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Signature Advantage Community (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Signature Advantage Community (HMO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Signature Advantage Community (HMO I-SNP) in 2025, please refer to our full plan details page.
Signature Advantage Community (HMO I-SNP) is a HMO I-SNP plan offered by SA Plan, LLC available for enrollment in 2025 to people living in KY (partial). This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Signature Advantage Community (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:
Signature Advantage Community (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 Signature Advantage Community (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 Signature Advantage Community (HMO 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. Additionally, this plan comes with a Part B Premium reduction of $31.50. You must continue to pay paying your reduced 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 Signature Advantage Community (HMO I-SNP) plan has a $590 deductible for prescription drugs. After you meet the deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000, at which point you will enter the next coverage phase. Once your yearly out-of-pocket drug costs reach $2000, you will pay nothing for your Medicare Part D covered drugs. If you qualify for the low-income subsidy, your premium may be reduced.
Additional Benefits
The Signature Advantage Community (HMO I-SNP) plan offers a range of benefits with varying cost-sharing arrangements. Hospital stays have a copay, with $400 for acute care and $374 for psychiatric care for the first five days, followed by no copay. Outpatient services, including partial hospitalization, have a 20% coinsurance, while ambulance services also have a 20% coinsurance and no copay for ambulance services. The plan provides coverage for primary care visits with a copay, specialist visits with a copay, and offers hearing, vision, and dental services with coinsurance. Preventive services are covered with no copay, and there are allowances for hearing aids and eyewear. Durable medical equipment and home health services are covered, and skilled nursing facilities have a copay after the first 30 days.
Inpatient Hospital See details
Inpatient Hospital coverage includes both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both of which require prior authorization. For Inpatient Hospital-Acute, you will pay a copay of $400 for days 1-5, and no copay for days 6-90. For Inpatient Hospital Psychiatric, you will pay a copay of $374 for days 1-5, and no copay for days 6-90.
Outpatient Services See details
Outpatient Services include all outpatient hospital services with a 20% coinsurance, observation services with a 20% coinsurance, ambulatory surgical center (ASC) services with a $200 copay, outpatient substance abuse services with a 20% coinsurance for individual and group sessions, and outpatient blood services with a 20% coinsurance. This plan waives the three (3) pint deductible for outpatient blood services.
Partial Hospitalization See details
Partial Hospitalization is covered by the Signature Advantage Community (HMO I-SNP) plan, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with no copay for ambulance services. Ground and Air Ambulance Services have a 20% coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Signature Advantage Community (HMO I-SNP) plan. Emergency Services have a 20% coinsurance, while Urgently Needed Services have a $45 copay. Worldwide Emergency Services are not covered.
Primary Care See details
The Signature Advantage Community (HMO I-SNP) plan covers primary care physician services with a copay between $0 and $15. Chiropractic services have a 20% coinsurance, while occupational therapy services have a 20% coinsurance and no copay. Physician specialist services have a copay between $0 and $40, and mental health specialty services have a copay between $0 and $40. Podiatry services have a 20% coinsurance for routine foot care, and other health care professional services have a copay between $0 and $40. Individual and group sessions for psychiatric services both have a 20% coinsurance, and physical and speech therapy services have a 20% coinsurance and no copay. Additional telehealth benefits have a coinsurance between 0% and 20%, and opioid treatment program services have a 20% coinsurance.
Preventive Services See details
The Signature Advantage Community (HMO I-SNP) plan covers Medicare-covered preventive services with no copay, but does not cover annual physical exams. Additional preventive services are partially covered, but services like health education and in-home safety assessments are not covered.
Hearing Services See details
Hearing Services include routine hearing exams with a coinsurance of 20%, and fitting/evaluation for hearing aids with no coinsurance. Prescription hearing aids are covered up to $4000 every two years, but inner ear, outer ear, and over the ear hearing aids are not covered. Over-the-counter hearing aids are not covered.
Vision Services See details
Vision Services includes coverage for eye exams and eyewear. Eye exams have a 20% coinsurance, and you can get one routine eye exam and one other eye exam (including glaucoma testing) per year. Eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, has a 20% coinsurance, and a combined maximum benefit of $325 per year.
Dental Services See details
The Signature Advantage Community (HMO I-SNP) plan offers Dental Services, with Medicare Dental Services covered at a 20% coinsurance, and other dental services including oral exams, dental x-rays, prophylaxis (cleaning), restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics, all covered at a 20% coinsurance. Fluoride treatment is not covered, and orthodontic services have a maximum benefit of $2400 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, coinsurance ranges from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the Signature Advantage Community (HMO I-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
The Signature Advantage Community (HMO I-SNP) plan covers Durable Medical Equipment, Prosthetic Devices, Medical Supplies, and Diabetic Therapeutic Shoes/Inserts with a 20% coinsurance. Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with no copay. Diagnostic Procedures/Tests and Lab Services have a coinsurance of at most 20%, with a minimum coinsurance of 0%. Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have a coinsurance of at most 20%, with a minimum coinsurance of 20%.
Home Health Services See details
Home Health Services are covered by the Signature Advantage Community (HMO I-SNP) plan with no copay and no coinsurance, but require authorization. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Signature Advantage Community (HMO I-SNP) plan. Prior authorization is required for this benefit, but the plan does not cover the services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. There is no copay for days 1-30, and a $160 copay for days 31-100.
Other Services See details
Other services include Over-the-Counter (OTC) Items, with a maximum benefit coverage of $300 every three months, though 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, and Self-Directed Personal Assistance Services are not covered.
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