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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 2025, 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 Broward. This plan received an overall rating of 4 out of 5 stars in 2025.
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.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 $2900.00 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:
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Drug Coverage
The Solis Wellness Plan (HMO C-SNP) has a $0 deductible for prescription drugs. During the initial coverage phase, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you will pay no copay for preferred generic and specialty tier drugs at a standard pharmacy. Standard generic drugs have a $15 copay, preferred brand drugs have a $70 copay, and non-preferred drugs have a 33% coinsurance. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for covered drugs.
Additional Benefits
The Solis Wellness Plan (HMO C-SNP) offers coverage for a wide range of services. This plan includes inpatient and outpatient hospital care, with copays ranging from $0 to $25. Emergency services have a $25 copay, and primary care services are covered, with some specialist visits having copays between $5 and $30. Additional benefits include hearing, vision, and dental coverage, with yearly maximums and specific copays. The plan also covers home health services with no copay, and skilled nursing facility services with a copay after the first 20 days. Furthermore, you can get coverage for ambulance and transportation services, as well as other services like acupuncture and over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, with prior authorization and a doctor referral required. Additional days for Inpatient Hospital-Acute are covered for one day per benefit period, but Non-Medicare-covered Stay and upgrades are not covered.
Outpatient Services See details
Outpatient services are covered under the Solis Wellness Plan (HMO C-SNP). Outpatient Hospital Services and Observation Services have a $25 copay, while individual and group sessions for Outpatient Substance Abuse have a copay between $30 and $30.
Partial Hospitalization See details
Partial Hospitalization is covered by the Solis Wellness Plan (HMO C-SNP) with a $55 copay, and requires prior authorization and a doctor referral.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered under the Solis Wellness Plan (HMO C-SNP), with Air Ambulance Services covered with a 20% coinsurance, while Ground Ambulance Services are not covered. Transportation Services to a plan-approved health-related location are covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered by the Solis Wellness Plan (HMO C-SNP). Emergency Services has a $25 copay, and Worldwide Emergency Coverage has a $50 copay, while Urgently Needed Services has no copay. Worldwide Urgent Coverage and Worldwide Emergency Transportation are not covered.
Primary Care See details
The Solis Wellness Plan (HMO C-SNP) covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Occupational therapy and physical therapy services have a copay between $5 and $25, and individual and group mental health and psychiatric sessions have a $20 copay. Opioid treatment services have a $30 copay.
Preventive Services See details
Preventive Services, including Medicare-covered services, annual physical exams, and other preventive services, are covered by the Solis Wellness Plan (HMO C-SNP). Additional benefits include Health Education, Nutritional/Dietary Benefit, In-Home Support Services, Additional Sessions of Smoking and Tobacco Cessation Counseling (up to 12 visits), Fitness Benefit, Remote Access Technologies, Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit; however, services such as In-Home Safety Assessment, Personal Emergency Response System, Medical Nutrition Therapy, and several others are not covered.
Hearing Services See details
Hearing services under the Solis Wellness Plan (HMO C-SNP) include routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids (all types) with a maximum plan benefit of $1,500 every year. Prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are also not covered.
Vision Services See details
The Solis Wellness Plan (HMO C-SNP) covers vision services, including routine eye exams with one visit per year, eyewear, contact lenses, eyeglasses (lenses and frames), eyeglass lenses and frames, and upgrades. Eyewear has a combined maximum benefit of $250.00 per year, and contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are unlimited.
Dental Services See details
The Solis Wellness Plan (HMO C-SNP) covers a variety of dental services, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatments, other preventive dental services, restorative services, adjunctive general services, endodontics, oral and maxillofacial surgery, and implant services. The plan has a maximum yearly benefit of $3,500. Orthodontics and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. There is a coinsurance for these services, ranging from 0% to 20% depending on the specific drug.
Dialysis Services See details
Dialysis Services are covered under the Solis Wellness Plan (HMO C-SNP) with prior authorization and a doctor referral required. You will pay 20% coinsurance.
Medical Equipment See details
Medical Equipment is covered by the Solis Wellness Plan (HMO C-SNP), with Durable Medical Equipment (DME) subject to a 0%-20% coinsurance and Prosthetic Devices subject to a 20% coinsurance. Durable Medical Equipment for use outside the home, Diabetic Supplies, Diabetic Therapeutic Shoes/Inserts, and Medical Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are partially covered by the Solis Wellness Plan (HMO C-SNP), with Diagnostic Procedures/Tests and Lab Services not covered. Diagnostic Radiological Services have a copay of at most $75, Therapeutic Radiological Services have a copay of at most $25, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Solis Wellness Plan (HMO C-SNP) with no copay and no coinsurance, but require authorization and a referral. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Solis Wellness Plan (HMO C-SNP), including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization and a doctor referral are required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Solis Wellness Plan (HMO C-SNP), but require prior authorization and a doctor's referral. There is no copay for days 1-20, and a $50 copay for days 21-100. Additional days beyond Medicare-covered for SNF, and Non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Solis Wellness Plan (HMO C-SNP) covers acupuncture with a limit of 24 treatments per year, and over-the-counter items with a maximum benefit of $111.00 per month. The plan also covers a meal benefit for those with a chronic illness or a medical condition that requires the enrollee to remain at home for a period of time. However, the plan does not cover Dual Eligible SNPs with Highly Integrated Services, and several additional services including Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, private duty nursing services, and more.
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