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Your Health, Our Commitment

2020 Ponce de Leon Blvd, Suite PH 1, Coral Gables, FL 33134

2022 MEDICARE ADVANTAGE PLANS

Doctors HealthCare Plans, Inc., offers six Miami-Dade County plans and three Broward County plans to accommodate your unique coverage needs. All plans provide the same benefits as traditional Medicare as well as additional benefits such as: Prescription Drug Coverage, Dental Services, Vision Benefits, Hearing Benefit, Acupuncture, Telehealth, Fitness Membership or At-Home-Fitness Kit, Over the Counter Medications (OTC), and Transportation.

All plans have a Point-of-Service benefit without a referral. This benefit allows you to access out-of-network specialists for office visits in Miami-Dade County and Broward County up to your plan’s specific benefit amount.* A prior authorization is required. The following specialties are excluded: Pain Management, Dermatology, Oncology, and Behavioral Health.

All plans provide coverage for Durable Medical Equipment.  The list of preferred vendors and manufacturers for durable medical equipment (DME) is attached. Click here to see listCovered DME items include but are not limited to: oxygen equipment and supplies, wheelchairs, walkers, powered mattress systems, crutches, diabetic supplies, speech generating devices, IV infusion pumps, and nebulizers.

To enroll, you must be entitled to Medicare Part A, enrolled in Medicare Part B, and reside in Miami-Dade or Broward County. For the Special Needs Plan (SNP), certain additional requirements apply.

HOW TO REACH US
If you are a member,
please call Member Services at:
786-460-3427
Toll Free: 1-833-342-7463, TTY 711,
7 days a week, 8:00 AM to 8:00 PM
If you are not a member,
please call a Licensed Sales Agent at:
786-420-3427
Toll Free: 833-639-3427, TTY 711,
7 days a week 8:00 AM to 6:00 PM

Miami-Dade Plans

DrMax

(HMO-POS)
A Plan with Richer Benefits and Prescription Drug Coverage
Click Here

DrPlus

(HMO-POS D-SNP)
A Special Needs Plan for Dual Eligible Individuals who have Medicare and Medicaid with Prescription Drug Coverage
Click Here

DrExtraCare

(HMO-POS C-SNP)
A Special Needs Plan for People Living with Diabetes and/or Chronic Heart Failure with Prescription Drug Coverage
Click Here

DrValue

(HMO-POS)
A Part B Give-Back Plan with Prescription Drug Coverage
Click Here

DrFirst

(HMO-POS)
A Plan with EXTRA Benefits and Prescription Drug Coverage
Click Here

DrChoice

(HMO-POS)
A Plan with a Defined PCP Network with EXTRA Benefits and Prescription Drug Coverage
Click Here
DrMax (HMO-POS)

Download the Summary of Benefits (SB) English / Spanish

Downloand the Over the Counter (OTC) Catalog.

You may conveniently order:

    • By calling: 1-888-628-2770; TTY: 1-877-672-2688, Monday to Friday, 9 AM to 8 PM E.S.T.
    • Online

Download the Evidence of Coverage (EOC) English / Spanish

Download the Annual Notice of Change for 2022 (ANOC) English / Spanish

Monthly Plan Premium $0
Maximum Out-of-Pocket Amount
$3,000
Primary Care / Specialists Visits $0 per visit
Inpatient Hospital Stays $0 per stay
Comprehensive Dental
  • 1 Root Canal per year
  • 1 Crown per year
  • 4 Extractions per year
  • 1 Deep Cleaning every 2 years
  • 2 Fillings per year
  • 1 Full Upper and 1 Full Lower Denture every 5 years
  • 1 Upper Partial and 1 Lower Partial Denture per 5 years
Telehealth
$0 copay for certain telehealth visits
Acupuncture $0 copayment for up to 20 treatments a year
Part D Prescription Drug Coverage

Copayment/Coinsurance during the Initial Coverage Stage, for a 30-day supply from a retail or mail order pharmacy:

  • Drug Tier 1: $0
  • Drug Tier 2: $0
  • Drug Tier 3: $0
  • Drug Tier 4: $45
  • Drug Tier 5: 33%
Initial Coverage Limit $6,500
Insulin Savings Program You will pay $0 for a 1-month supply of Select Insulins during the Initial Coverage and Coverage Gap Stages of your benefit. To find out which drugs are Select Insulins, review the most recent Drug List. You can identify Select Insulins by the “SI” designation in the Drug List.
DrPlus (HMO-POS D-SNP)

Download the Summary of Benefits (SB) English / Spanish

Downloand the Over the Counter (OTC) Catalog.

