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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 Polk. 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 $3400.00 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 drug deductible, allowing your prescription drug coverage to begin immediately. There is no copay for Tier 1 (Preferred Generic) and Tier 2 (Generic) medications filled at standard pharmacies or through standard mail order. Additionally, you will pay no copay for Tier 6 (Supplemental Drugs) for a 1-month supply at standard pharmacies. For brand-name and specialty medications, costs vary depending on the drug tier. Tier 3 (Preferred Brand) drugs have standard pharmacy copays of $30 for a 1-month supply, $60 for a 2-month supply, and $85 for a 3-month supply. Tier 4 (Non-Preferred) drugs require a $100 copay for a 1-month supply, while Tier 5 (Specialty Tier) drugs carry a 33% coinsurance for a 1-month supply.
Additional Benefits
The Solis Wellness Giveback Plan (HMO C-SNP) offers affordable medical coverage with no copay for primary care visits and a low $5 copay for specialist appointments. For inpatient hospital stays, members pay a $100 daily copay for days 1 through 5 and no copay for days 6 through 90, while outpatient hospital services require a $175 copay. Emergency care is available with a $120 copay, and urgent care costs just $10, both featuring no coinsurance. This plan also features robust supplemental benefits, including no copay for routine dental cleanings, annual vision exams with a $300 eyewear allowance, and routine hearing exams with up to $1,000 yearly for prescription hearing aids. Additionally, members benefit from a $115 monthly over-the-counter allowance, up to 24 one-way transportation trips per year with no copay, and home health services with no copay.
Inpatient Hospital See details
Solis Wellness Giveback Plan (HMO C-SNP) inpatient hospital benefits are partially covered, featuring no coinsurance and a copay of $100 per day for days 1 to 5, followed by no copay for days 6 to 90 for both acute and psychiatric stays. Prior authorization and referrals are required, while upgrades, additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Solis Wellness Giveback Plan (HMO C-SNP) with no coinsurance, featuring a $175 copay for outpatient hospital and observation services and a $25 copay for ambulatory surgical center services. Outpatient substance abuse sessions carry a $40 copay with no coinsurance, while outpatient blood services are provided with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered under the Solis Wellness Giveback Plan (HMO C-SNP) with a copay of $100.00 or $180.00 and no coinsurance. Prior authorization and a referral are required for 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. The plan also provides up to 24 one-way transportation trips per year to plan-approved health-related locations with no copay or coinsurance, 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 a $120 copay and no coinsurance, and urgently needed services are covered with a $10 copay and no coinsurance, with both copays waived if admitted to the hospital within 24 hours. Worldwide emergency services are partially covered up to a $75,000 maximum benefit with a $120 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, podiatry, and telehealth services with copays ranging from no copay to $5 and no coinsurance, while specialist visits require a $5 copay and no coinsurance. Licensed therapies, mental health, psychiatric, and opioid treatment services have copays between $10 and $40 with no coinsurance. Some chiropractic services are covered with no copay and no coinsurance, but routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by the Solis Wellness Giveback Plan (HMO C-SNP) with no copay and no coinsurance, although some services require a referral. Excluded sub-services that are not covered 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, in-home support, caregiver support, additional tobacco cessation, enhanced disease management, telemonitoring, home and bathroom safety devices, and counseling.
Hearing Services See details
Solis Wellness Giveback Plan (HMO C-SNP) covers hearing services with no copay and no coinsurance, including one routine exam and fitting evaluation annually, and up to $1,000 per year for prescription hearing aids. This benefit is partially covered, as OTC hearing aids, as well as inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered.
Vision Services See details
Solis Wellness Giveback 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 $300 annually for eyewear, such as contacts, eyeglasses, and upgrades, with referrals and prior authorizations required.
Dental Services See details
Dental services are partially covered by the Solis Wellness Giveback Plan (HMO C-SNP) with no copay and no coinsurance for covered services like oral exams, cleanings, fluoride, x-rays, and periodontics. Sub-services that are not covered under this plan include restorative, endodontics, prosthodontics, implants, oral surgery, orthodontics, adjunctive general, and other diagnostic or preventive dental services.
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 and step therapy are required. Part B insulin drugs require a $35 copay, while chemotherapy and other Part B drugs have no copay, with all Part B drugs carrying a coinsurance ranging from no coinsurance up to 20%.
Dialysis Services See details
Dialysis Services are covered by the Solis Wellness Giveback Plan (HMO C-SNP) with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these services.
Medical Equipment See details
Medical equipment is partially covered by the Solis Wellness Giveback Plan (HMO C-SNP), offering durable medical equipment and prosthetic devices with no copay and 20% coinsurance, and diabetic equipment with no copay and no coinsurance. Prior authorization is required for covered equipment, but medical supplies, diabetic supplies, and diabetic therapeutic shoes or inserts are not covered under this benefit.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by the Solis Wellness Giveback Plan (HMO C-SNP), as lab services are not covered. Outpatient diagnostic tests have no coinsurance and a copay ranging from no copay to $175, while diagnostic radiology and outpatient X-rays have no copay, and therapeutic radiological services require 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, although a referral and prior authorization are required.
Cardiac Rehabilitation Services See details
Solis Wellness Giveback Plan (HMO C-SNP) covers some cardiac rehabilitation services with no coinsurance, though cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by the Solis Wellness Giveback Plan (HMO C-SNP), with additional days beyond the Medicare-covered limit not being covered. This benefit features no coinsurance, offering no copay for days 1 through 20 and a $150 daily copay for days 21 through 100, subject to prior authorization and referral requirements.
Other Services See details
Other Services are partially covered by the Solis Wellness Giveback Plan (HMO C-SNP), featuring over-the-counter (OTC) items and a meal benefit with no copay and no coinsurance. While the plan provides a $115 monthly OTC allowance and chronic illness meal benefits with a referral, acupuncture and Naloxone are not covered.
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