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Sonder Complete Health Advantage (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Sonder Complete Health Advantage (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Sonder Complete Health Advantage (HMO) in 2025, please refer to our full plan details page.
Sonder Complete Health Advantage (HMO) is a HMO plan offered by Avian Health Holdings, LLC available for enrollment in 2025 to people living in Central Georgia Areas. This plan received an overall rating of 2 out of 5 stars in 2025.
It's important to know that Sonder Complete Health Advantage (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 Complete Health Advantage (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 Complete Health Advantage (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 $0.70. 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 $2950.00 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 Complete Health Advantage (HMO) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you will pay a copay for your prescriptions. For example, standard generic drugs have a $44 copay. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs. You may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The Sonder Complete Health Advantage (HMO) plan offers a range of benefits, including coverage for inpatient and outpatient services, with varying copays. Emergency and primary care services are covered with copays, and preventive services are included, with some additional options like hearing and vision exams. Dental services are available with a 20% coinsurance, and there is a $3,000 annual maximum. This plan also provides coverage for ambulance and transportation services, as well as home health, and skilled nursing facility services, with specific copays or coinsurance amounts. Additional benefits include coverage for medical equipment, diagnostic and radiological services, and home infusion services. The plan also offers an over-the-counter (OTC) benefit with a maximum of $200 every three months.
Inpatient Hospital See details
Inpatient Hospital benefits are covered by the Sonder Complete Health Advantage (HMO) plan, with a $200 copay for days 1-5, and no copay for days 6-90 for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. Additional days for Inpatient Hospital-Acute are covered with no copay, while 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 with the Sonder Complete Health Advantage (HMO) plan include coverage for Outpatient Hospital Services with a $250 copay, Observation Services with a $350 copay, Ambulatory Surgical Center (ASC) Services with a $150 copay, and Individual and Group Sessions for Outpatient Substance Abuse with copays of $25 and $15 respectively. Outpatient Blood Services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the Sonder Complete Health Advantage (HMO) plan, but requires prior authorization. The plan has a $40 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground ambulance services have a $300 copay, while air ambulance services have a $750 copay; there is no coinsurance. Transportation services to a plan-approved health-related location are covered for up to 50 one-way trips per year. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $125 copay and no coinsurance, while Urgently Needed Services have a $10 copay and no coinsurance. Worldwide Emergency Services has a maximum plan benefit coverage of $50,000.
Primary Care See details
The Sonder Complete Health Advantage (HMO) plan covers Primary Care Physician, Chiropractic, Occupational Therapy, Physician Specialist, Mental Health Specialty, Psychiatric, Physical Therapy, Speech-Language Pathology, Additional Telehealth, and Opioid Treatment Program Services. Chiropractic, Individual and Group Mental Health, and Individual and Group Psychiatric sessions have a $10 copay. Physical Therapy and Speech-Language Pathology Services have a $10 copay. Other Health Care Professional services have a copay between $0 and $40. Opioid Treatment Program Services have a $10 copay.
Preventive Services See details
The Sonder Complete Health Advantage (HMO) plan covers preventive services, including Medicare-covered preventive services with no copay, and additional preventive services like In-Home Safety Assessment, Personal Emergency Response System (PERS), Post discharge In-Home Medication Reconciliation, Alternative Therapies (6 visits), In-Home Support Services, Support for Caregivers of Enrollees, Fitness Benefit (Memory Fitness), and Remote Access Technologies, while services like Annual Physical Exam, Health Education, Medical Nutrition Therapy, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, 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. Other preventive services are covered, including Glaucoma Screening, Diabetes Self-Management Training, and EKG following Welcome Visit, while Barium Enemas have a $60 copay, and Digital Rectal Exams are covered, but have a copay, though the amount is not specified.
Hearing Services See details
Hearing exams are covered with a $40 copay, and routine hearing exams are covered for one visit every year. Prescription hearing aids are covered with a copay between $699 and $999, while fitting/evaluation for hearing aids, OTC hearing aids, prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision services include eye exams with a $40 copay. The plan also covers contact lenses and eyeglasses (lenses and frames), with a combined maximum benefit of $400 every year. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services. Other Dental Services have a $3,000 annual maximum. Oral exams are limited to one visit every six months, dental x-rays are limited to one every two years, and prophylaxis (cleaning) is limited to one visit every six months. Fluoride treatments and other preventative dental services are limited to one visit per year. Orthodontic Services have a $3,000 annual maximum. Adjunctive General Services, Implant Services, Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. Medicare Part B Insulin Drugs have a $35 copay, while the coinsurance for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs ranges from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the Sonder Complete Health Advantage (HMO) plan, but require prior authorization. You will pay 20% coinsurance for this service.
Medical Equipment See details
Medical Equipment benefits, including Durable Medical Equipment and Prosthetics/Medical Supplies, are covered by the Sonder Complete Health Advantage (HMO) plan. Durable Medical Equipment has a 20% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetics and Medical Supplies have a 20% coinsurance, and Diabetic Equipment is covered, but Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including all diagnostic services, diagnostic procedures/tests, and lab services, are covered with a doctor referral. Diagnostic Procedures/Tests have a copay between $0 and $55, and Lab Services have no copay. Radiological Services, including diagnostic and therapeutic radiological services, and outpatient X-ray services, are also covered; diagnostic radiological services have a copay up to $300, therapeutic radiological services have 20% coinsurance, and outpatient X-ray services have no copay.
Home Health Services See details
Home Health Services are covered by the Sonder Complete Health Advantage (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 covered, but the plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Sonder Complete Health Advantage (HMO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $184. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes coverage for over-the-counter (OTC) items and meal benefits, while acupuncture, Dual Eligible SNPs with Highly Integrated Services, and other services like Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services are not covered. The OTC benefit has a maximum coverage amount of $200 every three months.
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