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Select Health

Select Health Medicare Classic (HMO)

HMO/HMOPOS
Select Health
Last Updated: 
May 23, 2026
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Basic Costs and Coverage

Monthly premiums, deductibles, and core cost-sharing amounts.

CoverageCost
Monthly plan premium $59.00
Vision coverage false
Dental coverage false
Hearing coverage false
Prescription drug coverage true
Medical deductible
Out-of-pocket maximum
In$6,700.00
Combined$6,700.00
Initial drug coverage limit $0.00
Catastrophic drug coverage limit $2,100.00
Primary care doctor visit Included
Specialty doctor visit Included
Inpatient hospital care Included
Urgent care Included
Emergency room visit Included
Ambulance transportation Included

Health Care Services and Medical Supplies

Specialist services, therapies, and equipment.

ServiceCost
Chiropractic services Included
Diabetes supplies, training, nutrition therapy Included
Durable medical equipment (DME) Included
Diagnostic tests, lab, radiology, X-rays Included
Home health care BIncluded
Mental health inpatient care Included
Mental health outpatient care Included
Outpatient services / surgery Included
Outpatient substance abuse care Included
Over-the-counter items Not covered Not specified
Podiatry services Included
Skilled Nursing Facility (SNF) care Included

Dental Benefits

Preventive and comprehensive dental coverage.

CoverageCost & limits
Preventive dental Included
Comprehensive dental — covered? No
Annual dental maximum Not covered
Comprehensive dental — annual max Not covered

Vision Benefits

Routine Eye Exams and Eyewear.

CoverageCost & limits
Routine eye exam
InIncluded Included
Out$75 copay · 1 per year
Eyeglass frames & lenses Included
Eyewear allowance Not covered
Eye exam — covered? No
Eye exam supplement — max coverage Not covered

Hearing Benefits

Hearing exams, fittings, and aids.

CoverageCost & limits
Hearing exam
InIncluded
OutIncluded
Hearing exam — covered? No
Hearing aid fitting — covered? No
Hearing aid fitting cost Not covered
Hearing aids — covered? No
Hearing aids — max coverage Not covered

Preventive Services

All Medicare-covered preventive services at $0 in-network.

In-Network: $0.00 copay for all Medicare-covered preventive services.
  • Abdominal aortic aneurysm screening
  • Alcohol misuse screenings & counseling
  • Bone mass measurements (bone density)
  • Cardiovascular disease screenings
  • Cardiovascular disease (behavioral therapy)
  • Cervical & vaginal cancer screening
  • Colorectal cancer screenings
  • Depression screenings
  • Diabetes screenings
  • Diabetes self-management training
  • Glaucoma tests
  • Hepatitis B (HBV) infection screening
  • Hepatitis C screening test
  • HIV screening
  • Lung cancer screening
  • Mammograms (screening)
  • Nutrition therapy services
  • Obesity screenings & counseling
  • One-time Welcome to Medicare preventive visit
  • Prostate cancer screenings (PSA)
  • Sexually transmitted infections screening & counseling
  • Shots: COVID-19 · Flu · Hepatitis B · Pneumococcal
  • Tobacco use cessation
  • Yearly "Wellness" visit
Fitness / Wellness program: Not specified

Prescription Drug Costs and Coverage

Part D formulary tiers and supply length pricing.

Annual drug deductible: $200.00
Tier Drug type 30-day retail 30-day mail 90-day mail
1 Preferred generic Lowest-cost generic drugs $0 $0 $0
2 Generic Standard generic drugs $10 $10 $10
3 Preferred brand Preferred brand-name drugs 14% 14% 14%
4 Non-preferred brand Non-preferred brand drugs 19% 19% 19%
5 Specialty tier Specialty medications 30% 30% 30%

Not sure if this plan is right for you?

Peter Abilla is a licensed Medicare agent. He can walk you through this plan's costs, coverage, and whether your doctors are in-network.

Book a Free Plan Review
Independent agent. Not affiliated with any insurance carrier.
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Overall Rating
Part C Rating
Part D Rating

Where Is This Plan Available?

