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Solis Wellness Giveback Plan (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Solis Wellness Giveback 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 Giveback Plan (HMO C-SNP) in 2026, please refer to our full plan details page.
Solis Wellness Giveback Plan (HMO C-SNP) is a HMO C-SNP plan offered by Athena Healthcare Holdings, LLC available for enrollment in 2026 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 Giveback 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 Giveback 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 Giveback 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 Giveback 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 $185.00. 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:
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Drug Coverage
The Solis Wellness Giveback Plan (HMO C-SNP) offers prescription drug coverage with a $0 drug deductible, allowing your benefits to begin immediately. You will pay no copay for Tier 1 preferred generic and Tier 2 generic drugs at standard pharmacies for one-month, two-month, and three-month supplies, or for three-month standard mail orders. Tier 6 supplemental drugs also feature no copay for a one-month supply at standard pharmacies. For higher-tier medications, cost sharing at standard pharmacies varies depending on the drug tier. Tier 3 preferred brand drugs require a $35 copay for a one-month supply, a $70 copay for a two-month supply, and a $100 copay for a three-month supply. Tier 4 non-preferred drugs carry a $100 copay for a one-month supply, while Tier 5 specialty tier drugs require a 33% coinsurance for a one-month supply.
Additional Benefits
The Solis Wellness Giveback Plan (HMO C-SNP) offers robust coverage with no copays or coinsurance for primary care, specialist visits, preventive services, and home health care. For inpatient hospital stays, members pay a $50 daily copay for days 1 through 5 and no copay for days 6 through 90. Outpatient hospital services carry a $100 copay, while emergency room visits require an $85 copay which is waived upon admission. Supplemental benefits are highly accessible, featuring no copays for routine dental care, annual eye exams with a $300 eyewear allowance, and routine hearing exams with a $1,250 prescription hearing aid allowance. Members also benefit from a monthly $115 over-the-counter item allowance and up to 24 one-way transportation trips per year to plan-approved locations with no copay. Specialized services, such as durable medical equipment and dialysis, are covered with a coinsurance of up to 20% and no copays.
Inpatient Hospital See details
Solis Wellness Giveback Plan (HMO C-SNP) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $50 daily copay for days 1 through 5 and no copay for days 6 through 90 per stay. This benefit is partially covered, as upgrades, additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Solis Wellness Giveback Plan (HMO C-SNP) covers outpatient services with no coinsurance, featuring a $100 copay for outpatient hospital and observation services, a $25 copay for ambulatory surgical center and substance abuse sessions, and no copay for outpatient blood services.
Partial Hospitalization See details
Partial hospitalization is covered under the Solis Wellness Giveback Plan (HMO C-SNP) with either no copay or a $180 copay, and no coinsurance. Both prior authorization and a referral are required for these covered services.
Ambulance and Transportation Services See details
Solis Wellness Giveback Plan (HMO C-SNP) covers ground ambulance services with a $150 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required for both. Transportation services are partially covered with no copay and no coinsurance for up to 24 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
Emergency services under the Solis Wellness Giveback Plan (HMO C-SNP) are covered with an $85 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, while urgently needed services feature no copay and no coinsurance. Worldwide emergency services are partially covered up to a $75,000 maximum with an $85 copay and no coinsurance, though worldwide urgent coverage and worldwide emergency transportation are not covered.
Primary Care See details
Solis Wellness Giveback Plan (HMO C-SNP) covers primary care, specialist, telehealth, and routine podiatry services with no copay and no coinsurance. Physical and occupational therapy require a $0 to $10 copay with no coinsurance, while opioid treatment has a $25 copay and no coinsurance. Some chiropractic, mental health, and psychiatric services are covered with no copay and no coinsurance, but routine chiropractic care and individual or group therapy sessions are not covered.
Preventive Services See details
Solis Wellness Giveback Plan (HMO C-SNP) offers preventive services, including annual physical exams and kidney disease education, with no copay and no coinsurance. While services like health education and fitness benefits are included, this benefit is partially covered as several sub-services, such as in-home safety assessments, medical nutrition therapy, and weight management programs, are not covered.
Hearing Services See details
The Solis Wellness Giveback Plan (HMO C-SNP) partially covers hearing services, offering one routine hearing exam and fitting evaluation per year with no copay and no coinsurance. Prescription hearing aids are covered up to a $1,250 annual maximum for both ears combined with no copay or coinsurance, though over-the-counter hearing aids and inner ear, outer ear, or over-the-ear prescription models are not covered.
Vision Services See details
Solis Wellness Giveback Plan (HMO C-SNP) offers partially covered vision services with no copay, no coinsurance, and no deductible. This benefit includes one routine eye exam per year and a $300 annual allowance for eyewear, though other eye exam services are not covered.
Dental Services See details
Solis Wellness Giveback Plan (HMO C-SNP) offers partially covered dental services with no copay and no coinsurance for covered benefits, including oral exams, cleanings, dental X-rays, fluoride treatments, and periodontics. However, other diagnostic and preventive services, restorative services, endodontics, prosthodontics, implant services, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by the Solis Wellness Giveback Plan (HMO C-SNP) with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and radiation, carry a 0% to 20% coinsurance, while Part B insulin drugs require a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Solis Wellness Giveback 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 Giveback Plan (HMO C-SNP) partially covers medical equipment with no copays, requiring prior authorization for services. Durable medical equipment carries a 0% to 20% coinsurance, prosthetic devices require a 20% coinsurance, and diabetic equipment has no coinsurance, but medical supplies, diabetic supplies, and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Solis Wellness Giveback Plan (HMO C-SNP) partially covers diagnostic and radiological services, with lab services excluded from coverage. Covered diagnostic procedures have no coinsurance and a $0 to $50 copay, while diagnostic radiological services have no coinsurance and a $0 copay. Outpatient X-rays have a $0 copay, and therapeutic radiological services require a copay and a minimum 20% coinsurance, with referrals and prior authorizations required for services.
Home Health Services See details
Home Health Services are covered by the Solis Wellness Giveback Plan (HMO C-SNP) with no copay and no coinsurance. Prior authorization and a referral are required to receive these services.
Cardiac Rehabilitation Services See details
Solis Wellness Giveback Plan (HMO C-SNP) indicates some services are covered for Cardiac Rehabilitation with no copay and no coinsurance, though prior authorization and referrals are required. However, Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Solis Wellness Giveback Plan (HMO C-SNP) covers Skilled Nursing Facility (SNF) care with no coinsurance, offering no copay for days 1 through 20 and a $60 daily copay for days 21 through 100. Prior authorization and referrals are required for these services, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Solis Wellness Giveback Plan (HMO C-SNP) provides partial coverage for other services, excluding acupuncture and Naloxone. Covered benefits include over-the-counter (OTC) items up to $115 per month and a chronic illness meal benefit (referral required), both of which feature no copay and no coinsurance.
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