Altius Health Plans Altius Advantra Medicare Review

Altius Health Plans offers Medicare health insurance programs for residence of Utah and a county in Wyoming.  Altius Advantra and Altius Advantra Preference are Medicare Advantage HMO plans available in Box Elder, Cache, Daggett, Davis, Duchesne, Morgan, Rich, Salt Lake, Summitt, Tooele, Wasatch, and Weber counties in Utah as well as Uintah county in Wyoming.  Altius Advantra is an HMO-POS plan, and Altius Advantra Preference is a plain HMO only available in Davis, Salt Lake, and Tooele counties.  The coverage does include Part D drug coverage as well as health benefits.  Below is a review of the benefits they offer:

Altius Advantra (HMO-POS)

  • Premium – $0
  • Deductible – $0
  • $3,150 out-of-pocket limit
  • Network – Must go to in-network doctors and hospitals to receive benefits
  • Referrals – No Referral Required
  • Inpatient hospital – $200/day Days 1-8
  • Doctors Visits – $5 = Primary Care; $35 = Specialist
  • Outpatient Surgery – %20
  • Labs – $50
  • X-rays and Diagnostic Procedures and tests – $75 – $50
  • Part D Drug Coverage Included – Tier 1 – $5; Tier 2 – $45; Tier 3 – $85; Tier 4 – 33%

Altius Advantra Preference (HMO)

  • Premium – $36
  • Deductible – $0
  • $3,950 out-of-pocket limit
  • Network – Must go to in-network doctors and hospitals to receive benefits
  • Referrals – No Referral Required
  • Inpatient hospital – $200/day Days 1-8
  • Doctors Visits – $5 = Primary Care; $40 = Specialist
  • Outpatient Surgery – $250
  • Labs – $50
  • X-rays and Diagnostic Procedures and tests – $75 – $50
  • Part D Drug Coverage Included – You pay between $0 and $6.50 per prescription based on your level of assistance

Extra Benefits Included With Altius Advantra

  • Dental – No preventative dental
  • Hearing – Routine hearing exams – $40 co-pay and hearing aids covered up to $500
  • Vision – $0 co-pay for an eye exam up to $50 limit on glasses

Extra Benefits Included With Alohacare Advantage Plus

  • Dental – Routine dental care not covered
  • Hearing – Routine hearing tests not covered
  • Vision - $0 co-pay for an eye exam
  • POS (Point of Service) – Available at 30% co-pay

Since these plans are HMO’s you will have to use providers and facilities that are in the plan’s network, and you will not be covered for any services received outside the network with the exception of the POS.  You want to make sure your providers are in network by visiting their website.   You may also visit medicare.gov for more information regarding this plan.

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