You may conveniently order:

    • By calling: 1-888-628-2770; TTY: 1-877-672-2688, Monday to Friday, 9 AM to 8 PM E.S.T.
    • Online

Download the Evidence of Coverage (EOC) English / Spanish

Download the Annual Notice of Change for 2022 (ANOC) English / Spanish

Monthly Plan Premium $0-$26.40
Premium may be covered through your State Medicaid Program.
Maximum Out-of-Pocket Amount
$3,400
Primary Care / Specialists Visits $0 per visit
Inpatient Hospital Stays $0 per stay
Comprehensive Dental
  • 1 Root Canal per year
  • 2 Crowns per year
  • 4 Extractions per year
  • 1 Deep Cleaning every 2 years
  • 4 Fillings per year
  • 1 Full Upper and 1 Full Lower Denture every 5 years
  • 1 Upper Partial and 1 Lower Partial Denture per 5 years
Telehealth
$0 copay for certain telehealth visits.
Personal / Respite Care $0 copay for personal care assistance, 1 hour a day for 5 days a week.
Acupuncture $0 copayment for up to 20 treatments a year
Part D Prescription Drug Coverage

If you receive “EXTRA Help” from Medicare, your cost for prescription drugs may be lower.

Copayment/Coinsurance for a 30-day supply from a retail or mail order pharmacy:

  • Drug Tier 1: $0
  • Drug Tier 2: $0
  • Drug Tier 3: $0
  • Drug Tier 4: $35
  • Drug Tier 5: 33%
Initial Coverage Limit $6,000

Must be a Qualified Medicare Beneficiary (QMB, QMB+), Specified Low-Income Medicare Beneficiary (SLMB, SLMB+), Full Benefit Dual Eligible (FBDE), Qualified Individual (QI) or Qualified Disabled and Working Individual (QDWI). DrPlus (HMO-POS D-SNP) is sponsored by Doctors HealthCare Plans, Inc. and the State of Florida Agency for Health Care Administration. DrPlus (HMO-POS D-SNP) has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until December 31, 2024 based on a review of the Model of Care

DrExtraCare (HMO-POS C-SNP)

Download the Summary of Benefits (SB) English / Spanish

Downloand the Over the Counter (OTC) Catalog.

You may conveniently order:

    • By calling: 1-888-628-2770; TTY: 1-877-672-2688, Monday to Friday, 9 AM to 8 PM E.S.T.
    • Online

Download the Evidence of Coverage (EOC) English / Spanish

Download the Annual Notice of Change for 2022 (ANOC) English / Spanish

Monthly Plan Premium $0
Maximum Out-of-Pocket Amount
$3,400
Primary Care / Specialists Visits $0 per visit
Inpatient Hospital Stays $0 per stay
Comprehensive Dental
  • 1 Deep Cleaning every 2 years
  • 2 Fillings per year
  • 1 Full Upper and 1 Full Lower Denture every 5 years
  • 1 Upper Partial and 1 Lower Partial Denture per 5 years
Telehealth
$0 copay for certain telehealth visits.
Acupuncture $0 copayment for up to 20 treatments a year
Part D Prescription Drug Coverage

Copayment/Coinsurance for a 30-day supply from a retail or mail order pharmacy:

  • Drug Tier 1: $0
  • Drug Tier 2: $0
  • Drug Tier 3: $10
  • Drug Tier 4: $40
  • Drug Tier 5: 33%
Initial Coverage Limit $5,000
Insulin Savings Program You will pay $10 for a 1-month supply of Select Insulins during the Initial Coverage and Coverage Gap Stages of your benefit. To find out which drugs are Select Insulins, review the most recent Drug List. You can identify Select Insulins by the “SI” designation in the Drug List.

DrExtraCare (HMO-POS C-SNP) has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until December 31, 2022 based on a review of the Model of Care.

DrValue (HMO-POS)

Download the Summary of Benefits (SB) English / Spanish

Downloand the Over the Counter (OTC) Catalog.

You may conveniently order:

    • By calling: 1-888-628-2770; TTY: 1-877-672-2688, Monday to Friday, 9 AM to 8 PM E.S.T.
    • Online

Download the Evidence of Coverage (EOC) English / Spanish

Download the Annual Notice of Change for 2022 (ANOC) English / Spanish

Return of Part B Premium
Up to $100
Monthly Plan Premium $0
Maximum Out-of-Pocket Amount
$3,400
Primary Care / Specialists Visits $0 per visit
Inpatient Hospital Stays

Inpatient Hospital Stays:
$0 per stay Days 1-4
$85 per stay Days 5-90
$0 per stay Days 91+
OR until maximum out of pocket is reached

Inpatient Hospital Psychiatric Stays:
$100 per stay Days 1-5
$0 per stay Days 6-90+
OR until maximum out of pocket is reached

Preventative Dental Cleanings, X-rays, and Oral Exams
Telehealth $0 copay for certain telehealth visits.
Acupuncture $0 copayment for up to 20 treatments a year
Part D Prescription Drug Coverage

Copayment/Coinsurance during the Initial Coverage Stage, for a 30-day supply from a retail or mail order pharmacy:

  • Drug Tier 1: $0
  • Drug Tier 2: $0
  • Drug Tier 3: $45
  • Drug Tier 4: $90
  • Drug Tier 5: 33%
Initial Coverage Limit $4,430
DrFirst (HMO-POS)

Download the Summary of Benefits (SB) English / Spanish

Downloand the Over the Counter (OTC) Catalog.

