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Kansas Health Advantage Choice (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Kansas Health Advantage Choice (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 Choice (HMO I-SNP) in 2025, please refer to our full plan details page.
Kansas Health Advantage Choice (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 Choice (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 Choice (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 Choice (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 Choice (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 Choice (HMO I-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs for your drugs in each tier. Once your total drug costs reach $2000, you will enter the next coverage phase. If you qualify for the low-income subsidy (LIS), the plan's premium may be reduced. During the initial coverage phase, you will pay the costs for your drugs, and after your yearly out-of-pocket drug costs reach $2000, you pay nothing for your Medicare Part D covered drugs.
Additional Benefits
The Kansas Health Advantage Choice (HMO I-SNP) plan offers a variety of benefits with varying cost-sharing. Many services, such as primary care, home health, skilled nursing facility (days 1-100), and over-the-counter items have no copay. However, you will pay a 20% coinsurance for services like outpatient services, ambulance services, emergency services, and many specialist services. This plan also covers hearing, vision, and dental services, with specific cost-sharing details. Hearing exams have a coinsurance of up to 20%, and prescription hearing aids have a benefit of $500 per ear per year. Vision services include eye exams and eyewear, with 20% coinsurance and a combined annual maximum benefit for eyewear of $225.00. Dental services are partially covered with a 20% coinsurance for Medicare dental services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered under the Kansas Health Advantage Choice (HMO I-SNP) plan, but the specific cost-sharing details are not provided. Additional days, non-Medicare-covered stays, and upgrades for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services and observation services, both with a 20% coinsurance. Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services are covered with a coinsurance of at least 20%. Outpatient Blood Services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Kansas Health Advantage Choice (HMO I-SNP) plan. Ground and Air Ambulance Services have a 20% coinsurance, and there is no copay for these services. Transportation Services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Kansas Health Advantage Choice (HMO I-SNP) plan. Emergency Services and Urgently Needed Services have a 20% coinsurance, but no copay. Worldwide Emergency Services are not covered.
Primary Care See details
The Kansas Health Advantage Choice (HMO I-SNP) plan covers primary care physician services with no copay, and covers chiropractic services with 20% coinsurance. Occupational therapy services are covered with a coinsurance of 0% to 20%, and physician specialist services are covered with a coinsurance of 0% to 20%. Mental health specialty services and psychiatric services are covered with a coinsurance of 0% to 20% for individual and group sessions, and physical therapy and speech-language pathology services are covered with a coinsurance of 0% to 20%. Additional telehealth benefits and opioid treatment program services are covered with no copay. Podiatry services are covered with a coinsurance of 0% to 20% and Medicare-covered podiatry services have no copay, while routine foot care is covered, but routine chiropractic care is not. Other health care professional services are covered with a coinsurance of 0% to 20%.
Preventive Services See details
Preventive Services include Medicare-covered services with no copay, but annual physical exams, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, readmission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, fitness benefits, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services are not covered. Kidney Disease Education Services, Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKGs following a Welcome Visit have no copay. Additional Preventive Services require a doctor referral, and In-Home Support Services have no copay.
Hearing Services See details
Hearing services include hearing exams and prescription hearing aids. Hearing exams have a coinsurance of up to 20% for routine hearing exams and no copay, while prescription hearing aids have a maximum benefit of $500 per ear per year and no copay for all types of prescription hearing aids except inner ear, outer ear, and over the ear hearing aids.
Vision Services See details
The Kansas Health Advantage Choice (HMO I-SNP) plan covers vision services, including eye exams with 20% coinsurance and eyewear with 20% coinsurance, and offers no copay for routine eye exams, contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades. This plan provides a combined maximum plan benefit coverage of $225.00 per year for eyewear.
Dental Services See details
Dental Services are partially covered by the Kansas Health Advantage Choice (HMO I-SNP) plan, with Medicare Dental Services covered at 20% coinsurance. 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, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Kansas Health Advantage Choice (HMO I-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include coverage for Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, with authorization required. Prosthetic devices and medical supplies have a 20% coinsurance, while diabetic supplies and therapeutic shoes/inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a coinsurance of at most 20%, Lab Services with no copay, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services, each with a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Kansas Health Advantage Choice (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 covered, but the plan does not cover the specific services of Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Kansas Health Advantage Choice (HMO I-SNP) plan, with a $0 copay for days 1-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Kansas Health Advantage Choice (HMO I-SNP) plan covers Over-the-Counter (OTC) Items with no copay, with a maximum benefit coverage amount of $105 every month. Acupuncture, Meal Benefit, 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, and Self-Directed Personal Assistance Services are not covered.
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