Martin's Point Generations Advantage Alliance (HMO) Medicare Advantage Plan H5591-003 • 2027 • Waldo County, ME
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $5000.00In-network
- Part B Giveback
- −$50.00 reduction
- Prescription Coverage
- Not Included
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Waldo County, ME
- Local Enrollment
- 300 beneficiaries in Waldo County
Martin's Point Generations Advantage Alliance (HMO) Introduction
Martin's Point Generations Advantage Alliance is a Medicare Advantage HMO plan offered by Martin's Point Generations Advantage. It uses a Health Maintenance Organization (HMO) provider network and comes without prescription drug coverage. For the 2027 plan year it has a $0.00 monthly premium, $0.00 medical deductible, and $5000.00 in-network maximum out-of-pocket. CMS Plan ID H5591-003 identifies this plan.
You must live in Waldo County, Maine to enroll in this plan. CMS reports 300 beneficiaries enrolled in this plan in Waldo County. For assistance with this plan, new members can call (888)618-2049 (TTY 711).
Compare Similar Plans in Waldo County
Compare this plan with the two most-enrolled HMO plans available in Waldo County, Maine. Enrollment is based on CMS local enrollment data.
| Plan Detail | Martin's Point Generations Advantage Alliance | Anthem I MaineHealth Advantage Plus | Humana Gold Plus Giveback H5619-066 |
|---|---|---|---|
| CMS Plan ID | H5591-003-0 |
H9065-008-0 |
H5619-066-0 |
| Local Enrollment | 300 | 162 | 104 |
| Monthly Premium | $0.00 | $33.00 | $0.00 |
| Medical Deductible | $0.00 | $0.00 | $750 |
| Maximum Out-of-Pocket | $5,000.00 | $6,800.00 | $9,850.00 |
| Part B Giveback | −$50.00 reduction | Not offered | −$60.00 reduction |
| Primary Care | $0 copay | $0 copay | $0 copay |
| Specialist | $15 copay | $50 copay | $55 copay |
| Part D Deductible | Not Applicable | $235.00 | $700.00 |
| CMS Star Rating | 3.5 | 3.5 | 4.0 |
| Dental | $0 copay | Not covered | $0 copay |
| Vision | $0 copay | $0 copay | $0 copay |
| Hearing | Not covered | $0 copay | $0 copay |
Want to explore more options? Browse all Medicare Advantage plans in Waldo County, or compare Medicare Advantage plans across Maine, including premiums, out-of-pocket costs, CMS ratings, and enrollment.
Plan Benefits
Martin's Point Generations Advantage Alliance has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The tables below detail the most common in-network out-of-pocket expenses for plan H5591-003.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H5591-003-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
- Specialist
- In-network: $15 copay
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
- Telehealth benefit
- In-network: $0-$15 copay
- Routine chiropractic
- In-network: $20 copay
- Fitness benefits
- Coming soon
- Health education
- Not covered
- Counseling services
- In-network: $0 copay
- Over-the-counter drug benefits
- In-network: $0 copay
- Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: 20% coinsurance
- Lab services
- In-network: $0-$5 copay, 0%-20% coinsurance
- Outpatient x-rays
- In-network: 5% coinsurance
- Diagnostic tests and procedures
- In-network: 0%-5% coinsurance
Emergency and Urgent Care Services
- Emergency room care
- $125 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $0 copay
- Inpatient hospital care
- Tier 1
$350 per day for days 1-5
$0 per day for days 6-90
$0 per stay - Skilled Nursing Facility
- Tier 1
$10 per day for days 1-20
$221 per day for days 21-100 - Ground ambulance
- In-network: $325 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $0 copay
- Outpatient group therapy
- In-network: $0 copay
- Inpatient psychiatric hospital care
- Tier 1
$350 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $0 copay
- Occupational therapy
- In-network: $0 copay
Medical Equipment and Supplies
- Diabetes supplies
- In-network: $0 copay
- Durable medical equipment
- In-network: 10% coinsurance
- Prosthetics
- In-network: 10% coinsurance
Medicare Part B Drugs
- Chemotherapy
- In-network: 0%-20% coinsurance
- Other Part B drugs (Medicare-covered)
- In-network: 0%-20% coinsurance
Dental Services
- Oral exam
- In-network: $0 copay
- Dental x-rays
- In-network: $0 copay
- Cleaning
- In-network: $0 copay
- Periodontics
- In-network: 20% coinsurance
- Endodontics
- In-network: 20% coinsurance
- Restorative services
- In-network: 50% coinsurance
- Implant services
- Not covered
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- In-network: 50% coinsurance
Vision Services
- Routine eye exam
- In-network: $0 copay
- Contact lenses
- In-network: $0 copay
- Eyeglass frames only
- In-network: $0 copay
- Eyeglass lenses only
- In-network: $0 copay
- Eyeglasses (frames & lenses)
- In-network: $0 copay
- Upgrades
- In-network: $0 copay
Hearing Services
- Hearing exam
- Not covered
- Fitting/evaluation
- In-network: $0 copay
- Prescription hearing aids
- In-network: $0 copay
- OTC hearing aids
- Not covered
Additional and Special Needs Services
- Adult day health services
- Not covered
- Home-based palliative care
- Not covered
- Personal emergency response system
- Coming soon
- Weight management programs
- In-network: $0 copay
- Wigs for chemotherapy-related hair loss
- Coming soon
- Alternative therapies
- In-network: $0 copay
- Massage therapy
- Not covered
- Home/bathroom safety devices
- In-network: $0 copay
Certain preventive services are covered 100% by Martin's Point Generations Advantage Alliance as a Part B benefit.
Prescription Drug Coverage
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Performance Ratings (Contract ID: H5591)
Medicare Advantage (Part C) and Part D plans are rated each year by CMS on a 5-star scale. Ratings summarize plan performance across clinical care and member experience measures.
| CMS Measure | Star Rating |
|---|---|
| 2027 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 |
Contact Information for Martin's Point Generations Advantage
- Website
- Martin's Point Generations Advantage Plan Page
- Providers
- Martin's Point Generations Advantage Providers Page
- Formulary
- Martin's Point Generations Advantage Formulary Page
- Pharmacy
- Martin's Point Generations Advantage Pharmacy Page
- New Member Health Plan Help
- (888)618-2049
- New Member Health Plan TTY
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Medicare Advantage Plan Availability
Martin's Point Generations Advantage Alliance is available to eligible Medicare beneficiaries residing in Waldo County, Maine, including communities such as Palermo, Winterport, Lincolnville, Belfast, Brooks, Freedom, Morrill, Searsport, Stockton Springs, Thorndike, Unity, and other areas throughout the county. Enrollment eligibility is based on county of residence, not city.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | November 10, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | November 10, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | November 10, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | November 10, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Martin's Point Generations Advantage (official source) | http://MartinsPoint.org/Advantage | October 4, 2026 |
| Medicare.gov | Understanding Medicare Advantage Plans | 25 May, 2025 |
| NCOA.org | 5 Steps to Choosing the Right Medicare Plan for You | 25 May, 2025 |
| Medicare.gov | Explore your Medicare coverage options | 25 May, 2025 |
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