You may conveniently order:

    • By calling: 1-888-628-2770; TTY: 1-877-672-2688, Monday to Friday, 9 AM to 8 PM E.S.T.
    • Online

Download the Evidence of Coverage (EOC) English / Spanish

Download the Annual Notice of Change for 2022 (ANOC) English / Spanish

Monthly Plan Premium $0-$29.50
Premium may be covered through your State Medicaid Program.
Maximum Out-of-Pocket Amount $3,400
Primary Care / Specialists Visits $0 per visit
Inpatient Hospital Stays $0 per stay
Comprehensive Dental
  • 2 Extractions per year
  • 1 Deep Cleaning every 2 years
  • 2 Fillings per year
  • 1 Full Upper and 1 Full Lower Denture every 5 years
  • 1 Upper Partial and 1 Lower Partial Denture per 5 years
Telehealth
$0 copay for certain telehealth visits.
Acupuncture
$0 copayment for up to 20 treatments a year
Part D Prescription Drug Coverage

Deductible: $480 (for Tiers 3-5)

If you receive “EXTRA Help” from Medicare, your cost for prescription drugs may be lower.

Copayment/Coinsurance during the Initial Coverage Stage, for a 30-day supply from a retail or mail order pharmacy:

  • Drug Tier 1: $0
  • Drug Tier 2: $0
  • Drug Tier 3: 25%
  • Drug Tier 4: 25%
  • Drug Tier 5: 25%
Initial Coverage Limit $4,430
DrChoice (HMO-POS)

Download the Summary of Benefits (SB) English / Spanish

Downloand the Over the Counter (OTC) Catalog.

You may conveniently order:

    • By calling: 1-888-628-2770; TTY: 1-877-672-2688, Monday to Friday, 9 AM to 8 PM E.S.T.
    • Online

Download the Evidence of Coverage (EOC) English / Spanish

Download the Annual Notice of Change for 2022 (ANOC) English / Spanish

Monthly Plan Premium $0-$33.40
Premium may be covered through your State Medicaid Program.
Maximum Out-of-Pocket Amount
$3,400
Primary Care / Specialists Visits $0 per visit
Inpatient Hospital Stays $0 per stay
Dental
  • 1 Root Canal per year
  • 2 Crown per year
  • 4 Extractions per year
  • 1 Deep Cleaning every 2 years
  • 2 Fillings per year
  • 1 Full Upper and 1 Full Lower Denture every 5 years
  • 1 Upper Partial and 1 Lower Partial Denture per 5 years
Telehealth $0 copay for certain telehealth visits.
Acupuncture $0 copayment for up to 20 treatments a year
Part D Prescription Drug Coverage

Deductible: $480 (for Tiers 3-5)

If you receive “EXTRA Help” from Medicare, your cost for prescription drugs may be lower.

Copayment/Coinsurance during the Initial Coverage Stage, for a 30-day supply from a retail or mail order pharmacy:

  • Drug Tier 1: $0
  • Drug Tier 2: $0
  • Drug Tier 3: 25%
  • Drug Tier 4: 25%
  • Drug Tier 5: 25%
Initial Coverage Limit $4,430
Reward Program Up to $100 quarterly based on completion of identified health activities. (Read more)
Personal/Respite Care $0 copay for personal care assistance, 1 hour a day for 5 days a week.

Broward Plans

DrMax-B

(HMO-POS)
A Plan with Richer Benefits and Prescription Drug Coverage
Click Here

DrPlus-B

(HMO-POS D-SNP)
A Special Needs Plan for Dual Eligible Individuals who have Medicare and Medicaid with Prescription Drug Coverage
Click Here

DrValue-B

(HMO-POS)
A Part B Give-Back Plan with Prescription Drug Coverage
Click Here
DrMax-B (HMO-POS)

Download the Summary of Benefits (SB) English / Spanish

Downloand the Over the Counter (OTC) Catalog.

