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Senior Care (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Senior Care (HMO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Senior Care (HMO I-SNP) in 2025, please refer to our full plan details page.
Senior Care (HMO I-SNP) is a HMO I-SNP plan offered by Curana Health Holdings, LLC available for enrollment in 2025 to people living in Virginia (partial). This plan received an overall rating of 2.5 out of 5 stars in 2025.
It's important to know that Senior Care (HMO I-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Senior Care (HMO I-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 Senior Care (HMO I-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 Senior Care (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $30.70. 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 Senior Care (HMO I-SNP) plan has a $590 deductible for prescription drugs. Once you meet your deductible, you will pay the costs for your prescriptions, but the exact costs for each drug tier are not specified in the provided information. After your total drug costs reach $2,000, you enter the catastrophic coverage phase and pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy (LIS), your monthly premium for Part D will be $30.70.
Additional Benefits
The Senior Care (HMO I-SNP) plan offers a range of benefits with varying cost structures. Many services, such as preventive services, ambulance services, and home health services, are available with no copay. Other services, including outpatient services, primary care, and vision services, often have a 20% coinsurance. The plan also includes coverage for hearing aids up to $2750 every two years, along with dental services with a $2,400 annual maximum. Emergency services have a $90 copay, while other services have a mix of copays and coinsurance. Some services require prior authorization.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered under the Senior Care (HMO I-SNP) plan, but additional days, non-Medicare covered stays, and upgrades for both are not covered. The plan requires prior authorization and follows the cost sharing of Original Medicare, with coinsurance and deductible amounts detailed separately.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with 20% coinsurance, Observation Services with a $100 copay, Ambulatory Surgical Center (ASC) Services with a 20% coinsurance, and Outpatient Substance Abuse Services with 20% coinsurance for both individual and group sessions. Outpatient Blood Services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the Senior Care (HMO I-SNP) plan, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
The Senior Care (HMO I-SNP) plan covers all ambulance services with no copay and a 20% coinsurance for both ground and air ambulance services. The plan also covers transportation services to any health-related location, with a limit of 36 one-way trips per year, and covers rideshare services, bus/subway, medical transport, and other transportation methods. Transportation to plan-approved health-related locations is not covered.
Emergency Services See details
Emergency Services are covered under the Senior Care (HMO I-SNP) plan, with a $90 copay and no coinsurance, but Worldwide Emergency Services are not covered. Urgently Needed Services are covered with 20% coinsurance and no copay.
Primary Care See details
The Senior Care (HMO I-SNP) plan covers primary care physician services, chiropractic services, occupational therapy, specialist services, mental health services, podiatry services, other health care professional services, psychiatric services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Chiropractic services have a 20% coinsurance, and routine chiropractic care is not covered. Occupational therapy, specialist services, physical therapy, and speech-language pathology services have a 20% coinsurance. Individual and group sessions for mental health and psychiatric services have a 20% coinsurance. Podiatry services and other health care professional services have a 20% coinsurance. Additional telehealth benefits have 0% to 20% coinsurance.
Preventive Services See details
The Senior Care (HMO I-SNP) plan covers Medicare-covered preventive services with no copay, but does not cover annual physical exams. Other preventive services, such as glaucoma screenings and diabetes self-management training, are covered.
Hearing Services See details
Hearing exams are covered with a coinsurance of at most 20%, and routine hearing exams are limited to one visit per year. Prescription hearing aids are covered up to $2750 every two years, but inner ear, outer ear, and over the ear prescription hearing aids are not covered. Fitting/evaluation for hearing aids and OTC hearing aids are also covered.
Vision Services See details
Vision Services includes coverage for eye exams and eyewear. Eye exams have a 20% coinsurance, and routine eye exams are limited to one per year. Eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, also has a 20% coinsurance, with a combined maximum benefit of $200 per year.
Dental Services See details
The Senior Care (HMO I-SNP) plan covers Medicare Dental Services with a 20% coinsurance, while other dental services have a $2,400 maximum benefit per year. Oral exams, dental x-rays, and cleanings are covered, and other services are covered but limited in number. Maxillofacial Prosthetics 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%; other drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Senior Care (HMO I-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while 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 under the Senior Care (HMO I-SNP) plan. Diagnostic Procedures/Tests, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have a coinsurance of at most 20%, while Lab Services are not covered.
Home Health Services See details
Home Health Services are covered by the Senior Care (HMO I-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Senior Care (HMO I-SNP) plan, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Senior Care (HMO I-SNP) plan. However, additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Senior Care (HMO I-SNP) plan does not cover acupuncture, meal benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, or Self-Directed Personal Assistance Services. Over-the-counter (OTC) items are covered, and the plan offers Nicotine Replacement Therapy (NRT) as a Part C OTC benefit, but does not cover all drugs on the CMS OTC list.
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