2024 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 cover most Part D vaccines at no cost to you.
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 list. Covered 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 8:00 PM |
Miami-Dade Plans
DrMax
DrPlus
DrExtraCare
DrValue
DrSelect
DrFlex
DrMax (HMO)
Download the Over the Counter (OTC) Catalog English / Spanish
You may conveniently order:
-
- By calling: 1-888-628-2770; TTY: 711, Monday to Friday, 9 AM to 8 PM E.S.T.
- Online
- Or visit a CVS Pharmacy® store, CVS Pharmacy y más® o Navarro® (excluding Target, Schnucks and select other CVS Pharmacy® locations).
| 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 |
|
| Telehealth |
$0 copay for certain telehealth visits |
| Acupuncture | $0 copayment for up to 20 treatments a year Prior authorization required. |
| Part D Prescription Drug Coverage |
Copayment/Coinsurance during the Initial Coverage Stage, for a 30-day supply from a retail or mail order pharmacy:
You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on.
|
| Initial Coverage Limit | $7,000 |
DrPlus (HMO D-SNP)**
Download the Over the Counter (OTC) Catalog English / Spanish
You may conveniently order:
-
- By calling: 1-888-628-2770; TTY: 711, Monday to Friday, 9 AM to 8 PM E.S.T.
- Online
- Or visit a CVS Pharmacy® store, CVS Pharmacy y más® o Navarro® (excluding Target, Schnucks and select other CVS Pharmacy® locations).
| Monthly Plan Premium | $0-$31.50 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 |
|
| Prepaid Grocery / Utility Card* |
$50 monthly allowance on a prepaid card to be used at approved locations. Click here to learn more |
| 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 up to 60 hours a year. |
| Acupuncture | $0 copayment for up to 20 treatments a year Prior authorization is required. |
| Part D Prescription Drug Coverage |
Copayment/Coinsurance for a 30-day supply from a retail or mail order pharmacy:
|
| Initial Coverage Limit | You have coverage of all medications for all Tiers at $0 copayment thought all coverage stages. |
DrExtraCare (HMO C-SNP)
Download the Over the Counter (OTC) Catalog English / Spanish
You may conveniently order:
-
- By calling: 1-888-628-2770; TTY: 711, Monday to Friday, 9 AM to 8 PM E.S.T.
- Online
- Or visit a CVS Pharmacy® store, CVS Pharmacy y más® o Navarro® (excluding Target, Schnucks and select other CVS Pharmacy® locations).
| 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 |
|
| Telehealth |
$0 copay for certain telehealth visits. |
| Acupuncture | $0 copayment for up to 20 treatments a year Prior authorization is required. |
| Part D Prescription Drug Coverage |
Copayment/Coinsurance for a 30-day supply from a retail or mail order pharmacy:
You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on. |
| Initial Coverage Limit | $7,000 |
DrExtraCare (HMO C-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 (HMO)
Download the Over the Counter (OTC) Catalog English / Spanish
You may conveniently order:
-
- By calling: 1-888-628-2770; TTY: 711, Monday to Friday, 9 AM to 8 PM E.S.T.
- Online
- Or visit a CVS Pharmacy® store, CVS Pharmacy y más® o Navarro® (excluding Target, Schnucks and select other CVS Pharmacy® locations).
