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Premier Care (HMO-POS I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Premier Care (HMO-POS I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Premier Care (HMO-POS I-SNP) in 2026, please refer to our full plan details page.
Premier Care (HMO-POS I-SNP) is a HMO-POS 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 2026.
It's important to know that Premier Care (HMO-POS I-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Premier Care (HMO-POS 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 Premier Care (HMO-POS 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 Premier Care (HMO-POS I-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 $75.00 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 combined Maximum Out-Of-Pocket cost of $3000.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $3000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 Premier Care (HMO-POS I-SNP) plan features an annual drug deductible of $75 and offers affordable prescription drug coverage. You will pay no copay for Tier 1 preferred generic drugs filled at standard pharmacies or through standard mail order for up to a three-month supply. For Tier 2 generic drugs, copays start at $10 for a one-month supply and increase to $30 for a three-month supply. For brand-name and specialty medications, the cost sharing varies depending on the drug tier. Tier 3 preferred brand drugs cost $45 for a one-month supply, while Tier 4 non-preferred drugs require a $95 copay for a one-month supply. Tier 5 specialty drugs require a 25% coinsurance for a one-month supply at standard pharmacies or through standard mail order.
Additional Benefits
Premier Care (HMO-POS I-SNP) offers comprehensive healthcare coverage featuring no copay and no coinsurance for primary care, specialist visits, and home health services. For hospital stays, members pay a $100 daily copay for the first five days of acute inpatient care, with no copays for days six through ninety. Emergency room visits require a $75 copay, while urgently needed services have a $25 copay, both of which are waived if you are admitted to the hospital within three days. The plan also features robust supplemental benefits, including no copays or coinsurance for preventive and comprehensive dental services up to a $3,500 annual limit. Vision and hearing benefits offer excellent cost savings, with no copays for routine eye exams, up to $250 annually for eyewear, and up to $1,200 for prescription hearing aids. Additionally, members benefit from no copays or coinsurance on over-the-counter items and up to 24 free one-way trips per year to health-related locations.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Premier Care (HMO-POS I-SNP) with no coinsurance, though prior authorization is required. Acute stays require a $100 daily copay for days 1 to 5 and no copay for days 6 to 90, but hospital upgrades are not covered. Psychiatric stays require daily copays for initial days and no copay for days 9 to 90, while additional days and non-Medicare stays are not covered.
Outpatient Services See details
Premier Care (HMO-POS I-SNP) outpatient services are covered, featuring no coinsurance and copays ranging from $0 to $225 for outpatient hospital services, and a $100 copay per stay for observation services. Ambulatory surgical center and outpatient blood services both require a 20% coinsurance with no copay, while outpatient substance abuse services require a $30 copay per session with no coinsurance.
Partial Hospitalization See details
Premier Care (HMO-POS I-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under Premier Care (HMO-POS I-SNP), with ground and air ambulance services requiring a 20% coinsurance and no copay. Transportation services are partially covered with no copay or coinsurance for up to 24 one-way trips per year to any health-related location, though transportation to plan-approved health-related locations is not covered.
Emergency Services See details
Emergency services are covered by Premier Care (HMO-POS I-SNP) with a $75.00 copay and no coinsurance, while urgently needed services require a $25.00 copay and no coinsurance, with both copays waived if you are admitted to the hospital within 3 days. Worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
Primary care benefits offered by Premier Care (HMO-POS I-SNP) feature no copay and no coinsurance for primary care, specialist visits, therapies, telehealth, and opioid treatment. Routine chiropractic care is partially covered with a $30 copay and 20% coinsurance for up to 12 visits, while other chiropractic services and mental health specialty sessions (individual and group) are not covered. Routine podiatry, psychiatric sessions, and other health professional services are covered with no copay and a 20% coinsurance.
Preventive Services See details
Premier Care (HMO-POS I-SNP) partially covers preventive services with no copay and no coinsurance for covered options like kidney disease education, in-home support, and diabetes self-management. However, several sub-services are not covered, including the annual physical exam, fitness benefits, health education, personal emergency response systems, and medical nutrition therapy.
Hearing Services See details
Premier Care (HMO-POS I-SNP) covers hearing services, including routine hearing exams with no copay and 20% coinsurance, and fitting evaluations with no copay and no coinsurance. OTC hearing aids are covered with no copay or coinsurance, while prescription hearing aids are partially covered with no copay or coinsurance up to $1,200 annually, excluding inner ear, outer ear, and over-the-ear types.
Vision Services See details
Vision services are covered by Premier Care (HMO-POS I-SNP) with no copays, featuring a 20% coinsurance for contact lenses and routine eye exams (limited to one yearly). While other eye exam services are not covered, the plan has no deductible and offers up to $250 annually in combined coverage for eyewear, including eyeglasses, frames, and contact lenses.
Dental Services See details
Premier Care (HMO-POS I-SNP) partially covers dental services, offering Medicare-covered dental with no copay and a 20% coinsurance, and other covered preventive and comprehensive services with no copay and no coinsurance up to a $3,500 annual maximum. However, other preventive dental services, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Premier Care (HMO-POS I-SNP) with no copay and no coinsurance, subject to prior authorization. Covered Medicare Part B chemotherapy and other drugs require no copay and range from no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and ranges from no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Premier Care (HMO-POS I-SNP) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Premier Care (HMO-POS I-SNP) covers durable medical equipment and prosthetics with no copay and a 20% coinsurance, subject to prior authorization. Diabetic equipment is partially covered, offering therapeutic shoes and inserts with no copay and 20% coinsurance, while diabetic supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by Premier Care (HMO-POS I-SNP) with no copay and a 20% coinsurance, though prior authorization is required. Covered services include diagnostic procedures along with diagnostic and therapeutic radiological services, while outpatient lab services and outpatient x-ray services are not covered.
Home Health Services See details
Home Health Services are covered by Premier Care (HMO-POS I-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under Premier Care (HMO-POS I-SNP) with no copay, but some services are covered while cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered and require a 20% coinsurance. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by Premier Care (HMO-POS I-SNP) with no copay and no coinsurance, though prior authorization is required and additional days beyond Medicare-covered limits are not covered. Admission is allowed without a prior three-day inpatient hospital stay, and there is no cost-sharing on the day of discharge.
Other Services See details
Premier Care (HMO-POS I-SNP) partially covers other services, offering over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, and other services in this category are not covered.
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