VIVA Medicare Premier (HMO)

VIVA Medicare Premier (HMO) is a HMO plan offered by Triton Health Systems, L.L.C. available for enrollment in 2025 to people living in North, Central, and South Alabama. This plan received an overall rating of 4 out of 5 stars in 2026.

It's important to know that VIVA Medicare Premier (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about VIVA Medicare Premier (HMO).

Plan Costs:

The cost of a Medicare Advantage Plan is made up of four main parts.

• First, the monthly premium — the amount you pay every month.
• Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
• Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
• Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.

You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.

Common Services:

Drug Coverage

The VIVA Medicare Premier (HMO) plan features an Enhanced Alternative drug benefit with a $200.00 annual prescription drug deductible and a standard Part D premium of $99.00, which reduces to $71.30 for those qualifying for Extra Help. During the initial coverage phase, you will pay a $7.00 copay for tier 1 preferred generic drugs through preferred mail order, or an $8.00 copay at standard pharmacies. Tier 2 standard generic drugs carry a $47.00 copay at standard pharmacies, while preferred brand drugs require a 42% coinsurance and non-preferred drugs require a 30% coinsurance. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and will pay nothing for Medicare Part D covered drugs. This low out-of-pocket spending limit provides strong financial protection against high ongoing medication costs.

Additional Benefits

The VIVA Medicare Premier (HMO) plan offers robust medical coverage with predictable out-of-pocket costs, featuring no coinsurance for many key services. Primary and specialist office visits require low copays ranging from no copay up to $20, while inpatient hospital stays carry a $300 daily copay for the first six days and no copay thereafter. Emergency care is accessible with a $130 copay, and urgent care visits range from no copay to $40, ensuring affordable protection when you need it most. For everyday wellness, the plan provides valuable dental, vision, and hearing benefits, including a $1,300 annual dental limit and a $200 yearly eyewear allowance. Members also benefit from no copay on routine physical exams and fitness programs, alongside a $70 quarterly allowance for over-the-counter health items. High-cost medical needs like durable medical equipment and dialysis are covered with a standard 20% coinsurance and no copay.