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Our Plans

Because everyone has different needs, we have different Banner Medicare Advantage plan options. Our HMO and PPO plans each include comprehensive benefits, prescription drug coverage and access to 5,000+ providers to choose from. With both plans, you’ll get the same high-quality care and customer service. You decide which plan is right for your needs. 

Call to speak with one of our licensed agents who can answer any questions you may have and even help you enroll. (833) 516-1007 (TTY 711). Or if you’re ready, you can enroll now

Do you have the right Medicare coverage for your budget and health?

Learn more about our Medicare plan options.

Banner Medicare Advantage Prime HMO

View plan options or enroll now.

Already a member? 
View plan materials.

Banner Medicare Advantage Plus PPO

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Already a member? 
View plan materials.

Banner Medicare Advantage Dual HMO D-SNP

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Already a member? 
View plan materials.

Banner Medicare Rx PDP

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Looking for Part D coverage for 2022? 
View plan materials.

Learn about our plans and get a free $10 gift card just for calling.

Call (833) 516-1007 (TTY 711) to learn about our Banner Medicare Advantage plans. And get a $10 Gift Card just for calling.
No obligation.*
*Eligible for free gift with no obligation to enroll in Banner Medicare Advantage Prime HMO or Banner Medicare Advantage Plus PPO. One per household. Must be eligible for Medicare and reside in Maricopa, Pima, Pinal, Santa Cruz or Yuma County. May not redeem for cash. While supplies last.

Benefits At A Glance

Premiums and Benefits

Prime HMO Plus PPO
Monthly Plan Premium Prime HMO$0 Plus PPO$25
Annual Deductible Prime HMO$0 Plus PPO$0
Annual Out-of-Pocket Maximum Prime HMO$2,775 Plus PPOIn-Network $4,500 In-Network and Out-of-Network Combined $9,000
Inpatient Hospital: Acute
(up to 90 days per benefit period)
Prime HMODays 1-7: $195/day Days 8-90: $0/day Plus PPOIn-Network Days 1-5: $275/day; Days 6-90: $0/day | Out-of-Network Days 1-90: 40%
Skilled Nursing Facility (SNF)
(up to 100 days per benefit period)
Prime HMODays 1-20: $0/day Days 21-100: $178/day Plus PPOIn-Network Days 1-20: $0/day; Days 21-100: $178/day | Out-of-Network Days 1-100: $195/day
Outpatient Hospital: Surgery and Observation Prime HMO$175 Plus PPOIn-Network $250 | Out-of-Network 40% (Maricopa, Pinal, Yuma)
In-Network $275 | Out-of-Network 40% (Pima, Santa Cruz)
Ambulance (one-way trip) Prime HMO$265 (Maricopa, Pinal, Yuma)
$250 (Pima, Santa Cruz)
Plus PPOIn-Network and Out-of-Network $250
Emergency Care Prime HMO$90 Plus PPOIn-Network and Out-of-Network $90
Worldwide Emergency/Urgent Care Prime HMO$90-up to $25,000/calendar year Plus PPOIn-Network and Out-of-Network $90 Up to $25,000/calendar year
Urgently Needed Care Prime HMO$30 Plus PPOIn-Network and Out-of-Network $30
Primary Care Physician (PCP) Visit Prime HMO$0 Plus PPOIn-Network $0 | Out-of-Network $35
Preventative Care and Immunizations Prime HMO$0 Plus PPO$0
Specialist Visit Prime HMO$20 Plus PPOIn-Network $30 | Out-of-Network $70
Diagnostic Tests, Procedures and Lab Services Prime HMO$10 Plus PPOIn-Network $10 | Out-of-Network 40%
X-rays Prime HMO$15 Plus PPOIn-Network $20 | Out-of-Network $27
Diagnostic Radiology (e.g., CT, MRI) Prime HMO$125-$200 Plus PPOIn-Network $125 | Out-of-Network 40%
Therapeutic Radiology Prime HMO$60 Plus PPOIn-Network $60 | Out-of-Network 40%
Home Health Prime HMO$0 Plus PPOIn-Network $0 | Out-of-Network 50%
Durable Medical Equipment (DME) Prime HMO20% Plus PPOIn-Network 20% | Out-of-Network 50%
Prosthetics and Orthotics Prime HMO20% Plus PPOIn-Network20% | Out-of-Network 50%
Renal Dialysis Prime HMO20% Plus PPOIn-Network 20% | Out-of-Network 40%

