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Sonder Renal Health (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Sonder Renal Health (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 Renal Health (HMO C-SNP) in 2025, please refer to our full plan details page.
Sonder Renal Health (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, Athens Counties. This plan received an overall rating of 2 out of 5 stars in 2025.
It's important to know that Sonder Renal Health (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 Renal Health (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 Renal Health (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 Renal Health (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.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 Renal Health (HMO C-SNP) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you will pay a copay for your prescriptions based on the drug tier and pharmacy used. For example, you will pay a $15 copay for a preferred generic drug at a standard pharmacy. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered Part D drugs.
Additional Benefits
The Sonder Renal Health (HMO C-SNP) plan offers comprehensive coverage, including inpatient and outpatient hospital services, with varying copays depending on the service. Emergency services, primary care, preventive services, and home health services have copays, while some services like dialysis have no copay. This plan also provides additional benefits such as hearing, vision, and dental services with copays and maximum benefit limits. There are also services for ambulance and transportation, medical equipment, and diagnostic services.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a $350 copay for days 1-5, and no copay for days 6-90; for Inpatient Hospital Psychiatric, you will pay a $350 copay for days 1-5, and no copay for days 6-90.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a $280 copay, observation services with a $350 copay, ambulatory surgical center services with a $180 copay, and outpatient substance abuse services with a $75 copay for both individual and group sessions. Outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Sonder Renal Health (HMO C-SNP) plan, with a $10 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered. 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 up to 12 one-way trips per year, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered by Sonder Renal Health (HMO C-SNP), with a $120 copay for Emergency Services and a $25 copay for Urgently Needed Services; Worldwide Emergency Transportation is not covered. Worldwide Emergency Services has a service-specific out-of-pocket maximum of $10,000.
Primary Care See details
The Sonder Renal Health (HMO C-SNP) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $40 copay, specialist physician services, and mental health specialty services with a $40 copay for individual and group sessions. The plan also covers podiatry services, other healthcare professional services with a $35 copay, psychiatric services with a $40 copay for individual and group sessions, physical therapy and speech-language pathology services with a $40 copay, additional telehealth benefits, and opioid treatment program services with a $30 copay.
Preventive Services See details
The Sonder Renal Health (HMO C-SNP) plan covers preventive services, including Medicare-covered services with no copay, and additional preventive services, such as in-home safety assessments, personal emergency response systems, post-discharge in-home medication reconciliation, in-home support services, support for caregivers of enrollees, fitness benefits, remote access technologies, kidney disease education, glaucoma screenings, diabetes self-management training, barium enemas with 20% coinsurance, digital rectal exams, and EKGs following a welcome visit. Annual physical exams, health education, medical nutrition therapy, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
Hearing services include routine hearing exams with a $30 copay, and prescription hearing aids with a copay between $699 and $999; however, fitting/evaluation for hearing aids, inner ear hearing aids, outer ear hearing aids, and over-the-ear hearing aids are not covered, and OTC hearing aids are not covered. You are limited to 1 routine hearing exam per year.
Vision Services See details
Vision Services includes coverage for routine eye exams with a $30 copay, and eyewear with a combined maximum benefit of $200 every year. Contact lenses and eyeglasses (lenses and frames) are covered, while eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with 20% coinsurance, other dental services with a $2,500 maximum benefit per year, and specific services like oral exams (1 visit every 6 months), dental x-rays (1 every 2 years), other diagnostic dental services, prophylaxis (cleaning) (1 visit every 6 months), fluoride treatment (1 visit every 6 months), and other preventive dental services. Orthodontic Services are covered under Diagnostic and Preventive Dental. 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 Renal Health (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 with prior authorization required. There is no copay or coinsurance for this benefit.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetic Devices and Medical Supplies also with 20% coinsurance, and Diabetic Equipment. Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are partially covered by the Sonder Renal Health (HMO C-SNP) plan. Diagnostic services have no copay, but Diagnostic Procedures/Tests and Lab Services are not covered, and Therapeutic Radiological Services have a coinsurance of up to 20%, while Diagnostic Radiological Services have a copay of up to $275.
Home Health Services See details
Home Health Services are covered by the Sonder Renal Health (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 technically covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Sonder Renal Health (HMO C-SNP) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, there is a $184 copay. Additional days beyond Medicare-covered SNF and non-Medicare-covered SNF stays are not covered.
Other Services See details
The Sonder Renal Health (HMO C-SNP) plan's "Other Services" benefit includes Over-the-Counter (OTC) items, with a maximum benefit of $200 every three months, and a meal benefit for chronic illnesses. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several additional services are not covered.
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