Abrazo Advantage Health Plan And Advantage Plus Plan Review

Abrazo Advantage Health Plan and the Abrazo Advantage Plus Plan are Medicare Advantage plans administered through Abrazo Health Care.  They are only Blue Medicare PPOavailable in Maricopa and Pinal counties in Arizona.  The Abrazo Advantage Plan is a typical HMO Advantage plan while the Advantage Plus plan is an HMO-SNP plan.  In addition to Abrazo Health Care, The Abrazo Advantage Health Plan or (AAHP) is part of a larger network consisting of the Arizona Heart Hospital,  the Arizona Heart Institute, and the Phoenix Health Plan.  Below is the highlights of the two plans:

Abrazo Advantage Health Plan

  • Premium is $0
  • Max Out of Pocket is $6,700
  • Hospital co-pay $175/day Days 1-10
  • Doctor co-pays $10-Primary $40-Specialist
  • Outpatient Surgery $200/$250
  • Tier 1 co-pay is $0
  • Tier 2 co-pay is $20
  • Tier 3 co-pay is $40
  • Tier 4 co-pay is 33%
  • Routine eye exam is $10 co-pay
  • Routine hearing and dental not covered

Abrazo Advantage Plus

  • HMO-SNP plan for Dual Eligibles (Medicare/Medicaid)
  • Premium and benefits will be a $0 co-pay depending on level of Medicaid benefits.
  • Drug co-pays determined by level of LIS
  • Dental benefits include $0 co-pay for 2 cleaning, 2 exams, 1 x-ray, and up to $500 of comprehensive dental benefits
  • Hearing benefits include $0 co-pay for hearing exam and up to $700 toward hearing aids
  • Vision benefits include $0 co-pay for vision exam and eyeglasses or contacts up to $175 per year
  • Over the Counter (OTC) benefits included as well

The claim to have exceptional customer service and boast a network of over 4,000 doctors and hospital coverage of 85% across the state.  When choosing an HMO the network is first and foremost.  If their network is as big as stated then they may be a good solution for you.  Their website indicates that the Abrazo Advantage Health plan covers generics during the coverage gap; however, this is not evident in the Summary of Benefits.  Always refer to the Summary of Benefits or the Evidence of Coverage for how the plan will cover your health care needs.  The Abrazo Advantage Plus plan offers Medicare/Medicaid recipients additional vision, hearing, dental, and OTC benefits at no additional cost!


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