Medicare Advantage Plan H4140-001-0 in Miami-Dade County, FL Doctors HealthCare Plans, Inc. DrMax (HMO) • 2026
Doctors HealthCare Plans, Inc. DrMax (HMO), CMS Plan-ID H4140-001-0, is a 2026 Medicare Advantage Plan (Part C), with prescription drug coverage, by Doctors HealthCare Plans, Inc.. The plan uses a Health Maintenance Organization (HMO) provider network structure.
Based on the most recent CMS data, plan enrollments topped 6,304 members, with 6,304 in Miami-Dade County, Florida.
Doctors HealthCare Plans, Inc. DrMax Overview
Plan Overview for H4140-001-0 |
|
|---|---|
| CMS Plan ID: |
H4140-001-0
|
| Plan Type: | HMO |
| Plan Year: | 2026 |
| Monthly Premium: |
$0.00
Plus your Medicare Part B premium. |
| Medical Deductible: | $0.00 |
| Maximum Out-of-Pocket: | $3000.00 (In-Network) |
| Part B Give Back: | −$10.00 reduction |
| Prescription Drug Coverage: | Enhanced, $0.00 deductible |
| Additional Benefits: | Dental, Vision, Hearing |
| Service Area: | Miami-Dade County, FL |
| Enrollment (Nationwide): | 6,304 beneficiaries |
| Enrollment (CMS – Local) | 6,304 beneficiaries in Miami-Dade County |
| Provided By: | Doctors HealthCare Plans, Inc. |
To learn more about your plan options, costs, and enrollment periods without agent assistance, try our helpful Medicare Resources below (click to open).
Frequently Asked Questions About Doctors HealthCare Plans, Inc. DrMax (HMO)
Here are some of the most frequently asked questions people have about Plan ID H4140-001-0:
How much does Doctors HealthCare Plans, Inc. DrMax cost per month?
Doctors HealthCare Plans, Inc. DrMax has a $0.00 monthly premium for 2026. You must also continue to pay any Medicare Part B premium you owe.
What is the maximum out-of-pocket limit for Doctors HealthCare Plans, Inc. DrMax?
The 2026 in-network maximum out-of-pocket (MOOP) limit is $3000.00. After you reach this limit, the plan pays covered in-network Part A and Part B costs for the remainder of the year.
Does Plan ID H4140-001-0 cover prescription drugs?
Yes. Plan ID H4140-001-0 includes Medicare Part D prescription drug coverage, with a $0.00 deductible for 2026.
What is the CMS Star Rating for Doctors HealthCare Plans, Inc. DrMax?
Contract H4140, which includes this plan, has a ★4.0 out of 5 CMS Star Rating for 2026.
What type of network does Plan ID H4140-001-0 have?
Plan ID H4140-001-0 uses a Health Maintenance Organization (HMO) provider network.
How many members does Doctors HealthCare Plans, Inc. DrMax have?
The most recent CMS enrollment data shows approximately 6,304 beneficiaries enrolled in Plan ID H4140-001-0.
Which insurance company offers Plan ID H4140-001-0?
Plan ID H4140-001-0 is offered by Doctors HealthCare Plans, Inc..
Covered Services & Costs
Office Visits
This plan lists in-network cost sharing for primary care and specialist visits, along with related office-based services.
| Covered Service | In-Network Cost |
|---|---|
| Primary: | In-network: $0 copay |
| Specialist: | In-network: $0 copay |
Preventive and Wellness Services
Preventive and wellness benefits may include routine exams, telehealth, fitness programs, health education, and other in-network services.
| Covered Service | In-Network Cost |
|---|---|
| Annual wellness exam: | Not covered |
| Telehealth benefit: | In-network: $0 copay |
| Routine chiropractic: | In-network: $0 copay |
| Fitness benefits: | In-network: $0 copay |
| Health education: | In-network: $0 copay |
| Counseling services: | Not covered |
| Over-the-counter drug benefits: | In-network: $0 copay |
| Health transportation (non-emergency): | In-network: $0 copay |
Diagnostic, Lab, and Imaging Services
Diagnostic coverage includes in-network cost sharing for lab tests, x-rays, radiology, and other diagnostic procedures used to evaluate health conditions.
