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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 Orange, Osceola, Seminole. 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 no drug deductible, allowing your prescription coverage to begin immediately. You will pay no copay for Tier 1 (Preferred Generic) and Tier 2 (Generic) drugs at standard pharmacies for one, two, or three-month supplies, as well as no copay for a three-month standard mail order. There is also no copay for a one-month supply of Tier 6 (Supplemental Drugs) at standard pharmacies. For Tier 3 (Preferred Brand) drugs at standard pharmacies, copayments are $35 for a one-month supply, $70 for a two-month supply, and $100 for a three-month supply. Tier 4 (Non-Preferred Drugs) carry a $100 copay for a one-month supply at standard pharmacies, 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 affordable healthcare coverage with no copay for primary care visits, preventive services, and home health care. Specialist visits require a low $5 copay, while inpatient hospital stays cost a $130 copay for days 1 through 5, followed by no copay for days 6 through 90. Emergency room visits have a $120 copay, which is waived if you are admitted to the hospital within 24 hours. Additionally, the plan features extensive supplemental benefits, including no copay for routine dental cleanings, annual vision exams, and routine hearing tests. You also receive a $300 annual eyewear allowance, up to $1,000 for prescription hearing aids, and a $115 monthly allowance for over-the-counter drugs. Other key services, such as durable medical equipment and dialysis, are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
Solis Wellness Giveback Plan (HMO C-SNP) partially covers inpatient hospital acute and psychiatric services with no coinsurance, requiring a $130 copay for days 1 through 5 and no copay for days 6 through 90. Prior authorization and referrals are required, and the plan does not cover additional days, upgrades, or non-Medicare-covered stays.
Outpatient Services See details
Solis Wellness Giveback Plan (HMO C-SNP) covers outpatient services with no coinsurance, featuring a $175 copay for outpatient hospital and observation services, a $25 copay for ambulatory surgical center services, and a $40 copay for outpatient substance abuse sessions. Outpatient blood services are covered with no copay and no coinsurance, though prior authorizations and referrals are required for most of these services.
Partial Hospitalization See details
Solis Wellness Giveback Plan (HMO C-SNP) covers partial hospitalization with a copay of either $100.00 or $180.00 and no coinsurance. Prior authorization and a referral are required to access these services.
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. Transportation services are partially covered, providing up to 24 one-way trips per year to plan-approved locations with no copay and no coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Solis Wellness Giveback Plan (HMO C-SNP) covers emergency services with a $120 copay and urgently needed services with a $10 copay, both featuring no coinsurance and waived copays if admitted to the hospital within 24 hours. Worldwide emergency services are partially covered with a $120 copay, no coinsurance, and a $75,000 maximum benefit, but worldwide urgent coverage and worldwide emergency transportation are not covered.
Primary Care See details
Solis Wellness Giveback Plan (HMO C-SNP) offers primary care, podiatry, and other health professional services with no copay and no coinsurance, while specialist visits feature a $5 copay and no coinsurance. Therapy, mental health, psychiatric, and opioid treatment services require copays ranging from $10 to $40 with no coinsurance, and telehealth services cost up to a $5 copay with no coinsurance, though chiropractic services are not covered.
Preventive Services See details
Solis Wellness Giveback Plan (HMO C-SNP) provides partially covered preventive services with no copay and no coinsurance, though referrals are required for some benefits. Covered services include annual physical exams, nutritional benefits, and memory fitness, while services such as in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, alternative therapies, and therapeutic massages are not covered.
Hearing Services See details
Hearing services are covered by the Solis Wellness Giveback Plan (HMO C-SNP) with no copay and no coinsurance, including one routine hearing exam and one fitting evaluation annually. Prescription hearing aids are covered up to a $1,000 maximum per year for both ears combined, but the benefit is partially covered because OTC hearing aids and 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) offers partially covered vision services with no copay, no coinsurance, and no deductible. Covered benefits include one routine eye exam per year and up to $300 annually for eyewear like contacts and glasses, while other eye exam services are not covered.
Dental Services See details
Dental services are partially covered under the Solis Wellness Giveback Plan (HMO C-SNP) with no copay and no coinsurance for covered care, such as select exams, cleanings, fluoride, x-rays, and periodontics. Sub-services that are not covered include other diagnostic and preventive services, restorative care, endodontics, prosthodontics, implants, maxillofacial prosthetics, oral surgery, and orthodontics.
Home Infusion bundled Services See details
Solis Wellness Giveback Plan (HMO C-SNP) covers home infusion bundled services with no copay, subject to prior authorization. Covered Medicare Part B chemotherapy, radiation, and other Part B drugs have a coinsurance ranging from no coinsurance to 20%, while Part B insulin drugs require a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered under 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 covered services.
Medical Equipment See details
Solis Wellness Giveback Plan (HMO C-SNP) partially covers medical equipment with no copays, though prior authorization is required. Durable medical equipment and prosthetic devices are covered with 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) covers diagnostic services with no coinsurance and copays between $0 and $150, though lab services are not covered. Diagnostic radiological services and outpatient X-rays require no copay, while therapeutic radiological services carry a 20% coinsurance.
Home Health Services See details
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 are covered by the Solis Wellness Giveback Plan (HMO C-SNP) with no copay and no coinsurance, although some services are covered while cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered. Prior authorization and referrals are required for covered services.
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, requiring prior authorization and a referral but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $150 daily copay for days 21 through 100 per stay.
Other Services See details
Solis Wellness Giveback Plan (HMO C-SNP) partially covers other services, providing chronic illness meal benefits and a $115 monthly over-the-counter (OTC) drug allowance with no copay and no coinsurance. Acupuncture and Naloxone OTC items are not covered, and a referral is required to receive the meal benefits.
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