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

Astiva Health C-SNP WOW (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 WOW (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 WOW (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 WOW (HMO C-SNP) plan offers an Enhanced Alternative drug benefit with an annual prescription drug deductible of $615. After meeting this deductible, you will pay no copay for Tier 1 preferred generics through standard mail or Tier 5 specialty drugs through standard pharmacy and standard mail. For other prescriptions at a standard pharmacy, you will pay a $15 copay for Tier 1 preferred generics, a $35 copay for Tier 2 standard generics, a $95 copay for Tier 3 preferred brands, and a 25% coinsurance for Tier 4 non-preferred drugs. Once your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs. If you qualify for the low-income subsidy or Extra Help, your Part D cost is reduced to $4.40. This plan structure helps medicare beneficiaries easily estimate and manage their yearly medication expenses.

Additional Benefits

The Astiva Health C-SNP WOW (HMO C-SNP) plan provides comprehensive medical coverage, featuring no copay for the first 60 days of acute inpatient hospital stays and no copay for primary care doctor visits. Outpatient hospital services, diagnostic procedures, and dialysis generally require a 20% coinsurance with no copay, while emergency room visits carry a $115 copay that is waived upon admission. Additionally, urgent care services and up to 36 annual one-way trips to health-related locations are available to members with no copay and no coinsurance. For routine and supplemental care, the plan offers dental, vision, and hearing benefits with no deductibles. Hearing benefits include routine exams and up to $750 per ear for prescription hearing aids, while vision coverage provides a $300 eyewear allowance every two years. Select dental services are covered with no copay or coinsurance up to $550 every three months, and skilled nursing facility stays require no copay or coinsurance for the first 20 days.