Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Senior Care Plus Enriched 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 Enriched Duals Plan (HMO D-SNP) in 2025, please refer to our full plan details page.
Senior Care Plus Enriched Duals Plan (HMO D-SNP) is a HMO D-SNP plan offered by Renown Health available for enrollment in 2025 to people living in Clark County NV. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Senior Care Plus Enriched 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 Enriched 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.
Below are a few key facts and commonly-asked questions about Senior Care Plus Enriched Duals Plan (HMO D-SNP).
The cost of a Medicare Advantage Plan is made up of four main parts.
For Senior Care Plus Enriched Duals Plan (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $11.80. 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.
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
The Senior Care Plus Enriched Duals Plan (HMO D-SNP) has a $590 deductible for prescription drugs. After the deductible, your cost-sharing for covered drugs will depend on the specific drug tier and pharmacy you use. If you qualify for the low-income subsidy (LIS), your monthly premium for Part D is $11.80. Once your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for covered drugs.
The Senior Care Plus Enriched Duals Plan (HMO D-SNP) offers a range of benefits with varying cost-sharing. Many services, including primary care, outpatient services, and emergency services, have a 20% coinsurance. The plan also covers hearing exams and prescription hearing aids with copays and coinsurance, vision services with a 20% coinsurance, and dental services with a 20% coinsurance for Medicare dental services. This plan has no copay for home health services, and diagnostic and radiological services. Additionally, the plan offers an OTC benefit of up to $200 every three months. Some services, such as cardiac rehabilitation, are not covered.
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, as well as Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered. Additional Days for Inpatient Hospital-Acute has no coinsurance for the lowest tier.
Outpatient Services include coverage for all outpatient hospital services, observation services, and outpatient substance abuse services, all with a 20% coinsurance. Outpatient blood services are covered with a 20% coinsurance, and include a waiver for the first three pints of blood. Ambulatory Surgical Center (ASC) Services are covered with a coinsurance between 20% and 20%.
Partial Hospitalization is covered by the Senior Care Plus Enriched Duals Plan (HMO D-SNP) with a doctor referral. You will pay 20% coinsurance for this benefit.
The Senior Care Plus Enriched Duals Plan (HMO D-SNP) covers ambulance services, including ground and air ambulance, with a 20% coinsurance. Transportation services to a plan-approved health-related location are covered for up to 36 one-way trips per year, while transportation services to any health-related location are not covered.
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered under the Senior Care Plus Enriched Duals Plan (HMO D-SNP). Emergency Services and Urgently Needed Services have a 20% coinsurance with no copay. Worldwide Emergency Coverage also has a 20% coinsurance, while Worldwide Urgent Coverage and Worldwide Emergency Transportation are not covered.
Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services, Mental Health Specialty Services, Psychiatric Services, and Opioid Treatment Program Services are covered with a 20% coinsurance. Chiropractic Services are covered with a 20% coinsurance, but Routine Care is not covered. Podiatry Services are not covered.
Preventive Services include coverage for services like glaucoma screening, diabetes self-management training, barium enemas, and digital rectal exams, with a 20% coinsurance. The plan also covers counseling services, fitness benefits, Personal Emergency Response System (PERS), Post discharge In-Home Medication Reconciliation, and Remote Access Technologies. Health Education, In-Home Safety Assessment, 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, Nutritional/Dietary Benefit, 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.
Hearing services include hearing exams and prescription hearing aids. Hearing exams have a coinsurance of at most 20% and a copay for fitting/evaluation. Prescription hearing aids (all types) have a copay between $495 and $1970, while inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services includes coverage for eye exams and eyewear. Eye exams have a 20% coinsurance, and eyewear, including contact lenses, has a 20% coinsurance with a combined maximum of $400 per year.
The Senior Care Plus Enriched Duals Plan (HMO D-SNP) offers dental services with 20% coinsurance for Medicare dental services. Other dental services include oral exams, dental x-rays, prophylaxis (cleaning), restorative services, endodontics, periodontics, prosthodontics, and oral and maxillofacial surgery; fluoride treatment, maxillofacial prosthetics, implant services, prosthodontics, and orthodontics are not covered.
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 are covered with a doctor's referral, and the coinsurance is 20%.
Medical Equipment is covered by the Senior Care Plus Enriched Duals Plan (HMO D-SNP). Durable Medical Equipment (DME) has a 20% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services are covered by the Senior Care Plus Enriched Duals Plan, with no copay for diagnostic and radiological services. Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services each have a coinsurance of at most 20%.
Home Health Services are covered by the Senior Care Plus Enriched Duals Plan (HMO D-SNP) with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services are not covered under the Senior Care Plus Enriched Duals Plan (HMO D-SNP). This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered SNF stays and non-Medicare-covered SNF stays are not covered. A doctor referral and prior authorization are required, and you will pay the Medicare-defined cost share for tier 1.
The Senior Care Plus Enriched Duals Plan (HMO D-SNP) covers Over-the-Counter (OTC) items with a maximum benefit of $200 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.
SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
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* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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