| Covered Service | In-Network Cost |
|---|---|
| Diagnostic radiology services: | In-network: $0-$75 copay |
| Lab services: | In-network: $0 copay |
| Outpatient x-rays: | In-network: $0 copay |
| Diagnostic tests and procedures: | In-network: $0 copay |
Emergency and Urgent Care Services
Emergency and inpatient coverage includes cost sharing for urgent care, emergency room visits, ambulance transportation, hospital stays, and skilled nursing facility care.
| Covered Service | In-Network Cost |
|---|---|
| Emergency room care: | $100 copay |
| Worldwide emergency care: | $125 copay |
| Urgent care: | $0 copay |
| Inpatient hospital care: | Tier 1 | $0 per stay |
| Skilled Nursing Facility: | Tier 1 | $0 per day for days 1-20 | $75 per day for days 21-100 |
| Ground ambulance: | In-network: $125 copay |
Mental Health Services
Mental health coverage includes in-network cost sharing for outpatient individual and group therapy, as well as inpatient psychiatric hospital care.
| Covered Service | In-Network Cost |
|---|---|
| Outpatient individual therapy: | In-network: $0 copay |
| Outpatient group therapy: | In-network: $0 copay |
| Inpatient psychiatric hospital care: | Tier 1 | $0 per stay |
Rehabilitation Services
Rehabilitation coverage includes in-network cost sharing for physical therapy, speech and language therapy, and occupational therapy services.
| Covered Service | In-Network Cost |
|---|---|
| Physical therapy and speech and language therapy: | In-network: $0 copay |
| Occupational therapy: | In-network: $0 copay |
Medical Equipment and Supplies
Medical equipment coverage includes in-network cost sharing for diabetes supplies, durable medical equipment, prosthetics, and related supplies.
| Covered Service | In-Network Cost |
|---|---|
| Diabetes supplies: | In-network: 0%-20% coinsurance |
| Durable medical equipment: | In-network: 0%-20% coinsurance |
| Prosthetics: | In-network: 0%-20% coinsurance |
Medicare Part B Drugs
Medicare Part B drug coverage includes in-network cost sharing for chemotherapy and other medications covered under Medicare Part B.
| Covered Service | In-Network Cost |
|---|---|
| Chemotherapy: | In-network: 0%-20% coinsurance |
| Other Part B drugs (Medicare-covered): | In-network: 0%-20% coinsurance |
Dental Services
Dental coverage includes in-network cost sharing for preventive care, exams, x-rays, cleanings, and comprehensive dental procedures.
| Covered Service | In-Network Cost |
|---|---|
| Oral exam: | In-network: $0 copay |
| Dental x-rays: | In-network: $0 copay |
| Cleaning: | In-network: $0 copay |
| Periodontics: | In-network: $0 copay |
| Endodontics: | In-network: $0 copay |
| Restorative services: | In-network: $0 copay |
| Implant services: | In-network: $0 copay |
| Orthodontics: | Not covered |
| Oral/Maxillofacial surgery: | In-network: $0 copay |
Vision Services
Vision coverage includes in-network cost sharing for routine eye exams, contact lenses, eyeglass frames and lenses, and related eyewear services.
| Covered Service | In-Network Cost |
|---|---|
| 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 coverage includes in-network cost sharing for hearing exams, fittings and evaluations, prescription hearing aids, and over-the-counter hearing aids.
| Covered Service | In-Network Cost |
|---|---|
| Hearing exam: | In-network: $0 copay |
| Fitting/evaluation: | In-network: $0 copay |
| Prescription hearing aids: | In-network: $0 copay |
| OTC hearing aids: | Not covered |
Additional and Special Needs Services
Additional benefits may include in-network services for adult day health, palliative care, personal emergency response systems, weight management, alternative therapies, and home safety needs.
| Covered Service | In-Network Cost |
|---|---|
| Adult day health services: | Not covered |
| Home-based palliative care: | Not covered |
| Personal emergency response system: | Not covered |
| Weight management programs: | Not covered |
| Wigs for chemotherapy-related hair loss: | Not covered |
| Alternative therapies: | Not covered |
| Massage therapy: | Not covered |
| Home/bathroom safety devices: | Not covered |
Doctors HealthCare Plans, Inc. DrMax covers 100% of certain preventive services as a required Part B benefit.
