

Monthly premiums, out-of-pocket maximums, and CMS star ratings for 2 plans.
| Plan Name | Type | Monthly Premium | Max Out-of-Pocket | Star Rating |
|---|---|---|---|---|
| American Health Advantage of Pennsylvania (HMO I-SNP) | HMO | $32.70 | $9,250.00 | |
| American Health Advantage of Utah (HMO I-SNP) | HMO/HMOPOS | $54.70 | $9,250.00 |
Primary care copays, specialist visits, OTC credit, and dental maximums.
| Plan Name | PCP Copay | Specialist | OTC Credit | Dental Max |
|---|---|---|---|---|
| American Health Advantage of Pennsylvania (HMO I-SNP) | $0.00 | Included | Not covered | Not covered |
| American Health Advantage of Utah (HMO I-SNP) | $0.00 | Included | Not covered | Not covered |






