The NEW Experience Health Medicare AdvantageSM (HMO) plan

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A dollar bill

LOW $20
monthly premium,
plus Part B premium

This all-in-one plan is proof that not all Medicare Advantage plans are the same.

Experience Health includes everything from prescriptions and vision care, to travel coverage and a fitness membership — all for a low $20 per month!

Download Product Brochure

Experience More.

This new plan is everything you want in a Medicare plan and more, including a low monthly premium, a long list of valuable extras and low Maximum Out-of-Pocket costs to help protect your savings.

Plan Highlights Experience Health Medicare Advantage (HMO)
Monthly Plan Premium $20
Maximum Out-of-Pocket Amount $4,980 (in-network) per calendar year
Doctor and Hospital Visits
Primary Care Doctor Copay $0 per visit
Specialist Copay $35 per visit
Physical Therapy $35 copay
Mental Health Service $35 Outpatient individual/group therapy visit
Urgent Care Copay $50 copay
Emergency Room Visit $90 copay
Outpatient Hospital $300 copay
Inpatient Hospital $300 per day for days 1 – 6; $0 for days 7 and beyond
Skilled Nursing Facility $0 per day for days 1 – 20; $165 per day for days 21 – 60; $0 per day for days 61 – 100
Ambulance Services $375 copay
Diagnostics and Supplies
Lab Services 20% of cost
X-rays (Outpatient) $35 copay
Diagnostic Radiology (MRI, CT Scan) 20% of cost
Durable Medical Equipment 20% of cost
Diabetes Supplies $0 copay
Medicare Part B Drugs (including chemotherapy) 20% of cost
Additional Benefits
Fitness Programs SilverSneakers® included at no additional cost
Preventive Dental Allowance $200 per calendar year
Routine Eye Exam $20 copay
Eyewear Allowance (contacts, eyeglasses, eyeglass frames, eyeglass lenses) $200 per calendar year
Hearing Exam/Hearing Aids $0 copay for routine exam; $699 - $999 copay per hearing aid
Prescription Drug Benefits 30-Day 90-Day
Mail Order
Tier 1: Preferred Generic $0 copay $0 copay
Tier 2: Generic $5 copay $12.50 copay
Tier 3:* Preferred Brand $45 copay $112.50 copay
Tier 4:* Non-preferred Drug $99 copay $247.50 copay
Tier 5:* Specialty 30% coinsurance 30% coinsurance
Tier 6: Select Care Drugs $0 copay $0 copay

*Subject to $150 drug deductible

Enroll Now

This low premium plan also includes:

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Silversneakers® fitness membership

Stay fit and feel good with access to over 11,000 gyms and fitness centers.

A tooth

Preventive Dental Allowance

Dental health is better for overall health, so we’ve included a $200 per calendar year allowance.

An eye

Routine Eye Exam

Save money on vision care with a low $20 copay.

A pair of glasses

Eyewear Allowance

Includes contacts, eyeglasses, eyeglass frames, eyeglass lenses — it’s easy to see how this $200 per calendar year allowance is good to have.

An ear

Hearing Exam/Hearing Aids

You’ll like the sound of this: $0 copay for routine exam; $699-$999 copay per hearing aid.

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Worldwide Travel Coverage

Leaving town? Pack your Experience Health card for peace of mind.

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Care Support

You’ll have the help of a dedicated Care Support team member to help you manage health conditions and meet your health care goals.

The health systems you know and trust are part of the Experience Health network.

Duke Health

Primary Care Providers



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