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Sonder Harmony & Soul (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Sonder Harmony & Soul (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Sonder Harmony & Soul (HMO) in 2025, please refer to our full plan details page.
Sonder Harmony & Soul (HMO) is a HMO plan offered by Avian Health Holdings, LLC available for enrollment in 2025 to people living in Atlanta Metro. This plan received an overall rating of 2 out of 5 stars in 2025.
It's important to know that Sonder Harmony & Soul (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Sonder Harmony & Soul (HMO).
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 Harmony & Soul (HMO), 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 $0.30. 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 $6800.00 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 Harmony & Soul (HMO) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you will pay a copay depending on the drug tier and pharmacy. For example, the copay for a standard pharmacy is $10 for preferred generic drugs, $44 for standard generic drugs, and $95 for preferred brand drugs. Non-preferred drugs have 33% coinsurance. After your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The Sonder Harmony & Soul (HMO) plan offers a range of benefits, including inpatient and outpatient hospital care, with varying copays for different services. This plan also covers primary care, specialist visits, and mental health services, with copays applicable. Additionally, the plan includes coverage for ambulance services, emergency care, hearing, vision, and dental services, alongside home health services with no copay. Other benefits include coverage for home infusion, dialysis, and medical equipment, with some services requiring coinsurance or prior authorization. The plan also provides coverage for preventive services, along with additional services like acupuncture and over-the-counter items. However, certain services such as cardiac rehabilitation, podiatry, and additional hours of care are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with a copay of $350 for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered, but Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Additional days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a $200 copay, observation services with a $350 copay, Ambulatory Surgical Center (ASC) services with a $100 copay, and outpatient substance abuse services. Outpatient substance abuse services include individual sessions with a $25 copay, and group sessions with a $15 copay. Outpatient Blood Services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the Sonder Harmony & Soul (HMO) plan, with a $40 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services. Ground ambulance services have a copay of $325, while air ambulance services have a copay of $750; there is no coinsurance for either. Transportation Services - Any Health-related Location is covered for up to 50 one-way trips per year, using bus/subway, medical transport, or other methods; Transportation Services - Plan Approved Health-related Location is not covered.
Emergency Services See details
Emergency Services under the Sonder Harmony & Soul (HMO) plan include a $110 copay and no coinsurance, while Urgently Needed Services have a $30 copay and no coinsurance. Worldwide Emergency Services are covered up to $10,000, and Worldwide Emergency and Urgent Coverage are covered, but Worldwide Emergency Transportation is not covered.
Primary Care See details
The Sonder Harmony & Soul (HMO) plan covers primary care physician services, chiropractic services (with a $15 copay), occupational therapy (with a $25 copay), specialist services, mental health specialty services (with a $40 copay for individual and group sessions), psychiatric services (with a $40 copay for individual and group sessions), physical therapy and speech-language pathology services (with a $25 copay), additional telehealth benefits, and opioid treatment program services. The plan does not cover podiatry services, and routine chiropractic care is also not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, along with additional preventive services. The plan does not cover annual physical exams, health education, in-home safety assessments, Personal Emergency Response Systems (PERS), Medical Nutrition Therapy (MNT), post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications, and counseling services. Therapeutic massage and fitness benefits are covered. Other preventive services include coverage for glaucoma screening, diabetes self-management training, barium enemas with a $60 copay, digital rectal exams, and EKG following a Welcome Visit.
Hearing Services See details
Hearing Services include hearing exams with a $40 copay, and prescription hearing aids, but fitting/evaluation for hearing aids, prescription hearing aids - inner ear, prescription hearing aids - outer ear, prescription hearing aids - over the ear, and OTC hearing aids are not covered. Routine hearing exams and prescription hearing aids (all types) are covered, with a maximum plan benefit coverage of $3,000 every year.
Vision Services See details
The Sonder Harmony & Soul (HMO) plan covers vision services, including routine eye exams once per year. Eyewear is covered, with a $40 copay for contact lenses. Eyeglasses (lenses and frames) are also covered, but eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The Sonder Harmony & Soul (HMO) plan covers dental services with a 20% coinsurance for Medicare Dental Services. Other dental services have a maximum plan benefit of $4,000 every year. Oral exams, prophylaxis (cleaning), and fluoride treatments are limited to one visit every six months, and dental X-rays are limited to one every two years.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Sonder Harmony & Soul (HMO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment benefits are covered by the Sonder Harmony & Soul (HMO) plan, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance with authorization required, while durable medical equipment for use outside the home is not covered. Prosthetics and medical supplies have a 20% coinsurance for Medicare-covered items, and diabetic supplies and therapeutic shoes/inserts also have a 20% coinsurance.
Diagnostic and Radiological Services See details
The Sonder Harmony & Soul (HMO) plan covers diagnostic and radiological services, including diagnostic procedures and lab services with a copay between $0 and $100, and outpatient X-ray services with no copay. Therapeutic radiological services have a coinsurance of at least 20%, and diagnostic radiological services have a copay of at most $300.
Home Health Services See details
Home Health Services are covered by the Sonder Harmony & Soul (HMO) plan with no copay and no coinsurance, but a referral is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Sonder Harmony & Soul (HMO) plan. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Sonder Harmony & Soul (HMO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $203. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The Sonder Harmony & Soul (HMO) plan covers acupuncture, over-the-counter (OTC) items, and a meal benefit. Acupuncture has a limit of 24 treatments per year, while OTC items have a maximum benefit of $125 every three months. The plan does not cover 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, or Self-Directed Personal Assistance Services.
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