Core (HMO)
Suits members who already have prescription drug benefits
Monthly Premium
$0
Primary Care Copay
$0
Out-Of-Pocket Max
$4,500
(In-Network Only)
2027 Benefits Summary
The benefits and cost-sharing information below provide an overview of covered services and what you may pay. This summary does not include all covered services, limitations, or exclusions. For complete coverage details, please refer to the Evidence of Coverage (EOC). The EOC is the official member contract and the primary source of coverage information. If there is any difference between the information on this page and the EOC, the EOC will govern.
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2027 Medical Benefits
2027 Plan Summary
- $0 Monthly Premium
- Medical Coverage
- Preventive and Limited Comprehensive Dental Coverage
- Fitness Benefit
- Unlimited Transportation
- Over-the-Counter Allowance
- Hearing & Vision Allowances
You Must:
- Be eligible for Medicare Part A and enrolled in Part B;
- Continue to pay Part B premiums; and
- Live in the plan service area.
How Much Does it Cost?
You must continue to pay your Medicare Part B premium to remain enrolled in any Medicare Advantage plan. Most members pay the standard Part B premium amount. For information about your Part B premium, contact Social Security at 1-800-772-1213.
Provider Network
Members receive most of their medical care from providers at Kelsey-Seybold Clinic. KelseyCare Advantage also contracts with a network of affiliated providers and facilities to provide services that may not be available at Kelsey-Seybold Clinic. Members who are referred to a contracted affiliate provider will pay the applicable in-network cost-sharing amount. Our provider network may change at any time.
2026 Core (HMO)
Suits members who already have prescription drug benefits
Monthly Premium
$0
Primary Care Copay
$0
Out-Of-Pocket Max
$4,500
(In-Network Only)
2026 Benefits Summary
This is a summary of what our plan covers and what you pay. It does not list every service that we cover or list every limitation or exclusion. To get a complete list of services we cover, please refer to the Evidence of Coverage. This legal member contract is the primary source of the coverage information and supersedes all other information.
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2026 Medical Benefits
2026 Plan Summaries
- $0 Monthly Premium
- Medical Coverage
- Preventive and Comprehensive Dental Coverage
- Fitness Benefit
- Unlimited Transportation
- Over-the-Counter Allowance
- Hearing & Vision Allowances
You Must:
- Be eligible for Medicare Part A and enrolled in Part B;
- Continue to pay Part B premiums; and
- Live in the plan service area.
How Much Does it Cost
You must maintain your Medicare Part B coverage to be a member of any Medicare Advantage plan. Most people will pay the standard Part B premium amount. Please call Social Security at 1-800-772-1213 for information about your Part B premium.
Provider Network
Members will receive most of their medical care from the doctors at Kelsey-Seybold Clinic. KelseyCare Advantage also contracts with an affiliate network of doctors to provide care that is not offered at Kelsey-Seybold Clinic. Members who are referred to a contracted affiliate will pay the in-network cost-share. The health providers in our network can change at any time.