• Amerigroup Medicare Advantage (Part C) plans are referred to as Amerivantage plans.
  • The only types of Amerivantage plans offered are Health Maintenance Organization (HMO) plans and HMO Special Needs Plans (SNPs).
  • Amerivantage plans are available in many counties within six different states.

Amerigroup is a private insurance company that offers Medicare Advantage (Part C) plans in multiple counties throughout six states. These are referred to as Amerivantage plans. Each plan is either an HMO or an HMO SNP.

HMOs generally have their own network of doctors, hospitals, and healthcare providers. These providers have an agreement with Medicare to accept certain payment amounts for their services.

Like all Part C plans, Amerivantage plans cover at least as much as original Medicare (parts A and B). Amerivantage offers several different types of HMO plans, which we’ll discuss below in more detail.

Amerivantage plans are available for purchase through local insurers. States where you may be able to buy an Amerivantage plan are:

  • Arizona
  • New Jersey
  • New Mexico
  • Tennessee
  • Texas
  • Washington

Not every plan is available in every state, ZIP code, or county.

Amerigroup has several options for HMO and HMO SNP plans. Depending on your location, these may vary in plan name, costs, and benefits.

Next, we’ll go over the typical costs and coverage you’ll see with each of the Amerivantage plans.

HMOs

Amerivantage Classic

Like all HMOs, this plan requires you to use in-network providers.

Out-of-pocket costs include a $5 copay for primary care physician (PCP) visits and a $35 copay for specialist visits. The annual out-of-pocket maximum is $6,700 for in-network providers.

You’ll have a $0 annual deductible and a $0 monthly premium, but you will need to pay your monthly Part B premium.

Benefits included in this plan are:

  • prescription drug coverage
  • over-the-counter medication coverage
  • the SilverSneakers fitness program
  • coverage for vision, dental, and hearing services

Amerivantage Select

Aside from your monthly Part B premium, this plan has a low or no cost monthly premium ($0). It also has a $0 copay for PCP visits and a $25 copy for specialist visits.

It has a $0 annual deductible. Your annual out-of-pocket maximum for in-network providers will be $3,400.

Benefits of this plan include:

  • prescription drug coverage
  • over-the-counter medication coverage
  • SilverSneakers fitness program
  • hearing and dental coverage
  • transportation services
  • a personal emergency response system

Amerivantage Balance

In addition to your Part B monthly premium, the Balance plan requires you to pay a monthly premium of around $22, based on your location. It has a $0 copay for PCP visits and a $35 copay for specialist visits.

It also has a $0 annual deductible. Your annual out-of-pocket maximum for in-network providers is $5,900.

This plan includes additional benefits, such as:

  • transportation services
  • prescription drug coverage
  • over-the-counter medication coverage
  • SilverSneakers fitness program
  • hearing, dental, and vision coverage
  • a personal emergency response system

HMO SNPs

Amerivantage Dual Premier plans

There are several types of Dual Premier plans:

  • HMO Dual Eligible Special Needs Plans (D-SNPs): available to those who qualify for dual eligibility in Medicare and Medicaid
  • HMO Institutional Special Needs Plans (I-SNPs): open to those who’ve had or are expected to need long-term care of at least 90 days or longer in a skilled nursing facility
  • HMO Chronic Condition Special Needs Plans (C-SNPs): designed for people with chronic special needs
  • HMO Institutional-Equivalent Special Needs Plans (IE-SNPs): available to people who live at home or in an assisted living facility but need a level of care given in a skilled nursing facility

Amerivantage SNP plans have a $0 to $15 monthly premium, plus the annual Part B deductible.

They have a $0 annual deductible and $0 monthly copays for PCP and specialist visits. Your annual out-of-pocket maximum for these plans will be $6,700 for in-network providers.

These plans cover everything that original Medicare covers, plus:

  • acupuncture
  • over-the-counter medications
  • prescription drugs
  • SilverSneakers fitness program
  • a personal emergency response system

Some SNP plans also come with an option known as Everyday Extras. Everyday Extras include coverage for services such as personal home helpers, transportation, food delivery, pest control, and service dog support.

Medicare Part D is prescription drug coverage that Medicare beneficiaries are entitled to buy. It’s included in many Part C plans but can also be purchased from private insurers as a standalone plan.

Amerigroup offers several Part D plans in the same six states where you may be able to buy a Part C plan. Their Part D plans options include:

  • Amerivantage RX Basic
  • Amerivantage RX Enhanced

These plans cover prescription drugs at most major U.S. pharmacies. They have a preferred network of 24,000 pharmacies nationwide, where your copays may be less expensive.

In general, you can expect to pay a monthly premium of around $20 to $38 for an Amerigroup Part D plan. You will have an annual pharmacy deductible of around $300 to $350. Your copay for generic medications may be as little as $1 per prescription.

Amerivantage plans cover everything that Part A covers, including:

They also include medically necessary outpatient services that Part B covers, including:

Amerivantage plans also cover extras, such as:

Medicare Advantage (Part C) plans are an additional insurance option sold by private insurers. They cover everything that original Medicare covers, plus some extras you may benefit from.

You must be enrolled in original Medicare (parts A and B) before you can buy a Part C plan.

You might like Part C because these plans typically cover services that Part A and Part B don’t. These services include prescription drugs, vision, dental, and hearing.

If you choose a Part C plan, though, you’ll often have to use providers that are within a specific network. And since they’re sold by local insurance companies, not every Part C plan is available in every location. The plans you’re eligible to buy will be determined by your state, county, and ZIP code.

In 2020, if you have end stage renal disease (ESRD), you may only be eligible for an SNP type of Part C plan.

Medicare Part D is an additional insurance option that covers prescription drugs. Like Part C plans, Part D is sold by local private insurers.

You can only buy a Part D plan if you’re enrolled in original Medicare. If you have a Part C (Advantage) plan, you’re not eligible for Part D.

Every Part D plan has a tier or formulary system. A drug formulary is a list of prescription drugs that are covered at different rates. It may include both generic and brand-name medications.

Medicare’s formulary includes four or more tiers:

  • Tier 1: the least expensive tier that includes preferred generic drugs
  • Tier 2: includes preferred brand name drugs
  • Tier 3: includes nonpreferred brand name drugs
  • Tier 4 and up: includes high-end medications and specialty drugs

Amerigroup offers HMO and HMO SNP Medicare Advantage plans in six states. These plans have relatively low monthly premiums and copays.

Most plans provide some benefits that original Medicare doesn’t offer, such as prescription drug coverage; transportation services; and dental, vision, and hearing coverage.

Some plans also cover extra perks such as the SilverSneakers fitness program, acupuncture, and personal emergency response systems.

You can use Medicare’s plan finder tool to compare different options available in your location.

The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.

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