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Senior Care Plus Complete Plan (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Senior Care Plus Complete Plan (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Senior Care Plus Complete Plan (HMO) in 2025, please refer to our full plan details page.
Senior Care Plus Complete Plan (HMO) is a HMO plan offered by Renown Health available for enrollment in 2025 to people living in Clark and Nye Counties. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Senior Care Plus Complete Plan (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Senior Care Plus Complete Plan (HMO).
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 Senior Care Plus Complete Plan (HMO), 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $850.00 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:
Sign up for Senior Care Plus Complete Plan (HMO)
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Drug Coverage
The Senior Care Plus Complete Plan (HMO) has an enhanced alternative drug benefit with a $0 deductible. In the initial coverage phase, you'll pay varying copays or coinsurance depending on the drug tier and pharmacy. For example, standard generic drugs have a $47 copay, and preferred brand drugs have 50% coinsurance. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for covered Part D drugs. If you qualify for the low-income subsidy, you will pay $0.00 for Part D drugs.
Additional Benefits
The Senior Care Plus Complete Plan (HMO) provides coverage for a wide array of services with varying costs. You'll find no copays for primary care, vision and hearing exams, and many outpatient services, but expect copays for services like emergency care, specialist visits, and outpatient substance abuse. This plan also includes benefits for dental, home health, and medical equipment with copays or coinsurance. Additionally, there is coverage for ambulance and transportation services, along with an allowance for over-the-counter items, and prescription hearing aids, but note that some services like cardiac rehabilitation and certain types of hearing aids are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with prior authorization and a doctor referral. Additional Days for Inpatient Hospital-Acute are covered, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered, and Additional Days for Inpatient Hospital Psychiatric and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are also not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Individual and group sessions for outpatient substance abuse have a copay of $20.00.
Partial Hospitalization See details
Partial Hospitalization is covered under the Senior Care Plus Complete Plan (HMO) with a $75 copay, and a doctor referral is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Senior Care Plus Complete Plan (HMO). Ground ambulance services have a $175 copay, while air ambulance services have a $225 copay. Transportation Services to a plan-approved health-related location are covered for up to 24 one-way trips per year, with a maximum plan benefit of $1250, and transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered under the Senior Care Plus Complete Plan (HMO). Emergency Services have a $140 copay, Urgently Needed Services have a copay between $10 and $40, and Worldwide Emergency Coverage has a $140 copay. Worldwide Urgent Coverage has a $120 copay, and Worldwide Emergency Transportation is not covered. There is no coinsurance for these services.
Primary Care See details
The Senior Care Plus Complete Plan (HMO) covers primary care physician services, chiropractic services (excluding routine chiropractic care), occupational therapy services with no copay or coinsurance, physician specialist services, mental health specialty services with a $20 copay for individual and group sessions, and psychiatric services with a $20 copay for individual and group sessions. Additionally, the plan covers other health care professional services with a $10 copay, physical therapy and speech-language pathology services with no copay or coinsurance, additional telehealth benefits, and opioid treatment program services with a $10 copay.
Preventive Services See details
Preventive Services are covered, but annual physical exams, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Home-Based Palliative Care, In-Home Support Services, and Support for Caregivers of Enrollees are not covered. Additional services like Health Education, In-Home Safety Assessment, Post discharge In-Home Medication Reconciliation, Nutritional/Dietary Benefit, Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies, Home and Bathroom Safety Devices and Modifications, Counseling Services, Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are covered.
Hearing Services See details
Hearing Services include coverage for hearing exams, with no copay, and prescription hearing aids, with a maximum plan benefit of $3,000 per year. Routine hearing exams and fitting/evaluation for hearing aids are covered with no copay, limited to one visit per year. Prescription hearing aids (all types) are covered for two visits per year. Prescription hearing aids (inner ear, outer ear, and over the ear) are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision Services include eye exams and eyewear. Routine eye exams have no copay, and eyewear, including contact lenses, have no copay, with a combined maximum benefit of $170 per year.
Dental Services See details
The Senior Care Plus Complete Plan (HMO) covers a variety of dental services, including oral exams, dental x-rays, prophylaxis (cleaning), restorative services, endodontics, periodontics, prosthodontics (removable), and oral and maxillofacial surgery. Fluoride treatment, maxillofacial prosthetics, implant services, prosthodontics (fixed), and orthodontics are not covered. Restorative services, endodontics, periodontics, and oral and maxillofacial surgery have no coinsurance, and prosthodontics (removable) has no coinsurance.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B insulin drugs with a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are also covered with coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Senior Care Plus Complete Plan (HMO), with a coinsurance of 20%.
Medical Equipment See details
Medical Equipment benefits are covered under the Senior Care Plus Complete Plan (HMO). Durable Medical 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 have a coinsurance between 0% and 20%, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including all diagnostic services, are covered by the Senior Care Plus Complete Plan (HMO). Diagnostic Procedures/Tests have a copay between $0 and $80, while Lab Services have no copay. Radiological services, including Diagnostic and Therapeutic Radiological Services, are covered with a copay up to $100 for the former and 20% coinsurance for the latter. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Senior Care Plus Complete Plan (HMO) with no copay or coinsurance, but a referral is required and additional hours of care, as well as personal care services, are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Senior Care Plus Complete Plan (HMO).
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization. For days 1-20, there is no copay; for days 21-40, the copay is $200; and for days 41-100, there is no copay.
Other Services See details
The Senior Care Plus Complete Plan (HMO) covers Over-the-Counter (OTC) items with a maximum benefit of $105.00 every three months, while 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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