Astiva Health C-SNP Deluxe (HMO C-SNP)

Astiva Health C-SNP Deluxe (HMO C-SNP) is a HMO C-SNP plan offered by Astiva Health Holdings Incorporated available for enrollment in 2025 to people living in Counties: OC, LA, RIV, SB, SD. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that Astiva Health C-SNP Deluxe (HMO C-SNP) 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 Astiva Health C-SNP Deluxe (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.

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:

Drug Coverage

The Astiva Health C-SNP Deluxe (HMO C-SNP) plan offers an Enhanced Alternative drug benefit with no prescription drug deductible. If you qualify for the low-income subsidy, you will benefit from a $0 Part D premium. During the initial coverage phase, there is no copay for Tier 1 preferred generic and Tier 5 specialty drugs at standard pharmacies or through standard mail. For other medications, you will pay a $20 copay for Tier 2 standard generics, a $75 copay for Tier 3 preferred brands, and a 33% coinsurance for Tier 4 non-preferred drugs. Once your yearly out-of-pocket drug costs reach $2100.00, you enter the catastrophic coverage phase and pay nothing for covered Part D prescriptions.

Additional Benefits

The Astiva Health C-SNP Deluxe (HMO C-SNP) offers comprehensive medical coverage with highly affordable cost-sharing, including no copays for inpatient hospital stays during days 1 through 5 and 16 through 90. Outpatient hospital services require a $50 copay, while primary care therapies and outpatient substance abuse sessions carry a low $15 copay with no coinsurance. Additionally, emergency room visits have a $75 copay, whereas urgently needed care and standard preventive services are covered with no copays or coinsurance. For specialized care, the plan provides routine hearing and vision exams with no deductibles, alongside allowances for prescription hearing aids and eyewear. Dental benefits feature no copays or coinsurance up to $350 every three months for covered services, while medical equipment and dialysis require no copays and up to 20% coinsurance. Members also benefit from extra perks like 36 one-way transportation trips per year, covered acupuncture, and a $600 yearly meal benefit for chronic illnesses.