Prescription Drug Coverage
Part D Coverage Level (Benefit Design)
Doctors HealthCare Plans, Inc. DrMax includes an enhanced benefit Medicare Part D plan (PDP). Enhanced plans have a higher actuarial value than basic plans. Actuarial value simply refers to the percentage of cost that's covered by the plan.
Plan Premium
The following table outlines the prescription drug plan premium details of this plan.
| Part D Premium Component | Amount |
|---|---|
| Basic Part D Premium: | $0.00 |
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $0.00 |
| Low Income Premium Subsidy: | $4.82 |
| Low Income Premium Subsidy CMS Pays: | $0.00 |
| Low Income Subsidy Premium: | $0.00 |
For more information about the Low Income Subsidy, refer to the Social Security Extra Help page.
Plan Deductible
The Medicare Part D annual deductible with this plan is $0.00. This is the amount you must pay at the pharmacy before Doctors HealthCare Plans, Inc. begins paying its share.
Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Doctors HealthCare Plans, Inc. DrMax has out-of-pocket costs that you must pay when you pick up your prescriptions. The following table shows you those costs.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | Coming soon |
| Generic | $0.00 copay | Coming soon |
| Preferred Brand | $0.00 copay | Coming soon |
| Non-Preferred Drug | $55.00 copay | Coming soon |
| Specialty Tier | 33% coinsurance | Coming soon |
| Supplemental Drugs | $0.00 copay | Coming soon |
| *Deductible does not apply. | ||
CMS Medicare Star Ratings
Each year, Medicare Advantage HMOs are rated by the Centers for Medicare & Medicaid Services (CMS) across nine categories using a 5-star system. These star ratings are designed to help you assess the quality of care and service offered by this Doctors HealthCare Plans, Inc. plan.
| 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 |
Contact Doctors HealthCare Plans, Inc.
Call 833-748-3201 (TTY 711) to speak with a licensed HealthCompare insurance agent (M-F 8AM-10PM, Sat 9AM-8PM EST) and learn more about this plan and other plans on this site. You may also Enroll Online .
| Contact Type | Details |
|---|---|
| Website: | Doctors HealthCare Plans, Inc. Plan Page |
| New Members: | 1-833-639-3427 |
| Existing Members: | 1-833-342-7463 |
| Plan Address: | 2020 Ponce De Leon Blvd | PH 1 | Coral Gables, FL 33134 |
Medicare Plan Decision Resources
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | CMS Version |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | 202608 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | 2026-08 |
| Publisher | Reference | Last Accessed |
|---|---|---|
| Doctors HealthCare Plans, Inc. (official source) | http://www.doctorshcp.com | October 13, 2025 |
| CMS.gov | Medicare Advantage Plan Fact Sheet | 25 May, 2025 |
| Medicare.gov | Joining a plan | 25 May, 2025 |
| Medicare.gov | Your coverage options | 25 May, 2025 |
Medicare.org independently compiles and interprets Medicare plan information using data published by the Centers for Medicare & Medicaid Services (CMS), official plan information, and other authoritative Medicare sources. The sources used for this plan are documented below.
Medicare.org is an independent Medicare information and enrollment resource and is not affiliated with or endorsed by the U.S. Government or the federal Medicare program. Enrollment assistance is provided through HealthCompare, an Allstate company.
Medicare plan data and editorial content curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for Medicare plan interpretation and publication.