Trinity Health Plan of Michigan Glory No RX (HMO) Medicare Advantage Plan H9179-003 • 2026 • Ingham County, MI

Trinity Health Plan of Michigan Glory No RX Overview

Coverage Overview for Trinity Health Plan of Michigan Glory No RX

Trinity Health Plan of Michigan Glory No RX is a Medicare Advantage HMO plan that provides Medicare Part A and Part B coverage through a network of participating providers. The monthly premium is $0.00, and the plan generally requires selection of a primary care provider (PCP) and use of in-network services, except in emergency situations.

Primary care visits have a $0 copay, specialist visits come with a $30 copay, urgent care services carry a $45 copay, and ambulance transportation is $275 copay. These costs apply toward the maximum out-of-pocket (MOOP) limit of $6500.00. After this limit is reached, in-network services are fully covered.

This plan is listed by CMS under Plan ID H9179-003. A summary of cost sharing is provided below.

Cost-Sharing Overview

Cost-sharing for Trinity Health Plan of Michigan Glory No RX includes out-of-pocket expenses for covered healthcare services. The table below provides a summary of typical in-network out-of-pocket costs for plan H9179-003.

Certain preventive services are covered 100% by Trinity Health Plan of Michigan Glory No RX as a Part B benefit.

Prescription Drug Coverage

This plan does not include a Medicare Part D plan for prescriptions.

CMS 5-Star Ratings

CMS evaluates Medicare Advantage (Part C) and Part D plans annually using a 5-star rating system. Ratings reflect performance in preventive care, chronic condition management, and member experience.