Prior Authorization Required, Referral Required [snf] =>
Prior Authorization Required, Referral Required [pcp] =>
Referral Required [specialist] => $20.00 Copay
Referral Required [urgent_care] => $20.00 Copay
Prior Authorization Required, Referral Required [er] => $0.00 - $300.00 Copay
Prior Authorization Required, Referral Required [ambulance_ground] => $300.00 Copay
Prior Authorization Required, Referral Required [ambulance_air] => $300.00 Copay
Prior Authorization Required, Referral Required [dental] =>
$2000.00 max, Referral Required [vision] =>
$150.00/yr eyewear, Referral Required [hearing] =>
Referral Required [rx] => Array ( [deductible] => [tiers] => Array ( ) ) )
HAP Medicare MedicalAccess (HMO) (HMO) 2025 Plan Details for Allegan County, Michigan Residents
HAP Medicare MedicalAccess (HMO) (HMO) 2025 Plan Details for Allegan County, Michigan Residents
HAP Medicare MedicalAccess (HMO) is a HMO Medicare Advantage plan, from HAP Senior Plus, {with_without_pdp} a prescription drug plan. It's CMS Plan ID is: H2354-019-0. It is not available in all areas. The list of locations where this plan is available can be found below.
According to CMS enrollment data (July, 2025), there are approximately 1,139 members enrolled in this plan.
HAP Medicare MedicalAccess (HMO) (HMO) Overview
| CMS Fact | Landscape Value |
|---|---|
| Health Plan ID: | H2354-019-0 |
| CMS Overall Rating: | 0.0 out of 5 stars* |
| Medicare Advantage Plan Type: | HMO |
| Coverage Year: | CY2026 |
| Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $4500.00 (In-Network) |
| Part B Give Back: | $0.00/mo |
| Part D Drug Plan Benefit: | Not Included |
| Additional Benefits: | Dental, Vision, Hearing |
| Availability: | Allegan County, MI |
| Insured By: | HAP Senior Plus |
| Last Plan Content Update: |
Plan Availability by Location
Health Plan Out-of-Pocket Costs
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | Not Covered |
| Specialist: | $35 Copay |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | $125 Copay |
| Urgent care: | $45 Copay |
| Ground ambulance: | $300 Copay |
| Inpatient hospital care: | $325.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
| Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $214.00 per day for days 21 and beyond |
This section covers Medicare-approved foot care services, including exams and routine foot care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Foot Exams and Treatments (Medicare-covered): | $35 Copay |
| Routine Foot Care: | Not Covered |
Understand the coverage for Medicare-approved chiropractic services and routine chiropractic care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Medicare-covered chiropractic: | $20 Copay Referral Required |
| Routine chiropractic: | Not Covered |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | $15 Copay |
| Outpatient group therapy: | $15 Copay |
| Inpatient psychiatric hospital care: | $325.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | $20 Copay Prior Authorization Required |
| Occupational therapy: | $20 Copay Prior Authorization Required |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | 20% Coinsurance |
| Durable medical equipment: | 20% Coinsurance Prior Authorization Required |
| Prosthetics: | 20% Coinsurance |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | $200 Copay Prior Authorization Required |
| Lab services: | Not Covered |
| Outpatient x-rays: | $35 Copay Prior Authorization Required |
| Diagnostic tests and procedures: | $150 Copay Prior Authorization Required |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | 20% Coinsurance |
| Other Part B drugs (Medicare-covered): | 20% Coinsurance |
This section details the dental services covered under your plan including, Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
| Service | Member Cost (in-network) |
|---|---|
| Medicare Covered Preventive Dental | Not Covered |
| Oral exam | $0 |
| Dental x-rays | $0 |
| Cleaning | $0 |
| Periodontics | Not Covered |
| Endodontics | Not Covered |
| Restorative Services | Not Covered |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
| Service | Member Cost (in-network) |
|---|---|
| Fitting/evaluation | Covered Limits may apply |
| Hearing aids | Covered Limits may apply |
| Hearing exam | Covered Limits may apply |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
| Service | Member Cost (in-network) |
|---|---|
| Medicare-covered eye exam (in-network) | $0 to $35 Copay |
| Routine eye exam (in-network) | Covered Limits may apply |
| Eyewear benefits | Eyeglasses: Yes Contact Lenses: Yes Eyeglass Lenses: Yes Eyeglass Frames: Yes Eyewear Upgrades: Yes |
Maximum eyewear benefit: | $150.00 Every year |
Prescription Drug Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Rating Marks
The Centers for Medicare & Medicaid Services (CMS) reviews and rates Medicare Advantage (Part C) and drug plans (Part D) annually, using a 5-star system to measure aspects such as member satisfaction, preventive services, and management of chronic conditions.
Higher star ratings generally indicate better plan performance, which can be a useful factor to consider when deciding on a plan that aligns with your healthcare goals and preferences.
| CMS Measure | Star Rating |
|---|---|
| 2026 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
Need Help Enrolling?
| Website: | HAP Senior Plus Plan Page |
|---|---|
| Providers: | HAP Senior Plus Providers Page |
| New Member Health Plan Help: | (833)923-1630 |
| New Member Health Plan TTY: | 711 |
Frequently Asked Questions
📘 What does Medicare plan code H2354 019 mean?
HAP Medicare MedicalAccess (HMO) is a Medicare Advantage plan by HAP Senior Plus. The code H2354 is the CMS contract ID, whereas 019 is its plan ID.
- Plan Name: HAP Medicare MedicalAccess (HMO)
- Plan Type: HMO
- Premium: $0.00/mo + your monthly Part B premium
- Out-of-Pocket Max: $4500.00 (in-network)
- Drug Coverage: {pdp_faq_summary}
- CMS Star Rating: 0.0 out of 5
- Contract Year: 2026
This information is based on official CMS data and is provided for educational purposes. Always review your plan’s official documents or contact the provider directly before making enrollment decisions.
📋 What type of plan is H2354 019?
This plan is a HMO — specifically, it's an HMO plan with a Medicare Advantage contract that's offered by HAP Senior Plus. It comes with defined provider network rules you should be aware of.
- Plan Marketing Name: HAP Medicare MedicalAccess (HMO)
- Network Type: {plan_type_expanded}
- Referral Requirement: {referral_required_expanded}
- Prescription Coverage: {pdp_faq_summary}
Plan types like HMOs and PPOs determine whether you can go out-of-network or need referrals to see specialists.
📦 What benefits are included in H2354 019?
This plan covers all Medicare Part A and Part B services. Depending on the plan, it may also include valuable extras like dental, vision, and hearing benefits.
- Medical Services: Hospital, doctor visits, preventive care
- Prescription Drugs: Not Included
- Dental: {dental_benefit}
- Vision: {vision_benefit}
- Hearing: {hearing_benefit}
Benefit availability may vary by location and plan version. Confirm specific details in your plan's Evidence of Coverage (EOC).