AHM_Classic Plus (HMO SNP) 2012
The AHM_Classic Plus (HMO SNP) plan has been designed for Medicare beneficiaries who had been diagnosed with diabetes and are interested in a detailed program that caters to their specific medical needs.
$0 monthly premium
$0 deductible
$5 copayment on visits to PCP
$5 copayment on visits to participating Specialists
$0 copayment on laboratories and X-rays
$0 copayment on Diabetes monitoring and supplements
$0 copayment on Podiatrist visits
$0 copayment on Oral Nutritional Supplements *
$0 copayment on Blood Pressure Monitors *
$0 copayment on adults diapers (Incontinence) *
$0 copayment on Shower Chairs *
* Certain restrictions apply.
Plan is available to beneficiaries residing in one of the 78 municipalities of Puerto Rico.
This plan is available to all people with Medicare who have been diagnosed with diabetes.
Please refer to the Evidence of Coverage and/or the Summary of Benefits for information on copayments/coinsurance.
Annual Notice of Change AHM_Classic Plus (HMO SNP) H5774_1027_12_03_E File & Use 09042011
Evidence of Coverage AHM_Classic Plus (HMO SNP) H5774_1027_12_03_E File & Use 09042011
Errata Sheet to AHM_Classic Plus (HMO SNP) ANOC/EOC H5774_1030_12_03_E CMS Approved 09072011
Summary of Benefits AHM_Classic Plus (HMO SNP) H5774_1001_12_04_E CMS Approved 09292011
Last Updated 01/17/2012
