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Select Health Medicare Dual (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Select Health Medicare Dual (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Select Health Medicare Dual (HMO D-SNP) in 2026, please refer to our full plan details page.
Select Health Medicare Dual (HMO D-SNP) is a HMO D-SNP plan offered by Intermountain Health Care, Inc. available for enrollment in 2025 to people living in Davis, Iron, Salt Lake, Utah, Washington, Weber. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Select Health Medicare Dual (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Select Health Medicare Dual (HMO D-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 Select Health Medicare Dual (HMO D-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 Select Health Medicare Dual (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $37.60. 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 a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $8850.00 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 Select Health Medicare Dual (HMO D-SNP) plan features an annual prescription drug deductible of $615. This deductible is the amount you must pay out-of-pocket for your medications before the plan begins to cover its share of the costs. Specific drug coverage tier details, such as copayments and coinsurance for individual tiers, are currently unavailable for this plan. You can review the plan's formulary to see how your specific prescription medications are classified and covered.
Additional Benefits
The Select Health Medicare Dual (HMO D-SNP) plan offers comprehensive coverage with no copay for primary care visits, home health services, and select preventive care. For inpatient hospital stays, members pay a $410 copay per day for the first four days and no copay for days five through 90. Outpatient services generally feature no copays, though coinsurance rates between 20% and 30% apply to most procedures. This plan also includes valuable everyday benefits, such as dental care with no copay or coinsurance up to a $1,500 annual limit, and vision coverage featuring a $200 yearly allowance for eyewear. Additionally, members can access unlimited one-way transportation to plan-approved health locations with no copay. Durable medical equipment, dialysis, and diagnostic tests are also covered with no copay, though coinsurance still applies to these services.
Inpatient Hospital See details
Select Health Medicare Dual (HMO D-SNP) partially covers inpatient hospital services with no coinsurance, requiring a $410 copay per day for days 1 through 4 and no copay for days 5 through 90. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Select Health Medicare Dual (HMO D-SNP) covers outpatient services with no copays, though coinsurance applies to most benefits and prior authorization may be required. Outpatient hospital services have a 20% to 30% coinsurance, ambulatory surgical center and outpatient substance abuse services have a 20% coinsurance, and outpatient blood services feature no coinsurance.
Partial Hospitalization See details
Select Health Medicare Dual (HMO D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Select Health Medicare Dual (HMO D-SNP), with ground and air ambulance services requiring a 30% coinsurance and no copay. Unlimited one-way rides to plan-approved health locations are provided with no copay and no coinsurance, but transportation to other health-related locations is not covered.
Emergency Services See details
Select Health Medicare Dual (HMO D-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services and worldwide emergency transportation or urgent care are covered with a 30% coinsurance (up to $40 per visit for urgent care) and no copay, while worldwide emergency coverage requires a $115 copay and no coinsurance.
Primary Care See details
Select Health Medicare Dual (HMO D-SNP) covers primary care provider services with no copay and no coinsurance, while specialist, therapy, and mental health services require no copay and a 30% coinsurance. Some chiropractic services are covered, though routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by Select Health Medicare Dual (HMO D-SNP), with no copay and no coinsurance for annual physicals and select benefits like fitness programs and in-home support. Uncovered services include health education, PERS, medication reconciliation, readmission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, caregiver support, smoking cessation, disease management, telemonitoring, home safety devices, and counseling. Kidney education and diabetes self-management training are covered with no copay and a 20% coinsurance.
Hearing Services See details
Select Health Medicare Dual (HMO D-SNP) covers hearing exams with no copay and no deductible, though routine exams require a 30% coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance, but inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Select Health Medicare Dual (HMO D-SNP) with no deductible and no copay, as separate eyeglass lenses and eyeglass frames are not covered. Covered routine eye exams require a 30% coinsurance, while eligible eyewear has no coinsurance and is covered up to a $200 annual maximum.
Dental Services See details
Dental services are partially covered by Select Health Medicare Dual (HMO D-SNP), offering no copay and no coinsurance for most preventive and comprehensive care up to a $1,500 yearly limit, though Medicare-covered dental services require a 30% coinsurance and no copay. Fluoride treatments, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Select Health Medicare Dual (HMO D-SNP) with no copay, though prior authorization and step therapy are required. Associated Medicare Part B drugs, including chemotherapy and insulin, are covered with no coinsurance to 20% coinsurance, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered by Select Health Medicare Dual (HMO D-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
Select Health Medicare Dual (HMO D-SNP) covers durable medical equipment, prosthetics, and diabetic supplies with no copay and a 20% coinsurance. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Select Health Medicare Dual (HMO D-SNP) covers diagnostic and radiological services with prior authorization and no copays. Diagnostic procedures and tests have no coinsurance, while there is a 20% coinsurance for lab services, diagnostic radiological services, and therapeutic radiological services, and a 30% coinsurance for outpatient X-ray services.
Home Health Services See details
Home Health Services are covered by Select Health Medicare Dual (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the Select Health Medicare Dual (HMO D-SNP) plan with no copay and require prior authorization. Although some services are covered, specific options like cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 30% coinsurance.
Skilled Nursing Facility (SNF) See details
Select Health Medicare Dual (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization and no prior three-day hospital stay. There is no copay for days 1 to 20 and days 66 to 100, while a $218 daily copay applies for days 21 to 65, with additional days not covered.
Other Services See details
Other Services under the Select Health Medicare Dual (HMO D-SNP) plan are partially covered, featuring a meal benefit for chronic illnesses with no copay and no coinsurance, subject to prior authorization. Acupuncture, over-the-counter (OTC) items, and other additional services are not covered under this benefit.
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