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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 2026, 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 4.5 out of 5 stars in 2026.
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 $55.20. 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 Kansas Health Advantage (HMO I-SNP) Medicare Advantage plan features an annual prescription drug deductible of $615. This deductible is the amount you must pay out-of-pocket for covered medications before the plan's coverage begins to pay its share. Specific drug coverage tier details, including individual copayments and coinsurance amounts, are not available for this plan. Beneficiaries should consult the plan's formulary to verify how specific prescription medications are covered and to estimate their total out-of-pocket expenses.
Additional Benefits
The Kansas Health Advantage (HMO I-SNP) plan provides comprehensive coverage with no copay and no coinsurance for primary care, home health services, and skilled nursing facility stays for up to 100 days. For inpatient hospital stays, standard Medicare-defined deductibles and copayments apply, but members pay no coinsurance. Outpatient services, emergency care, and dialysis are covered with no copay and a 20% coinsurance. Additionally, members benefit from up to 36 one-way transportation trips per year to health-related locations with no copay and no coinsurance. Vision and hearing benefits include routine exams and annual allowances of $300 for eyewear and $500 for hearing aids with no copay. Dental coverage is limited to Medicare-approved care, which features a 20% coinsurance and no copay.
Inpatient Hospital See details
Kansas Health Advantage (HMO I-SNP) partially covers inpatient hospital services, excluding additional days, non-Medicare-covered stays, and hospital upgrades. Covered acute and psychiatric inpatient stays require prior authorization and feature no coinsurance, though Medicare-defined copayments and deductibles apply.
Outpatient Services See details
Kansas Health Advantage (HMO I-SNP) covers outpatient services, including outpatient hospital, observation, ambulatory surgical center, substance abuse, and blood services, with no copay and a 20% coinsurance. Prior authorization is required for outpatient hospital, observation, and surgical center services, and the deductible is waived for the first three pints of blood.
Partial Hospitalization See details
Partial hospitalization services are covered by Kansas Health Advantage (HMO I-SNP) with no copay and a 20% coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Kansas Health Advantage (HMO I-SNP) covers ambulance services with a 20% coinsurance and no copay for both ground and air transport, subject to prior authorization. Transportation services are partially covered, offering up to 36 one-way trips per year to any health-related location with no copay and no coinsurance, though transport to plan-approved health-related locations is not covered.
Emergency Services See details
Kansas Health Advantage (HMO I-SNP) covers emergency and urgently needed services with a 20% coinsurance and no copay, which count toward the plan-level deductible and are waived if admitted to the hospital within one day. Worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
Kansas Health Advantage (HMO I-SNP) primary care benefits feature no copay and no coinsurance for primary care physician services, telehealth, and opioid treatment. Specialist visits, mental health, podiatry, and physical therapy are covered with no copay and 0% to 20% coinsurance, though routine chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by Kansas Health Advantage (HMO I-SNP) with no copay and no coinsurance for covered options like kidney disease education and in-home support. However, several sub-services are not covered, including the annual physical exam, fitness benefits, health education, and home safety assessments.
Hearing Services See details
Hearing services are covered by Kansas Health Advantage (HMO I-SNP) with no deductible, offering Medicare-covered exams and hearing aid fittings with no copay or coinsurance, and annual routine exams with a 20% coinsurance and no copay. Prescription hearing aids are partially covered with no copay or coinsurance up to a $500 annual maximum for up to two aids, though OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services are covered by Kansas Health Advantage (HMO I-SNP) with no deductibles, including one routine eye exam per year with no copay and a 20% coinsurance, though other eye exams are not covered. Eyewear is covered with no copay up to a $300 annual limit, with contact lenses requiring a 20% coinsurance and no coinsurance for eyeglasses.
Dental Services See details
Kansas Health Advantage (HMO I-SNP) provides partial coverage for dental services, covering only Medicare-approved dental care with no copay and a 20% coinsurance. All other dental services, including preventive cleanings, exams, x-rays, and orthodontic treatments, are not covered.
Home Infusion bundled Services See details
Kansas Health Advantage (HMO I-SNP) covers Home Infusion bundled Services with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin features a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require no copay and a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Kansas Health Advantage (HMO I-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
Kansas Health Advantage (HMO I-SNP) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic equipment, supplies, and therapeutic shoes are covered with no copay and no coinsurance, with prior authorization required for all medical equipment benefits.
Diagnostic and Radiological Services See details
Kansas Health Advantage (HMO I-SNP) covers diagnostic and radiological services with prior authorization required. Diagnostic procedures require a copay and a 20% coinsurance, lab services have no copay but require coinsurance, and all radiological, therapeutic, and outpatient X-ray services feature no copay and a 20% coinsurance.
Home Health Services See details
Kansas Health Advantage (HMO I-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required before receiving these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Kansas Health Advantage (HMO I-SNP) with no copay and require prior authorization, though only some services are covered. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for peripheral artery disease (PAD) are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Kansas Health Advantage (HMO I-SNP) with no copay and no coinsurance for days 1 through 100, although prior authorization is required. While a three-day prior inpatient hospital stay is not required for admission, additional days beyond the standard Medicare-covered period are not covered.
Other Services See details
Other Services are not covered under the Kansas Health Advantage (HMO I-SNP) plan, meaning there is no coverage, copay, or coinsurance for acupuncture, over-the-counter (OTC) items, or meal benefits.
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