Riverside

Meyersdale

McDonald

New Eagle

Moscow

Mount Holly Springs

Cleona

Port Allegany

Topton

Pine Grove

Leechburg

New Wilmington

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See Interactive Medicare Tools

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Enrollment Special Enrollment Period Checker Whether a life event qualifies you for enrollment outside the standard windows
Enrollment Late Enrollment Penalty Checker How much extra you'll pay monthly if you missed your enrollment window
Enrollment Part B Penalty Calculator The exact 10%-per-year premium increase for delayed Part B enrollment
Enrollment Part D Penalty Calculator The 1%-per-month premium increase for gaps in creditable drug coverage
Costs Cost Scenario Planner Estimated annual spending across plan types at different health utilization levels
Costs Advantage vs. Medigap Cost Comparison True cost difference between Medicare Advantage and Original Medicare with Medigap
Costs IRMAA Calculator Whether your income triggers higher Part B and Part D premiums
Costs Part A Premium Estimator Your monthly Part A premium based on work history and quarters of coverage
Costs M3P Calculator How the Medicare Prescription Payment Plan smooths your drug costs into monthly payments
Coverage Doctor & Drug Assessment Whether your providers and prescriptions are covered by a specific plan
Coverage Part D Shopping Tool Which Part D plan has the lowest total annual cost for your specific medications
Coverage Travel & Network Risk Assessment How your coverage works outside your home area and which plan types travel best
Employer/COBRA COBRA vs. Medicare Why COBRA can trigger permanent Medicare penalties and how costs compare
Employer/COBRA Employer Coverage vs. Medicare Whether your employer plan or Medicare is primary and when to transition
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Planning Caregiver Readiness Checklist Whether you have everything in place to help a loved one with Medicare decisions
Planning Document Gatherer Which documents you need to have ready before enrolling or changing plans
Planning Medigap Fit Assessment Whether Medigap or Medicare Advantage is the better fit for how you use healthcare
Planning Medigap Open Enrollment Window Whether you're inside your one-time guaranteed issue window for Medigap
Planning Medicare Savings Program Eligibility Whether your income qualifies you for help paying Medicare premiums and cost-sharing
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Medicare Questions About 

Medicare Advantage HMO-POS

 Plans

How often do Medicare Advantage provider networks change?

Which Utah Medicare Advantage plans are best for snowbirds?

Do Medicare Advantage plans include drug coverage?

Does Medicare Advantage require prior authorization, and for what services?

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Are dental and vision benefits on Medicare Advantage plans worth it?

Understanding 

Medicare Advantage HMO-POS

An HMO-POS (Point of Service) plan works like a standard HMO but gives you the option to see out-of-network providers at a higher cost. You still have a primary care doctor and generally need referrals for specialists, but you're not completely locked out of seeing providers outside the network when you need to.

‍

The HMO-POS is a middle-ground option. You get some of the cost savings that come with an HMO, but with a built-in escape hatch if you end up needing care that isn't available in-network. That might mean seeing a specialist with a narrow subspecialty, getting a second opinion at a major academic medical center, or accessing care when you're traveling.

‍

The tradeoff is cost. Out-of-network care under an HMO-POS typically comes with higher copays and a separate (higher) out-of-pocket limit. Make sure you understand both the in-network and out-of-network maximums before enrolling — the gap between them can be significant.

‍

In Utah, HMO-POS plans are available through several carriers including SelectHealth and Regence BlueCross. If you spend time both along the Wasatch Front and in rural areas where your primary network may not reach, this plan type is worth comparing side by side with a standard PPO. The premium difference is often small but the network access difference can be meaningful.

‍

When comparing HMO-POS plans, pay attention to whether the out-of-network benefit applies nationwide or only within your service area. Plans vary on this point, and it matters if you travel outside your home region for care. Getting a clear answer on that before you enroll takes five minutes and could save you a real headache later.

Go to Plan Type
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HMO vs PPO — Which Is Right for You?

Summary of Benefits

Evidence of Coverage

Star Ratings Report

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Not sure if this plan is right for you?

Peter Abilla is a licensed Medicare agent. He can walk you through this plan's costs, coverage, and whether your doctors are in-network.

Book a Free Plan Review
Independent agent. Not affiliated with any insurance carrier.
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‍CMS TPMO Compliance Disclaimer: We do not offer every plan available in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

Participating sales agencies represent Medicare Advantage [HMO, PPO, PFFS, and PDP] organizations that are contracted with Medicare. Enrollment depends on the plan’s contract renewal.

Not Government Affiliated: Resting Sycamore Advisors is a licensed Medicare insurance agency. We are not affiliated with or endorsed by the U.S. government or the federal Medicare program.

‍Data & Methodology for Research Articles: All provider, facility, quality star ratings, and enrollment data is sourced from primary CMS records (cms.gov), including the December 2025 CPSC Enrollment files and the January 2026 Provider Data Catalog. Calculations for patient-to-provider ratios are performed using indexed clinician and facility data. Everything on restingsycamore.com is for educational purposes and does not constitute an endorsement of any specific plan or provider.

Non-CMS Data Sources: Some  specific data was obtained from https://opendata.gov