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Shared Health Dual Plus (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Shared Health Dual Plus (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Shared Health Dual Plus (HMO D-SNP) in 2025, please refer to our full plan details page.
Shared Health Dual Plus (HMO D-SNP) is a HMO D-SNP plan offered by BlueCross BlueShield of Tennessee available for enrollment in 2025 to people living in Mississippi. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Shared Health Dual Plus (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:
Shared Health Dual Plus (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 Shared Health Dual Plus (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 Shared Health Dual Plus (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $39.10. 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 Shared Health Dual Plus (HMO D-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs for your drugs based on the tier and pharmacy you use. Once your total drug costs reach $2000, you will enter the catastrophic coverage phase where you will pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy, you will pay $39.10 for Part D.
Additional Benefits
The Shared Health Dual Plus (HMO D-SNP) plan offers a range of benefits. This plan includes coverage for inpatient hospital stays with a copay, and outpatient services with 20% coinsurance. The plan also provides coverage for ambulance services, emergency services, and various primary care services, all with coinsurance. Additional benefits include hearing exams, vision exams, and dental services. The plan also covers home infusion, dialysis, medical equipment, and diagnostic services with varying cost-sharing structures.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered under the Shared Health Dual Plus (HMO D-SNP) plan, with a copay of $2045 for Medicare-covered acute stays and $2036 for Medicare-covered psychiatric stays. Additional days, non-Medicare-covered stays, and upgrades for both acute and psychiatric care are not covered.
Outpatient Services See details
Outpatient Services include coverage for 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. Ambulatory Surgical Center (ASC) services, individual sessions for outpatient substance abuse, and group sessions for outpatient substance abuse have a minimum coinsurance of 20% and a maximum coinsurance of 20%. Outpatient blood services have a 20% coinsurance, and the plan waives the three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered with prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services, including services not usually covered by Medicare, are covered by the Shared Health Dual Plus (HMO D-SNP) plan. Ground and Air Ambulance Services have a 20% coinsurance, while Transportation Services to a plan-approved health-related location are covered.
Emergency Services See details
Emergency Services are covered, with a 20% coinsurance. Urgently Needed Services are covered with a 20% coinsurance, and no copay. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
Primary Care services, including services from a primary care physician, are covered with a 20% coinsurance. Chiropractic services, including routine care, are covered with a 20% coinsurance, with a limit of 12 visits per year, and require prior authorization. Occupational therapy services are covered with a 20% coinsurance, and require prior authorization. Physician specialist services are covered with a 20% coinsurance. Mental health specialty services, including individual and group sessions, are covered with a coinsurance of 20%. Podiatry services, including routine foot care, are covered with a 20% coinsurance, with a limit of 6 visits per year. Other health care professional services are covered with a 20% coinsurance. Psychiatric services, including individual and group sessions, are covered with a 20% coinsurance. Physical therapy and speech-language pathology services are covered with a 20% coinsurance, and require prior authorization. Additional telehealth benefits and Opioid Treatment Program Services are covered with a 20% coinsurance.
Preventive Services See details
The Shared Health Dual Plus (HMO D-SNP) plan covers preventive services, including Medicare-covered services with no copay, and additional preventive services such as a fitness benefit with no cost. The plan does not cover annual physical exams, health education, in-home safety assessments, medical nutrition therapy, post-discharge in-home medication reconciliation, 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, or counseling services. Kidney disease education, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following the Welcome Visit have a 20% coinsurance. Personal Emergency Response System (PERS), and Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline) are covered.
Hearing Services See details
The Shared Health Dual Plus (HMO D-SNP) plan covers hearing exams with a 20% coinsurance, and includes one routine hearing exam annually with no copay. Prescription hearing aids are covered, but inner ear, outer ear, and over the ear hearing aids are not covered; there is also a $0 service-specific out-of-pocket maximum for hearing aids, and you can get one hearing aid per ear every three years.
Vision Services See details
Vision Services include eye exams with a 20% coinsurance. Eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames, are covered with a 20% coinsurance and a $300 allowance per year for glasses and/or contact lenses and fittings. Upgrades are not covered.
Dental Services See details
Shared Health Dual Plus (HMO D-SNP) covers a variety of dental services, including oral exams, dental x-rays, and cleanings, with a maximum plan benefit of $4,000 per year. Adjunctive General Services, Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered.
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 have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Shared Health Dual Plus (HMO D-SNP) plan. The coinsurance for dialysis services is between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance and no copay, while Durable Medical Equipment for use outside the home is not covered. Prosthetics, Medicare-covered Prosthetic Devices, Medicare-covered Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance with no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Shared Health Dual Plus (HMO D-SNP) plan. There is no copay for these services, but you may have to pay up to 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 Shared Health Dual Plus (HMO D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Shared Health Dual Plus (HMO D-SNP) plan. The plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Shared Health Dual Plus (HMO D-SNP) plan, but require prior authorization. There is no copay for days 1-20, and a $214 copay per day for days 21-100; additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The Shared Health Dual Plus (HMO D-SNP) plan covers acupuncture with a 20% coinsurance and up to 20 treatments per year, as well as over-the-counter (OTC) items with a maximum benefit of $200 per month, including nicotine replacement therapy and naloxone. The plan also covers a meal benefit of 14 meals following a discharge from a hospital or skilled nursing facility to a home setting for a chronic illness, and the maximum plan benefit is $0.
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