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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 Hillsborough, Pasco, Pinellas. 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 $2700.00 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) features a $0 prescription drug deductible, meaning your coverage begins immediately without any upfront out-of-pocket drug costs. Members pay no copay for Tier 1 preferred generic and Tier 2 generic medications for one, two, or three-month supplies at standard pharmacies, as well as no copay for three-month standard mail order fills. Tier 6 supplemental drugs also feature no copay for a one-month supply at standard pharmacies. For brand-name and specialty medications, Tier 3 preferred brand drugs at standard pharmacies require a copay of $30 for a one-month supply, $60 for a two-month supply, and $85 for a three-month supply. Tier 4 non-preferred drugs have a $100 copay for a one-month supply at standard pharmacies. Finally, Tier 5 specialty drugs require a 33% coinsurance for a one-month supply at standard pharmacies.
Additional Benefits
The Solis Wellness Giveback Plan (HMO C-SNP) offers comprehensive medical coverage featuring no copays or coinsurance for primary care, preventive services, and home health care. Specialist visits require a low $5 copay, while inpatient hospital stays have a $100 daily copay for the first five days and no copay for days six through ninety. Outpatient and emergency services are covered with flat copays and no coinsurance, though specialized services like dialysis and durable medical equipment require a 20% coinsurance. This plan also provides outstanding additional benefits at no copay or coinsurance, including routine dental care, annual hearing exams, and routine vision exams. Members can take advantage of a $300 annual eyewear allowance, a $1,000 annual hearing aid allowance, and up to 24 free one-way trips to plan-approved locations. Additionally, the plan features a generous $115 monthly allowance for over-the-counter items to help you save on everyday health needs.
Inpatient Hospital See details
Solis Wellness Giveback Plan (HMO C-SNP) partially covers inpatient acute and psychiatric hospital services with no coinsurance, though prior authorization and referrals are required. For both types of stays, there is a $100 copay for days 1 through 5 and no copay for days 6 through 90, while additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services under the Solis Wellness Giveback Plan (HMO C-SNP) are covered with no coinsurance, featuring a $150 copay for outpatient hospital and observation services, and a $15 copay for ambulatory surgical center services. Outpatient substance abuse sessions require a $40 copay with no coinsurance, while outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Solis Wellness Giveback Plan (HMO C-SNP) covers partial hospitalization services with a copay of either $100.00 or $180.00 and no coinsurance. Prior authorization and referrals are required to access this benefit.
Ambulance and Transportation Services See details
Solis Wellness Giveback Plan (HMO C-SNP) covers ground ambulance services with a $200 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both requiring prior authorization. Transportation services are partially covered with no copay or coinsurance for up to 24 one-way trips per year to plan-approved locations, but trips to any health-related location are not covered.
Emergency Services See details
Solis Wellness Giveback Plan (HMO C-SNP) covers emergency services with a $110 copay and urgently needed services with a $10 copay, both featuring no coinsurance and waived fees if admitted to the hospital within 24 hours. Worldwide emergency services are partially covered up to a $75,000 maximum with a $110 copay and no coinsurance, though worldwide urgent coverage and worldwide emergency transportation are not covered.
Primary Care See details
Primary care benefits under the Solis Wellness Giveback Plan (HMO C-SNP) feature no copay and no coinsurance for primary care, podiatry, and other health professionals, while specialist visits require a $5 copay and no coinsurance. Physical, occupational, and speech therapy services have a $10 to $40 copay, mental health and psychiatric sessions require a $20 copay, and telehealth ranges from no copay to $5, all with no coinsurance, though chiropractic services are not covered.
Preventive Services See details
Solis Wellness Giveback Plan (HMO C-SNP) covers preventive services, including annual physical exams and kidney disease education, with no copay and no coinsurance. These benefits are partially covered, as several additional services like in-home safety assessments, personal emergency response systems, and medical nutrition therapy are not covered under the plan.
Hearing Services See details
Solis Wellness Giveback Plan (HMO C-SNP) covers annual routine hearing exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered up to a $1,000 annual maximum with no copay or coinsurance, though OTC hearing aids and inner ear, outer ear, or over the ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by the Solis Wellness Giveback Plan (HMO C-SNP) with no copay, no coinsurance, and no deductible for covered services. The plan covers one routine eye exam per year and provides up to $300 annually for eyewear, including contact lenses and eyeglasses, while other eye exam services are not covered.
Dental Services See details
Solis Wellness Giveback Plan (HMO C-SNP) provides partially covered dental services with no copay and no coinsurance for covered care, including Medicare-covered dental, oral exams, dental x-rays, cleanings, fluoride, and periodontics. Services that are not covered under this plan include other diagnostic, other preventive, restorative, adjunctive general, endodontics, prosthodontics, maxillofacial prosthetics, implants, oral and maxillofacial surgery, and orthodontics.
Home Infusion bundled Services See details
Solis Wellness Giveback Plan (HMO C-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, require no coinsurance to 20% coinsurance, with insulin also carrying a $35 copay.
Dialysis Services See details
Solis Wellness Giveback Plan (HMO C-SNP) covers dialysis services with no copay and a 20% coinsurance. Both a referral and prior authorization are required to receive these services.
Medical Equipment See details
Solis Wellness Giveback Plan (HMO C-SNP) partially covers medical equipment, offering durable medical equipment and prosthetic devices with no copay and 20% coinsurance, while medical supplies are not covered. Diabetic equipment is covered with no copay and no coinsurance, but diabetic supplies and 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, though lab services are not covered. Diagnostic tests require a referral and have no coinsurance with a copay of $0 to $125, while radiological services require prior authorization and referrals, offering x-rays with no copay (coinsurance applies) and therapeutic services with a copay and a minimum 20% coinsurance.
Home Health Services See details
The Solis Wellness Giveback 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, including intensive cardiac, pulmonary, and supervised exercise therapy (SET) services, are not covered under the Solis Wellness Giveback Plan (HMO C-SNP).
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) care is covered by the Solis Wellness Giveback Plan (HMO C-SNP) with no coinsurance, featuring no copay for days 1 through 20 and a $150 daily copay for days 21 through 100. This benefit is partially covered as additional days beyond Medicare-covered limits are not covered, and both prior authorization and referrals are required.
Other Services See details
Other services are partially covered under the Solis Wellness Giveback Plan (HMO C-SNP), as acupuncture is not covered. Covered benefits include over-the-counter (OTC) items up to $115 monthly and a chronic illness meal benefit requiring a referral, both of which feature no copay and no coinsurance.
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