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Kansas Health Advantage (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Kansas Health Advantage (HMO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Kansas Health Advantage (HMO I-SNP) in 2025, please refer to our full plan details page.
Kansas Health Advantage (HMO I-SNP) is a HMO I-SNP plan offered by Kansas Superior Select available for enrollment in 2025 to people living in Central and East Kansas. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Kansas Health Advantage (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:
Kansas Health Advantage (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 Kansas Health Advantage (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 Kansas Health Advantage (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $51.70. 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 Kansas Health Advantage (HMO I-SNP) plan has a defined standard for drug coverage. The plan has a deductible of $590.00. If you qualify for the low-income subsidy, you will pay $51.70 for Part D. After the deductible is met, you will enter the initial coverage phase where you will pay the costs for drugs in each tier until your total drug costs reach $2000.00. After your yearly out-of-pocket drug costs reach $2000.00, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Kansas Health Advantage (HMO I-SNP) plan offers a range of benefits, including coverage for inpatient and outpatient hospital services with coinsurance. The plan also covers ambulance and transportation services, emergency services, primary care, preventive services, hearing, vision, and dental services. Many services have no copay, such as primary care, and home health services, while others have a coinsurance, such as outpatient services and vision exams. This plan provides coverage for several medical services, with varying cost-sharing arrangements. The plan includes coverage for home infusion, dialysis, medical equipment, diagnostic and radiological services, and skilled nursing facilities. However, some services, like cardiac rehabilitation, and other services such as acupuncture and over-the-counter items are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered under the Kansas Health Advantage (HMO I-SNP) plan. The plan requires prior authorization for these services, and the cost sharing is the same as Original Medicare.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, and outpatient substance abuse services, with a 20% coinsurance for outpatient hospital and observation services, and a minimum of 20% coinsurance for individual and group sessions for outpatient substance abuse. Outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Kansas Health Advantage (HMO I-SNP) plan. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Kansas Health Advantage (HMO I-SNP), including ground and air ambulance services with a 20% coinsurance. Transportation Services to any health-related location are covered with no copay, with a limit of 34 one-way trips per year.
Emergency Services See details
Emergency Services, including Urgently Needed Services, are covered by the Kansas Health Advantage (HMO I-SNP) plan with a 20% coinsurance, and no copay. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
The Kansas Health Advantage (HMO I-SNP) plan covers primary care physician services with no copay and chiropractic services with 20% coinsurance. It also covers occupational therapy, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy, speech-language pathology services, additional telehealth benefits with no copay, and opioid treatment program services with no copay. However, routine chiropractic care is not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, with annual physical exams not covered. Additional preventive services, including those not usually covered by Medicare, are covered with a doctor referral. Glaucoma screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit have no copay.
Hearing Services See details
Hearing services include hearing exams and prescription hearing aids. Routine hearing exams have no copay and a 20% coinsurance, while fitting/evaluation for hearing aids have no copay and no coinsurance. Prescription hearing aids have a maximum benefit of $500 per year, and the plan covers all types of prescription hearing aids with no copay.
Vision Services See details
The Kansas Health Advantage (HMO I-SNP) plan covers vision services, including eye exams and eyewear. Eye exams have a 20% coinsurance, and routine eye exams have no copay. Eyewear has a 20% coinsurance, while contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades have no copay, with a combined maximum benefit of $300 per year.
Dental Services See details
Dental Services are partially covered under the Kansas Health Advantage (HMO I-SNP) plan. Medicare Dental Services are covered with a 20% coinsurance, while Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics, removable, Maxillofacial Prosthetics, Implant Services, Prosthodontics, fixed, Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered by the Kansas Health Advantage (HMO I-SNP) plan. You will pay a 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 Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices have a 20% coinsurance, and Medical Supplies have a 20% coinsurance. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Kansas Health Advantage (HMO I-SNP). Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, and Lab Services have no copay. Therapeutic Radiological Services and Outpatient X-Ray Services also have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Kansas Health Advantage (HMO I-SNP) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Kansas Health Advantage (HMO I-SNP) plan. This includes Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Kansas Health Advantage (HMO I-SNP), with no copay for days 1-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services are not covered by the Kansas Health Advantage (HMO I-SNP) plan, including acupuncture, over-the-counter items, meal benefits, and more. Other services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and Case Management are also not covered.
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