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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 Clark and Nye Counties. 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 $21.30. 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 $590.00 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 a $590 deductible for prescription drugs. If you qualify for the low-income subsidy, you will pay $21.30 per month for Part D. During the initial coverage phase, you will pay the costs for your drugs in each tier. After your yearly out-of-pocket drug costs reach $2000, you will enter the catastrophic coverage phase and pay nothing for your drugs.
Additional Benefits
The Select Health Medicare Dual (HMO D-SNP) plan offers a range of benefits with varying cost-sharing. Hospital stays have a copay of $535 per admission for the first three days, and then no copay for acute care. Outpatient services, primary care, and some specialist visits have coinsurance, while ambulance services, home health, and preventive services have no copay. Dental, vision, and hearing services are included, with coverage for exams, eyewear, and hearing aids. The plan also covers services like home infusion, dialysis, and medical equipment with coinsurance. Other benefits include OTC items, meal benefits, and skilled nursing facility stays with no copay for some days.
Inpatient Hospital See details
Inpatient Hospital coverage includes acute and psychiatric care, with a copay of $535 per admission for days 1-3, and no copay for days 4-90 for acute care; psychiatric care has a $560 copay for days 1-3 and no copay for days 4-60. Additional days and non-Medicare-covered stays for both acute and psychiatric care, and upgrades for acute care, are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services and Observation Services with a 30% coinsurance, as well as Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services with a coinsurance between 35% and 35%. Outpatient Blood Services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the Select Health Medicare Dual (HMO D-SNP) plan, but requires prior authorization and a doctor referral. You will be responsible for a 35% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with no copay. Ground and air ambulance services have a 35% coinsurance, and transportation services to a plan-approved health-related location are covered.
Emergency Services See details
Emergency Services are covered by the Select Health Medicare Dual (HMO D-SNP) plan and have a $110 copay, and Urgent Services have a 35% coinsurance. Worldwide Emergency Coverage has a $110 copay, Worldwide Urgent Coverage has a 35% coinsurance, and Worldwide Emergency Transportation has a 35% coinsurance.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physical Therapy and Speech-Language Pathology Services, and Opioid Treatment Program Services are covered with 35% coinsurance. Chiropractic Services are covered with a $15 copay, but routine care is not covered. Physician Specialist Services and Mental Health Specialty Services are covered with 35% coinsurance, and the plan covers additional telehealth benefits with 0-35% coinsurance. Podiatry Services are covered with 35% coinsurance for routine foot care, with 6 visits per year. Other Health Care Professional services are covered with 0-35% coinsurance.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, annual physical exams, health education, Medical Nutrition Therapy, weight management programs, nutritional/dietary benefits, In-Home Support Services, Fitness Benefits, Remote Access Technologies, Home and Bathroom Safety Devices and Modifications, Kidney Disease Education Services, Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit. In-Home Safety Assessment, Personal Emergency Response System (PERS), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Home-Based Palliative Care, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, and Counseling Services are not covered.
Hearing Services See details
Hearing services include coverage for 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 every year, and prescription hearing aids (all types) are covered for two visits every year. Prescription hearing aids - inner ear, outer ear, and over the ear are not covered, nor are OTC hearing aids.
Vision Services See details
Vision services include coverage for routine eye exams, other eye exam services, contact lenses, eyeglasses (lenses and frames), and upgrades. Routine eye exams and other eye exam services are covered once per year. Eyeglasses (lenses and frames) are covered once per year, while contact lenses are unlimited, and the combined maximum amount for eyewear is $300 every year.
Dental Services See details
The Select Health Medicare Dual (HMO D-SNP) plan covers dental services including Medicare Dental Services with 35% coinsurance, and other dental services up to a $2,500 annual maximum. The plan also covers oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay, with coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Select Health Medicare Dual (HMO D-SNP) plan, with a doctor referral required. You are responsible for 20% coinsurance.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, and Prosthetic Devices and Medical Supplies have a 20% coinsurance. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts also have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with a doctor referral and prior authorization required. Diagnostic Procedures/Tests and Outpatient X-Ray Services have a coinsurance of at most 35%, while Therapeutic Radiological Services have a coinsurance of at most 20%. Lab Services are not covered.
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 require prior authorization and a referral. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but none of the sub-services are covered. Prior authorization and a doctor referral are required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Select Health Medicare Dual (HMO D-SNP) plan. You will have 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 includes coverage for Over-the-Counter (OTC) Items and Meal Benefits, while acupuncture, Dual Eligible SNPs with Highly Integrated Services, and many other services are not covered. The plan covers OTC items, and also offers a Meal Benefit for chronic illnesses with prior authorization and a doctor's referral.
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