deductibles?

    • In-Network: No

Outpatient hospital coverage

    • $25-250 copay or 20% coinsurance per visit (Authorization Required)

Preventive care

    • $0 copay

Rehabilitation services

  • Occupational therapy visit
    • $30 copay (Authorization Required)
  • Physical therapy and speech and language therapy visit
    • $30 copay (Authorization Required)

Skilled Nursing Facility

    • $0 per day for days 1 through 20
      $214 per day for days 21 through 55
      $0 per day for days 56 through 100 (Authorization Required)

Transportation

    • Not covered

Vision

  • Contact lenses
    • $0 copay (Limits Apply)
  • Routine eye exam
    • $0 copay (Limits Apply)
  • Upgrades
    • $0 copay (Limits Apply)
  • Eyeglass frames
    • Not covered
  • Eyeglass lenses
    • Not covered
  • Eyeglasses (frames and lenses)
    • $0 copay (Limits Apply)
  • Other
    • $0 copay (Limits Apply)

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

    • Covered (Authorization Required)

Ready to sign up for Select Health Medicare Flex (HMO) ?

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 Select Health Medicare Flex (HMO)? See 2025 Select Health Medicare Flex (HMO) at MedicareAdvantageRX.com.

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Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Anthem Blue Cross, Aspire Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, GlobalHealth, Health Care Service Corporation, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Baylor Scott & White Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint

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