 

Additional Benefits

Prime HMO Plus PPO
Diabetic Supplies Prime HMO$0 Plus PPOIn-Network 0% | Out-of-Network 40%
Mental Health Services
(individual and group sessions)
Prime HMO$25 Plus PPOIn-Network $30 | Out-of-Network $40
Physical Therapy, Occupational Therapy and Speech Therapy Prime HMO$25 Plus PPOIn-Network $40 | Out-of-Network 40% (Maricopa | Pinal)
In-Network $30 Out-of-Network 40% (Pima)
Routine Chiropractic Prime HMO$35 (up to 6 visits per calendar year) In-Network $35 | Out-of-Network 40%
Medicare-covered Chiropractic Prime HMO$20 In-Network $20 | Out-of-Network $70
Medicare-covered Podiatry Prime HMO$25 In-Network $30 | Out-of-Network 40%
Medicare-covered Eye Exam Prime HMO$0 In-Network $0 | Out-of-Network 50%
Annual Routine Eye Exam Prime HMO$0 In-Network $0 | Out-of-Network 40%
Medicare-covered Eyewear
(glasses or contacts after cataract surgery)
Prime HMO20% In-Network $0 | Out-of-Network 40%
Routine Eyewear
Prime HMO$25 | $200 every 2 years
(1 pair of contacts or glasses)
$200 every 2 years
In-Network $0 | Out-of-Network 40%
(In- & Out-of-Network Combined)
Medicare-covered Hearing Exam Prime HMO$0 Plus PPOIn-Network $0 | Out-of-Network 40%
Annual Routine Hearing Exam Prime HMO$0 In-Network $0 | Out-of-Network 40%
Hearing Aid Fitting/Evaluation
(every 2 years)
Prime HMO$0 In-Network $0 | Out-of-Network 40%
(In- & Out-of-Network combined)
Hearing Aids Prime HMO$0 | $1,000 every 2 years In-Network $0 | Out-of-Network 40%
$1,000 every 2 years
Preventive Dental Prime HMO$0 In-Network $0 | Out-of-Network 40%
(up to 2 visits per year)
Over-the-Counter (OTC) Items Prime HMO$50/quarter; unused amount rolls over $50/quarter unused amount rolls over to next period
Fitness: Silver&Fit Prime HMO$0 In-Network $0 | Out-of-Network 40%
Meals 

Prime HMO$0 | 12 meals when ordered within 30 days of discharge
(post-inpatient discharge from hospital or SNF)

In-Network $0 | Out-of-Network 40%
(12 meals ordered within 30 days of inpatient discharge)

 

Optional Supplemental Benefits - Comprehensive Dental

Prime HMO Plus PPO
Monthly Premium Prime HMO$20.20 Plus PPO$20.20
Comprehensive Dental
(non-routine service, diagnostic services, restorative services, endodontics)
Prime HMO$1,000/calendar year Plus PPO$1,000/calendar year

 

Part D Prescription Drug Coverage

Prime HMO Plus PPO
Annual Part D Deductible Prime HMO$0 Plus PPO$0
Retail: 31-day Supply Prime HMOTier 1: $0 / Tier 2: $5 / Tier 3: $47 / Tier 4: $100 / Tier 5: 33% Plus PPOTier 1: $0 / Tier 2: $5 / Tier 3: $47 / Tier 4: $100 / Tier 5: 33%
Mail Order: 90-day Supply Prime HMOTier 1: $0 / Tier 2: $10 / Tier 3: $141 / Tier 4: $300 / Tier 5: Specialty drugs not available through mail order Plus PPOTier 1: $0 / Tier 2: $10 / Tier 3: $141 / Tier 4: $300 / Tier 5: Specialty drugs not available through mail order