You may conveniently order:

    • By calling: 1-888-628-2770; TTY: 1-877-672-2688, Monday to Friday, 9 AM to 8 PM E.S.T.
    • Online

Download the Evidence of Coverage (EOC) English / Spanish

Monthly Plan Premium $0
Maximum Out-of-Pocket Amount
$3,400
Primary Care / Specialists Visits $0 per visit
Inpatient Hospital Stays $0 per stay
Comprehensive Dental
  • 1 Root Canal per year
  • 1 Crown per year
  • 4 Extractions per year
  • 1 Deep Cleaning every 2 years
  • 2 Fillings per year
  • 1 Full Upper and 1 Full Lower Denture every 5 years
  • 1 Upper Partial and 1 Lower Partial Denture per 5 years
Telehealth
$0 copay for certain telehealth visits
Part D Prescription Drug Coverage

Copayment/Coinsurance during the Initial Coverage Stage, for a 30-day supply from a retail or mail order pharmacy:

  • Drug Tier 1: $0
  • Drug Tier 2: $0
  • Drug Tier 3: $45
  • Drug Tier 4: $100
  • Drug Tier 5: 33%
Initial Coverage Limit  $4,430
Insulin Savings Program You will pay $35 for a 1-month supply of Select Insulins during the Initial Coverage and Coverage Gap Stages of your benefit. To find out which drugs are Select Insulins, review the most recent Drug List. You can identify Select Insulins by the “SI” designation in the Drug List.
DrPlus-B (HMO-POS D-SNP)

Download the Summary of Benefits (SB) English / Spanish

Downloand the Over the Counter (OTC) Catalog.

You may conveniently order:

    • By calling: 1-888-628-2770; TTY: 1-877-672-2688, Monday to Friday, 9 AM to 8 PM E.S.T.
    • Online

Download the Evidence of Coverage (EOC) English / Spanish

Monthly Plan Premium $0-$26.50
Premium may be covered through your State Medicaid Program.
Maximum Out-of-Pocket Amount
$2,850
Primary Care / Specialists Visits $0 per visit
Inpatient Hospital Stays $0 per stay
Comprehensive Dental
  • 1 Root Canal per year
  • 1 Crown per year
  • 2 Extractions per year
  • 1 Deep Cleaning every 2 years
  • 2 Fillings per year
  • 1 Full Upper and 1 Full Lower Denture every 5 years
  • 1 upper partial and 1 upper lower every 5 years
Telehealth
$0 copay for certain telehealth visits.
Personal / Respite Care $0 copay for personal care assistance, 1 hour a day for 5 days a week.
Part D Prescription Drug Coverage

If you receive “EXTRA Help” from Medicare, your cost for prescription drugs may be lower.

Copayment/Coinsurance for a 30-day supply from a retail or mail order pharmacy:

  • Drug Tier 1: $0
  • Drug Tier 2: $0
  • Drug Tier 3: $0
  • Drug Tier 4: $35
  • Drug Tier 5: 33%
Initial Coverage Limit: $4,430

Must be a Qualified Medicare Beneficiary (QMB, QMB+), Specified Low-Income Medicare Beneficiary (SLMB, SLMB+), Full Benefit Dual Eligible (FBDE), Qualified Individual (QI) or Qualified Disabled and Working Individual (QDWI). DrPlus (HMO-POS D-SNP) is sponsored by Doctors HealthCare Plans, Inc. and the State of Florida Agency for Health Care Administration. DrPlus (HMO-POS D-SNP) has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until December 31, 2024 based on a review of the Model of Care.

DrValue-B (HMO-POS)

Download the Summary of Benefits (SB) English / Spanish

Downloand the Over the Counter (OTC) Catalog.

You may conveniently order:

    • By calling: 1-888-628-2770; TTY: 1-877-672-2688, Monday to Friday, 9 AM to 8 PM E.S.T.
    • Online

Download the Evidence of Coverage (EOC) English / Spanish

Return of Part B Premium
Up to $100
Monthly Plan Premium $0
Maximum Out-of-Pocket Amount
$3,400
Primary Care / Specialists Visits $0 per Primary Care visit
$20 per Specialist visit
Inpatient Hospital Stays

Inpatient Hospital Stays:
$200 per stay Days 1-6
$0 per stay Days 7-90+
OR until maximum out of pocket is reached

Inpatient Hospital Psychiatric Stays:
$100 per stay Days 1-5
$0 per stay Days 6-90+
OR until maximum out of pocket is reached

Preventative Dental Cleanings, X-rays, and Oral Exams
Telehealth $0 copay for certain telehealth visits.
Part D Prescription Drug Coverage

Copayment/Coinsurance during the Initial Coverage Stage, for a 30-day supply from a retail or mail order pharmacy:

  • Drug Tier 1: $0
  • Drug Tier 2: $0
  • Drug Tier 3: $45
  • Drug Tier 4: $95
  • Drug Tier 5: 33%
Initial Coverage Limit $4,430

*Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call our Member Services number or see the Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

H4140_DHCPWSMAPD2022_M
Last Updated: 10/18/2021

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