| Return of Part B Premium |
Up to $110 |
| Monthly Plan Premium | $0 |
| Maximum Out-of-Pocket Amount |
$3,400 |
| Primary Care / Specialists Visits | $0 per visit |
| Inpatient Hospital Stays |
Inpatient Hospital Stays Inpatient Hospital Psychiatric Stays: |
| Comprehensive Dental |
|
| Telehealth | $0 copay for certain telehealth visits. |
| Acupuncture | $0 copayment for up to 20 treatments a year Prior authorization is required. |
| Part D Prescription Drug Coverage |
Copayment/Coinsurance during the Initial Coverage Stage, for a 30-day supply from a retail or mail order pharmacy:
You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on. |
| Initial Coverage Limit | $5,030 |
DrSelect (HMO)
| 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 |
|
| Prepaid Card – Special Supplemental Benefits for the Chronically Ill (SSBCI)*** |
$105 per month for groceries and over-the-counter (OTC) items |
| Telehealth | $0 copay for certain telehealth visits. |
| Acupuncture | $0 copayment for up to 20 treatments a year. Prior authorization required. |
| Part D Prescription Drug Coverage |
Copayment/Coinsurance for a 30-day supply from a retail
You won’t pay more than $35 for a one-month supply of each |
| Initial Coverage Limit | $8,000 |
DrFlex (HMO D-SNP)**
| Monthly Plan Premium | $0-$31.80 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 |
|
| Prepaid Grocery / OTC / Utility Card* | $275 monthly allowance on a prepaid card to be used at approved locations. Click here to learn more. |
| Telehealth | $0 copay for certain telehealth visits. |
| Acupuncture | $0 copayment for up to 20 treatments a year. Prior authorization required. |
| Part D Prescription Drug Coverage |
Copayment/Coinsurance for a 30-day supply from a retail
|
| Initial Coverage Limit | You have coverage of all medications for all Tiers at $0 copayment thought all coverage stages. |
Broward Plans
DrMax-B
DrPlus-B
DrValue-B
DrMax-B (HMO)
| 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 |
|
| 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:
You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on. |
| Prepaid Card – Special Supplemental Benefits for the Chronically Ill (SSBCI)*** |
$107 per month for groceries and over- the counter (OTC) items |
| Initial Coverage Limit | $5,030 |
DrPlus-B (HMO D-SNP)**
| Monthly Plan Premium | $0-$25.60 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 |
|
| Prepaid Grocery / OTC / Utility Card* | $150 monthly allowance on a prepaid card to be used at approved locations. Click here to learn more |
| Telehealth |
$0 copay for certain telehealth visits. |
| Part D Prescription Drug Coverage |
Copayment/Coinsurance for a 30-day supply from a retail or mail order pharmacy:
|
| Initial Coverage Limit: |
You have coverage of all medications for all Tiers at $0 copayment thought all coverage stages. |
DrValue-B (HMO)
Download the Over the Counter (OTC) Catalog English / Spanish
You may conveniently order:
-
- By calling: 1-888-628-2770; TTY: 711, Monday to Friday, 9 AM to 8 PM E.S.T.
- Online
- Or visit a CVS Pharmacy® store, CVS Pharmacy y más® o Navarro® (excluding Target, Schnucks and select other CVS Pharmacy® locations).
| 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: Inpatient Hospital Psychiatric Stays: |
| Comprehensive Dental |
|
| 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:
You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on. |
| Initial Coverage Limit | $5,030 |
* Medicare approved Doctors HealthCare Plans, Inc. to provide these benefits and lower co- payments as part of the Value-Based Insurance Design program. This program lets Medicare try new ways to improve Medicare Advantage plans. Funds are available the first of the month. Unused funds do not roll over form month to month. Please refer to Evidence of Coverage for Details.
**DrPlus (HMO D-SNP), DrPlus-B (HMO D-SNP) and DrFlex (HMO D-SNP) – 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 D-SNP), DrPlus-B(HMO D-SNP) and DrFlex (HMO D-SNP) is sponsored by Doctors HealthCare Plans, Inc. and the State of Florida Agency for Health Care Administration. DrPlus (HMO D-SNP), DrPlus-B (HMO D-SNP) and DrFlex(HMO D-SNP) have been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until December 31, 2025 based on a review of the Model of Care.
*** Funds are available the first of the month. Unused funds do not roll over form month to month. Please refer to Evidence of Coverage for Details.
H4140_DHCPWSMAPD2024_M
Last Updated: 04/30/2024
