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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 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 Broward. 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.
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) features a $0 drug deductible, meaning your prescription coverage begins immediately. Under this plan, you will enjoy no copay for Tier 1 (Preferred Generic) and Tier 2 (Generic) medications at standard pharmacies and through standard mail order. Additionally, Tier 6 supplemental drugs are available at standard pharmacies with no copay for a one-month supply. For brand-name and specialty medications, the plan utilizes a clear copay and coinsurance structure. Tier 3 preferred brand drugs require a $15 copay for a one-month supply at standard pharmacies, while Tier 4 non-preferred drugs carry a $70 copay. Tier 5 specialty drugs require a 33% coinsurance for a one-month supply at standard pharmacies.
Additional Benefits
The Solis Wellness Plan (HMO C-SNP) offers robust healthcare coverage featuring no copay and no coinsurance for inpatient hospital stays, primary care, specialist visits, and home health services. Outpatient hospital services carry a low $25 copay, while emergency care has a $75 copay that is waived if you are admitted. For skilled nursing facility stays, members enjoy no copay for the first 20 days and a $50 daily copay for days 21 through 100. This plan also provides excellent supplemental coverage with no copay or coinsurance for routine dental, vision, and hearing exams. Members receive generous annual allowances, including up to $3,500 for dental care, $250 for eyewear, and $1,500 for prescription hearing aids. To further support your health, the plan covers up to 48 one-way trips to approved medical locations and provides a $125 monthly allowance for over-the-counter items with no copay.
Inpatient Hospital See details
Solis Wellness Plan (HMO C-SNP) covers inpatient acute and psychiatric hospital stays with no copay and no coinsurance, though referrals and prior authorizations are required. This benefit is partially covered because upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
Solis Wellness Plan (HMO C-SNP) covers outpatient hospital and observation services with a $25 copay and no coinsurance, and outpatient substance abuse sessions with a $30 copay and no coinsurance. Ambulatory surgical center (ASC) and outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Solis Wellness Plan (HMO C-SNP) covers partial hospitalization with copays of either $55.00 or $180.00 and no coinsurance. Prior authorization and referrals are required for these covered services.
Ambulance and Transportation Services See details
Solis Wellness Plan (HMO C-SNP) covers ambulance services with prior authorization, requiring a $50 copay and no coinsurance for ground transport, and a 20% coinsurance (waived if admitted) with no copay for air transport. Transportation services are partially covered, offering up to 48 one-way trips per year to plan-approved health-related locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Solis Wellness Plan (HMO C-SNP) covers emergency services with a $75 copay and no coinsurance, which is 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 maximum benefit with a $75 copay and no coinsurance, though worldwide urgent coverage and worldwide emergency transportation are not covered.
Primary Care See details
Solis Wellness Plan (HMO C-SNP) provides primary care, specialist, telehealth, podiatry, and routine chiropractic services with no copay and no coinsurance, though other chiropractic services are not covered. Occupational, physical, and speech therapy services have a $0 to $15 copay, while mental health, psychiatric, and opioid treatment services carry copays ranging from $20 to $30, all with no coinsurance.
Preventive Services See details
Solis Wellness Plan (HMO C-SNP) offers partially covered preventive services with no copay and no coinsurance, although referrals are required for some services. Covered benefits include annual physical exams, health education, and fitness benefits, while excluded sub-services include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, home-based palliative care, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, home and bathroom safety devices, and counseling.
Hearing Services See details
Solis Wellness Plan (HMO C-SNP) covers hearing services with no copay and no coinsurance, including one routine hearing exam and one fitting evaluation yearly. Prescription hearing aids are partially covered with a $1,500 annual maximum, but OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Solis Wellness Plan (HMO C-SNP) provides partially covered vision services with no copay and no coinsurance, although other eye exam services are not covered. Covered benefits include one routine eye exam per year and up to a $250 annual maximum for eyewear, including contacts, eyeglasses, and upgrades.
Dental Services See details
Dental services are partially covered by the Solis Wellness Plan (HMO C-SNP) with no copay and no coinsurance for covered benefits, up to a maximum annual limit of $3,500. While many preventive and comprehensive 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, though prior authorization is required. Under this plan, Medicare Part B insulin drugs feature no copay and no coinsurance, while chemotherapy and other Part B drugs have a coinsurance ranging from 0% to 20% and may require step therapy.
Dialysis Services See details
Dialysis services are covered by the Solis Wellness Plan (HMO C-SNP) with no copay and a 20% coinsurance. Prior authorization and a referral are required to access this benefit.
Medical Equipment See details
Medical equipment is partially covered by Solis Wellness Plan (HMO C-SNP) with no copays, up to 20% coinsurance for durable medical equipment and prosthetics, and no coinsurance for diabetic equipment. Prior authorization is required, and medical supplies, diabetic supplies, and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by the Solis Wellness Plan (HMO C-SNP) because lab services are not covered. Covered diagnostic procedures and tests have no coinsurance and a copay of up to $25, while radiological and outpatient X-ray services feature no copay and no coinsurance.
Home Health Services See details
Solis Wellness Plan (HMO C-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Solis Wellness Plan (HMO C-SNP). This exclusion applies to all related sub-services, including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services.
Skilled Nursing Facility (SNF) See details
Solis Wellness Plan (HMO C-SNP) partially covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization and referrals but no prior three-day hospital stay. There is no copay for days 1 through 20 and a $50 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Solis Wellness Plan (HMO C-SNP) provides partial coverage for other services, offering over-the-counter items and a chronic illness meal benefit with no copay and no coinsurance. Under this plan, members receive a $125 monthly allowance for over-the-counter items, while acupuncture and other additional services are not covered.
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