A non-government entity
Solis Wellness Plan (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Solis Wellness Plan (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Solis Wellness Plan (HMO C-SNP) in 2026, please refer to our full plan details page.
Solis Wellness Plan (HMO C-SNP) is a HMO C-SNP plan offered by Athena Healthcare Holdings, LLC available for enrollment in 2025 to people living in Miami-Dade. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Solis Wellness Plan (HMO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Solis Wellness Plan (HMO C-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Solis Wellness Plan (HMO C-SNP).
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.
For Solis Wellness Plan (HMO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $5.30. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $2500.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for Solis Wellness Plan (HMO C-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Solis Wellness Plan (HMO C-SNP) offers excellent prescription drug savings with a $0 drug deductible, meaning your coverage starts right away. Beneficiaries pay no copay for Tier 1 preferred generic, Tier 2 generic, and Tier 3 preferred brand drugs for one, two, or three-month supplies at a standard pharmacy. Standard mail order options also offer no copay for a three-month supply of Tier 1 and Tier 2 drugs. For Tier 4 non-preferred drugs, a one-month supply at a standard pharmacy carries a $25 copay, while Tier 5 specialty drugs require a 33% coinsurance. Tier 6 supplemental drugs are highly accessible with no copay for a one-month supply at standard pharmacies. This budget-friendly plan ensures low out-of-pocket costs for a wide variety of essential medications.
Additional Benefits
The Solis Wellness Plan (HMO C-SNP) offers robust healthcare coverage with many essential medical services available at no cost to members. You will pay no copay and no coinsurance for inpatient hospital stays, primary and specialist care, and home health services. Outpatient hospital services and emergency care are also highly affordable, requiring only a low $25 copay and no coinsurance. Supplemental benefits include comprehensive dental coverage up to $3,500 annually and eyewear up to $350 per year with no copay, deductible, or coinsurance. Members also receive a $125 monthly allowance for over-the-counter items and up to 48 one-way trips to approved health locations at no cost. For skilled nursing care, there is no copay for the first 20 days and a $50 daily copay for days 21 to 100.
Inpatient Hospital See details
Inpatient hospital care is covered by Solis Wellness Plan (HMO C-SNP) with no copay and no coinsurance for both acute and psychiatric stays, though prior authorization and referrals are required. This benefit is partially covered, as upgrades and non-Medicare-covered stays are not covered, and additional psychiatric days are excluded.
Outpatient Services See details
Solis Wellness Plan (HMO C-SNP) covers outpatient hospital and observation services with a $25 copay and no coinsurance, while ambulatory surgical center and outpatient blood services are offered with no copay and no coinsurance. Some outpatient substance abuse services are covered with no copay and no coinsurance, though individual and group sessions are not covered.
Partial Hospitalization See details
Solis Wellness Plan (HMO C-SNP) covers partial hospitalization services with either no copay or a $180 copay, and no coinsurance. Prior authorization and a referral are required to receive these services.
Ambulance and Transportation Services See details
Solis Wellness Plan (HMO C-SNP) provides partially covered ambulance services, offering air ambulance coverage with a 20% coinsurance and no copay, while ground ambulance services are not covered. Transportation services are covered with no copay or coinsurance for up to 48 one-way trips per year to plan-approved health-related locations, though trips to any health-related location are not covered.
Emergency Services See details
Solis Wellness Plan (HMO C-SNP) covers emergency services with a $25 copay and no coinsurance (waived if admitted to the hospital within 24 hours), and urgently needed services with no copay or coinsurance. Worldwide emergency services are partially covered up to a $75,000 limit with a $25 copay and no coinsurance, but worldwide urgent coverage and worldwide emergency transportation are not covered.
Primary Care See details
Solis Wellness Plan (HMO C-SNP) covers primary care, specialist, and therapy services with no copay and no coinsurance. The benefit is partially covered, as other chiropractic services, as well as individual and group sessions for both mental health and psychiatric services, are not covered.
Preventive Services See details
Solis Wellness Plan (HMO C-SNP) offers partially covered preventive services with no copay and no coinsurance, though referrals are required for some services. Covered benefits include annual physical exams and kidney disease education, while excluded services include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, home-based palliative care, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, home/bathroom safety devices, and counseling.
Hearing Services See details
Solis Wellness Plan (HMO C-SNP) offers partially covered hearing services with no copay and no coinsurance, though OTC hearing aids and inner, outer, and over-the-ear prescription aids are not covered. Covered benefits include one annual routine exam, one fitting evaluation, and other prescription hearing aids up to a $2,000 yearly maximum.
Vision Services See details
Solis Wellness Plan (HMO C-SNP) offers partially covered vision services with no copay, no coinsurance, and no deductible, though other eye exam services are not covered. Covered benefits include one routine eye exam per year and up to $350 annually for eyewear, including contacts, lenses, frames, and upgrades.
Dental Services See details
Solis Wellness Plan (HMO C-SNP) provides partially covered dental services with no copay and no coinsurance, up to a maximum plan benefit of $3,500 every year. While many diagnostic, preventive, and comprehensive dental services are covered, other diagnostic dental services, other preventive dental services, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Solis Wellness Plan (HMO C-SNP) covers Home Infusion bundled Services with no copay and no coinsurance, though prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin is covered with no copay and no coinsurance, while Medicare Part B chemotherapy and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Solis Wellness Plan (HMO C-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization and a referral are required to access this benefit.
Medical Equipment See details
Solis Wellness Plan (HMO C-SNP) partially covers medical equipment with no copay for covered items, though medical supplies, diabetic supplies, and diabetic therapeutic shoes or inserts are not covered. Covered durable medical equipment has a 0% to 20% coinsurance, prosthetic devices require a 20% coinsurance, and diabetic equipment features no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are partially covered by the Solis Wellness Plan (HMO C-SNP) since lab services are not covered. Covered diagnostic procedures and tests require no coinsurance and a copay of no copay to $20, while radiological and outpatient X-ray services require no copay and no coinsurance.
Home Health Services See details
Home Health Services are covered under the Solis Wellness Plan (HMO C-SNP) with no copay and no coinsurance, though prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services, including intensive cardiac, pulmonary, and SET for PAD services, are not covered under the Solis Wellness Plan (HMO C-SNP).
Skilled Nursing Facility (SNF) See details
Solis Wellness Plan (HMO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 to 20 and a $50 daily copay for days 21 to 100. Prior authorization and referrals are required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by the Solis Wellness Plan (HMO C-SNP), offering meal benefits and up to $125 monthly for over-the-counter items with no copay and no coinsurance, while acupuncture is not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved