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Sonder Mind Matters (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Sonder Mind Matters (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Sonder Mind Matters (HMO C-SNP) in 2025, please refer to our full plan details page.
Sonder Mind Matters (HMO C-SNP) is a HMO C-SNP plan offered by Avian Health Holdings, LLC available for enrollment in 2025 to people living in Atlanta, Augusta, Columbus Counties. This plan received an overall rating of 2 out of 5 stars in 2025.
It's important to know that Sonder Mind Matters (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:
Sonder Mind Matters (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 Sonder Mind Matters (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 Sonder Mind Matters (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 $1.50. 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 $3950.00 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 Sonder Mind Matters (HMO C-SNP) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you will pay different copays depending on the drug tier and pharmacy you use. For example, a standard pharmacy has a $15 copay for preferred generic drugs, and a $100 copay for preferred brand drugs. Once your total drug costs reach $2000, you enter the catastrophic coverage phase. In this phase, you will pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy (LIS), you will pay $0.00.
Additional Benefits
The Sonder Mind Matters (HMO C-SNP) plan offers a range of benefits, including coverage for inpatient and outpatient hospital services, with varying copays. You'll find coverage for emergency services, primary care, preventive services, and mental health services with copays ranging from $20-$120. This plan also includes benefits for hearing, vision, and dental services, with specific copays and maximum benefits. Additionally, it covers ambulance and transportation services, home health services, and durable medical equipment, as well as other services like home infusion and dialysis, with associated copays or coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, there is a $350 copay for days 1-5, and no copay for days 6-90. For Inpatient Hospital Psychiatric, there is a $350 copay for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered with no copay. Non-Medicare-covered stay and upgrades for Inpatient Hospital-Acute, as well as additional days and non-Medicare-covered stay for Inpatient Hospital Psychiatric, are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a $280 copay, and observation services with a $350 copay. Ambulatory Surgical Center (ASC) Services have a $180 copay, and outpatient substance abuse services, including individual and group sessions, have a copay between $75 and $75. Outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will have a $10 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Sonder Mind Matters (HMO C-SNP) plan. Ground ambulance services have a $225 copay, and air ambulance services have a $450 copay, with no coinsurance. Transportation Services to a plan-approved health-related location are covered for 12 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Sonder Mind Matters (HMO C-SNP) plan. Emergency Services has a $120 copay, Urgently Needed Services has a $25 copay, and Worldwide Emergency Services has a service-specific out-of-pocket maximum of $10,000. Worldwide Emergency Transportation is not covered.
Primary Care See details
The Sonder Mind Matters (HMO C-SNP) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $40 copay, physician specialist services, mental health specialty services with a $40 copay, podiatry services with a $40 copay, other health care professional services with a $35 copay, psychiatric services with a $40 copay, physical therapy and speech-language pathology services with a $40 copay, additional telehealth benefits, and opioid treatment program services with a $30 copay. Routine chiropractic care is covered for 12 visits per year.
Preventive Services See details
The Sonder Mind Matters (HMO C-SNP) plan covers preventive services, including Medicare-covered preventive services with no copay. Additional preventive services are covered, but annual physical exams, health education, medical nutrition therapy, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, therapeutic massage, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications, counseling services, additional sessions of smoking and tobacco cessation counseling are not covered. Other preventive services have varying coinsurance, including 20% coinsurance for barium enemas.
Hearing Services See details
Hearing Services include coverage for routine hearing exams with a $30 copay, and prescription hearing aids with a copay between $699 and $999. Fitting/evaluation for hearing aids, prescription hearing aids for the inner ear, outer ear, and over the ear, and OTC hearing aids are not covered.
Vision Services See details
The Sonder Mind Matters (HMO C-SNP) plan covers vision services, including routine eye exams with a $30 copay, and eyewear with a combined maximum benefit of $200 per year. Contact lenses and eyeglasses (lenses and frames) are also covered, but eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The Sonder Mind Matters (HMO C-SNP) plan covers Medicare Dental Services with 20% coinsurance, and other dental services with a $1,000 maximum benefit per year. Oral exams, prophylaxis (cleaning), and fluoride treatment are covered for one visit every six months, while dental X-rays are covered once every two years. Other diagnostic dental services, restorative services, endodontics, periodontics, prosthodontics (removable), maxillofacial prosthetics, prosthodontics (fixed), and oral and maxillofacial surgery are also covered. However, adjunctive general services, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Sonder Mind Matters (HMO C-SNP) plan, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Sonder Mind Matters (HMO C-SNP) plan, but require prior authorization. The coinsurance for Dialysis Services is 20%.
Medical Equipment See details
Medical Equipment benefits are covered, including Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetics/Medical Supplies with a 20% coinsurance. Diabetic Equipment is covered, including Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts, each with a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are partially covered under the Sonder Mind Matters (HMO C-SNP) plan. Diagnostic Procedures/Tests, Lab Services, and Outpatient X-Ray Services are not covered, while Diagnostic Radiological Services have a copay of up to $275, and Therapeutic Radiological Services have a coinsurance of up to 20%.
Home Health Services See details
Home Health Services are covered by the Sonder Mind Matters (HMO C-SNP) plan with a $10 copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are generally covered, but none of the sub-services including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are covered. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Sonder Mind Matters (HMO C-SNP) plan, but require prior authorization. There is no copay for days 1-20, and a $184 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for Skilled Nursing Facility (SNF) are not covered.
Other Services See details
The Sonder Mind Matters (HMO C-SNP) plan offers Over-the-Counter (OTC) Items with a maximum benefit of $200 every three months, and a Meal Benefit for a chronic illness. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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