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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 2025, 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 Colorado Front Range. This plan received an overall rating of 4 out of 5 stars in 2025.
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 $0.00. 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 $410.00 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 $9350.00 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 has an enhanced alternative drug benefit. The plan has a deductible of $410. After the deductible is met, you will pay 25% coinsurance for all drugs at standard pharmacies, and standard mail order. If you qualify for the low-income subsidy, you will pay no copay for Part D drugs. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The Select Health Medicare Dual (HMO D-SNP) plan offers a range of benefits, including inpatient and outpatient hospital care, with varying copays and coinsurance. Emergency services have a $110 copay, while primary care and specialist visits may involve copays or coinsurance depending on the service. Preventive services and home health services are covered with no copay, and there are also benefits for hearing, vision, and dental care, with specific coverage limits and cost-sharing arrangements. This plan provides coverage for medical equipment, diagnostic services, and skilled nursing facility stays, with associated coinsurance or copays. Additionally, the plan includes coverage for home infusion, dialysis, and other services, such as over-the-counter items and meal benefits, with specific cost-sharing requirements. However, some services like cardiac rehabilitation and certain types of hearing aids are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a copay of $728 for days 1-3, and no copay for days 4-90; for Inpatient Hospital Psychiatric, you will pay a copay of $645 for days 1-3, and no copay for days 4-60.
Outpatient Services See details
Outpatient services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient hospital services and observation services have a 30% coinsurance, while outpatient blood services have a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered by the Select Health Medicare Dual (HMO D-SNP) plan, but requires prior authorization. You will pay 30% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance, as well as transportation to plan-approved health-related locations. There is no copay for ambulance services, but there is a 30% coinsurance for both ground and air ambulance services. Transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services are covered, with a $110 copay, and no coinsurance. Urgently Needed Services are covered with 30% coinsurance, and no copay, with a maximum per visit amount of $45. Worldwide Emergency Services are covered, with a $110 copay for Worldwide Emergency Coverage, and 30% coinsurance for Worldwide Urgent Coverage and Worldwide Emergency Transportation.
Primary Care See details
The Select Health Medicare Dual (HMO D-SNP) plan covers Primary Care Physician Services, Chiropractic Services with a $15 copay, Occupational Therapy Services with 30% coinsurance, Physician Specialist Services with 30% coinsurance, Mental Health Specialty Services with 30% coinsurance, Podiatry Services with 30% coinsurance, Other Health Care Professional services with 0-30% coinsurance, Psychiatric Services with 30% coinsurance, Physical Therapy and Speech-Language Pathology Services with 30% coinsurance, Additional Telehealth Benefits with 0-30% coinsurance, and Opioid Treatment Program Services with 30% coinsurance. Routine Chiropractic Care is not covered.
Preventive Services See details
The Select Health Medicare Dual (HMO D-SNP) plan covers preventive services, including Medicare-covered services with no copay, annual physical exams, health education, in-home safety assessments, Personal Emergency Response System (PERS), medical nutrition therapy, weight management programs, nutritional/dietary benefits, In-Home Support Services, Fitness Benefit, Remote Access Technologies, Home and Bathroom Safety Devices and Modifications, Kidney Disease Education Services, and Other Preventive Services. Kidney Disease Education Services have a 20% coinsurance, while Diabetes Self-Management Training has a 30% coinsurance. Barium Enemas have a coinsurance.
Hearing Services See details
Hearing Services include routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids. Routine hearing exams and fitting/evaluation for hearing aids are covered for one visit per year, while prescription hearing aids (all types) are covered for two visits per year. However, prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are also not covered.
Vision Services See details
Vision services include coverage for routine eye exams once per year, and other eye exam services once per year, with no deductible. Eyewear is covered up to a combined maximum of $300 per year, contact lenses are covered, and eyeglasses (lenses and frames) are covered once per year. Eyeglass lenses and frames are not covered, and upgrades are covered.
Dental Services See details
Dental Services are covered, with a maximum plan benefit of $4,000 per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services are covered, with prior authorization required. Restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery are also covered. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, requiring prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%, and 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 Select Health Medicare Dual (HMO D-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetics and Medical Supplies have a 20% coinsurance, and Diabetic Supplies and Therapeutic Shoes/Inserts also have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with no copay required. Diagnostic Procedures/Tests and Lab Services have a coinsurance of at most 30%, while Diagnostic Radiological Services and Outpatient X-Ray Services have a coinsurance of at most 30%, and Therapeutic Radiological Services have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Select Health Medicare Dual (HMO D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Select Health Medicare Dual (HMO D-SNP) plan. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Select Health Medicare Dual (HMO D-SNP) plan, but require prior authorization. There is no copay for days 1-20 and days 66-100, but there is a $214 copay for days 21-65.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items and Meal Benefits, but Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and many other services are not covered. Over-the-Counter (OTC) Items are covered with no copay, and the plan offers Naloxone coverage. Meal Benefits require prior authorization.
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