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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 Clark and Nye Counties. 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 $9.50. 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 $9250.00 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) prescription drug plan has an annual drug deductible of $615. This means you will pay the full cost of your medications up to this amount before the plan's coverage begins to pay. Specific drug coverage tier details, such as copayments and coinsurance rates for individual medication tiers, are not available for this plan. You can consult the plan's formulary to verify if your specific prescription drugs are covered and to determine your potential out-of-pocket expenses.
Additional Benefits
The Select Health Medicare Dual (HMO D-SNP) plan offers comprehensive medical coverage with no copay for primary care visits, home health care, and routine preventive services. For specialized medical care, beneficiaries generally pay coinsurance rather than copays, such as a 30% coinsurance for specialist visits and outpatient hospital services, and a 20% coinsurance for durable medical equipment and dialysis. Inpatient hospital stays require a $410 copay per day for the first three days, followed by no copay for days four through 90. This plan also includes valuable supplemental benefits, featuring no copays or coinsurance for annual routine eye and hearing exams, a $150 yearly eyewear allowance, and up to $2,000 annually for covered preventive and comprehensive dental care. Additionally, members can access up to 60 one-way transportation trips per year to plan-approved locations with no copay or coinsurance. Emergency medical care is covered with a $115 copay, which is waived if the patient is admitted to the hospital within 24 hours.
Inpatient Hospital See details
Select Health Medicare Dual (HMO D-SNP) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $410 copay per day for days 1 through 3 and no copay for days 4 through 90. Unlimited additional days are covered for acute care, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Select Health Medicare Dual (HMO D-SNP) with no copays, though coinsurance applies to several services. Beneficiaries pay a 30% coinsurance for outpatient hospital, observation, and substance abuse services, a 20% coinsurance for ambulatory surgical center services, and no coinsurance or deductible for outpatient blood services.
Partial Hospitalization See details
Select Health Medicare Dual (HMO D-SNP) covers partial hospitalization services with no copay and a 30% coinsurance. Prior authorization is required for these services, and a referral may also be required.
Ambulance and Transportation Services See details
Select Health Medicare Dual (HMO D-SNP) covers ground and air ambulance services with a 30% coinsurance and no copay. Transportation services are partially covered, offering up to 60 one-way trips per year to plan-approved locations with no copay and no coinsurance, though transportation to any health-related location 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, worldwide urgent care, and worldwide emergency transportation are covered with a 30% coinsurance (capped at $40 per domestic urgent visit) and no copay, while worldwide emergency services require a $115 copay and no coinsurance.
Primary Care See details
Select Health Medicare Dual (HMO D-SNP) offers primary care doctor visits with no copay and no coinsurance, while specialist, therapy, and mental health services are covered with no copay and 30% coinsurance. Chiropractic services are not covered, but podiatry is covered with no copay and 30% coinsurance for up to six routine visits yearly.
Preventive Services See details
Select Health Medicare Dual (HMO D-SNP) covers preventive services, offering annual physical exams and fitness benefits with no copay and no coinsurance. While some additional benefits like medical nutrition therapy are covered, other services such as health education, weight management, and personal emergency response systems are not covered, and kidney disease education and diabetes self-management training require a 20% and 30% coinsurance, respectively.
Hearing Services See details
Hearing services are partially covered by Select Health Medicare Dual (HMO D-SNP) with no copay, no coinsurance, and no deductible. Covered benefits include one routine hearing exam and fitting annually, plus up to two prescription hearing aids every two years, though OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Select Health Medicare Dual (HMO D-SNP) with no copay, no coinsurance, and no deductible, offering one routine eye exam and one refraction exam annually alongside a $150 yearly eyewear allowance. While contact lenses and complete eyeglasses are covered, individual eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Select Health Medicare Dual (HMO D-SNP) dental services are partially covered, offering no copay and a 30% coinsurance for Medicare-covered dental, and no copay and no coinsurance for other covered preventive and comprehensive services up to a $2,000 annual limit. While most diagnostic, preventive, and restorative services are covered, 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 and no coinsurance, though prior authorization and step therapy are required. Associated Medicare Part B drugs, including chemotherapy and radiation, feature no copay and range from no coinsurance to 20% coinsurance, while Part B insulin drugs require a $35 copay and range from no coinsurance to 20% coinsurance.
Dialysis Services See details
Select Health Medicare Dual (HMO D-SNP) covers Dialysis Services with no copay and a 20% coinsurance, though a referral is required.
Medical Equipment See details
Select Health Medicare Dual (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with no copay and a 20% coinsurance. Prior authorization is required for these covered services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Select Health Medicare Dual (HMO D-SNP) partially covers diagnostic and radiological services with prior authorization and referral requirements, though lab services are not covered. Covered services feature no copay, with no coinsurance for diagnostic procedures and tests, 20% coinsurance for therapeutic radiology, and 30% coinsurance for diagnostic radiology and outpatient X-rays.
Home Health Services See details
Home Health Services are covered by Select Health Medicare Dual (HMO D-SNP) with no copay and no coinsurance, though prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered under Select Health Medicare Dual (HMO D-SNP) with no copay, but only some services are covered. Standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 30% coinsurance, while prior authorization and referrals are required for coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Select Health Medicare Dual (HMO D-SNP) with no coinsurance and no copay for days 1 to 20 and days 66 to 100, though days 21 to 65 require a $218 daily copay. Prior authorization and referrals are required, but a prior three-day hospital stay is not, and coverage does not extend to additional days beyond the standard Medicare limit.
Other Services See details
Select Health Medicare Dual (HMO D-SNP) partially covers other services, offering a chronic illness meal benefit with no copay and no coinsurance, although a referral and prior authorization are required. Acupuncture, over-the-counter (OTC) items, and highly integrated dual-eligible SNP services are not covered under this benefit.
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