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Senior Care Plus Extensive Duals Plan (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Senior Care Plus Extensive Duals Plan (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Senior Care Plus Extensive Duals Plan (HMO D-SNP) in 2025, please refer to our full plan details page.
Senior Care Plus Extensive Duals Plan (HMO D-SNP) is a HMO D-SNP plan offered by Renown Health available for enrollment in 2025 to people living in Washoe, Carson City Counties, NV. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Senior Care Plus Extensive Duals Plan (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Senior Care Plus Extensive Duals Plan (HMO D-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 Senior Care Plus Extensive Duals Plan (HMO D-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 Senior Care Plus Extensive Duals Plan (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $21.30. 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 $8300.00 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 Senior Care Plus Extensive Duals Plan (HMO D-SNP) has a $590 deductible for prescription drugs. After the deductible is met, you will pay the costs for drugs in each tier until your total drug costs reach $2000. This plan's premium may be reduced if you qualify for the low-income subsidy (LIS). If you have LIS, the monthly premium for Part D is $21.30. Once your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Senior Care Plus Extensive Duals Plan (HMO D-SNP) offers a range of benefits, including coverage for inpatient and outpatient services, with coinsurance typically around 20%. The plan also covers emergency and ambulance services, also with a 20% coinsurance, and offers transportation to plan-approved health-related locations. Additional benefits include coverage for vision, hearing, and dental services, with varying cost-sharing. Hearing exams and hearing aid fittings have no copay, while prescription hearing aids have a copay between $495 and $1970. The plan also includes coverage for home health services with no copay, and medical equipment with a 20% coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, but Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered. Contact the plan for more information on coinsurance.
Outpatient Services See details
Outpatient Services are covered, including all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital and observation services have a 20% coinsurance, and outpatient blood services have a 20% coinsurance; outpatient substance abuse services have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered with a doctor's referral and a 20% coinsurance.
Ambulance and Transportation Services See details
Ambulance and Transportation Services, including services not usually covered by Medicare, are covered. Ambulance services require prior authorization and have no copay, but do have a 20% coinsurance for both ground and air ambulance services. Transportation Services to a plan-approved health-related location are covered for up to 36 one-way trips per year, while 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 Extensive Duals Plan (HMO D-SNP), with a 20% coinsurance for each service. Worldwide Urgent Coverage and Worldwide Emergency Transportation are not covered.
Primary Care See details
The Senior Care Plus Extensive Duals Plan (HMO D-SNP) covers primary care physician services, chiropractic services, occupational therapy, physician specialist services, mental health specialty services, other health care professional services, psychiatric services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services, chiropractic services, physician specialist services, physical therapy, and speech-language pathology services have a 20% coinsurance, with occupational therapy, individual and group mental health sessions, individual and group psychiatric sessions, and opioid treatment program services also having a 20% coinsurance. Podiatry services are not covered, and routine chiropractic care is not covered.
Preventive Services See details
Preventive services include coverage for Medicare-covered services, annual physical exams, and additional preventive services, but health education, in-home safety assessments, medical nutrition therapy, re-admission 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, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications are not covered. Other services such as Personal Emergency Response System (PERS), Post discharge In-Home Medication Reconciliation, Counseling Services, Kidney Disease Education Services, and Fitness Benefit are covered. Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit have a 20% coinsurance.
Hearing Services See details
Hearing services include routine hearing exams with no copay and a 20% coinsurance, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids (all types) are covered with a copay between $495 and $1970, while prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
The Senior Care Plus Extensive Duals Plan (HMO D-SNP) covers vision services, including eye exams with a 20% coinsurance, and eyewear with a 20% coinsurance and a combined maximum benefit of $400 per year. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames are covered with a limit of one per year, and upgrades are also covered.
Dental Services See details
Dental Services are covered, with 20% coinsurance for Medicare Dental Services. Other Dental Services include oral exams, dental x-rays, and prophylaxis (cleaning), with no coinsurance; however, fluoride treatment, maxillofacial prosthetics, implant services, prosthodontics, fixed, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Senior Care Plus Extensive Duals Plan (HMO D-SNP), with a $35 copay for Medicare Part B insulin drugs, and a coinsurance between 0% and 20% for Medicare Part B Chemotherapy/Radiation and Other Medicare Part B drugs. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the Senior Care Plus Extensive Duals Plan (HMO D-SNP) with a doctor's referral. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment coverage includes Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance, but does not cover DME for use outside the home; Diabetic Equipment has a coinsurance, and Diabetic Supplies and Therapeutic Shoes/Inserts each have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services, are covered by this plan. There is no copay for any of these services, but you will pay at most 20% coinsurance for diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services.
Home Health Services See details
Home Health Services are covered by the Senior Care Plus Extensive Duals Plan (HMO D-SNP) with no coinsurance and no copay. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with a doctor referral, but none of the listed sub-services are covered. There is coinsurance for some services, but the details of the coinsurance are not provided.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. Prior authorization and a doctor's referral are required, and the plan charges the Medicare-defined cost share for tier 1.
Other Services See details
Other Services includes Over-the-Counter (OTC) Items, with a maximum benefit of $205 every three months, and a Meal Benefit that requires prior authorization. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered.
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