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Senior Care (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Senior Care (HMO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Senior Care (HMO I-SNP) in 2025, please refer to our full plan details page.
Senior Care (HMO I-SNP) is a HMO I-SNP plan offered by Curana Health Holdings, LLC available for enrollment in 2025 to people living in California partial. The overall rating for this plan is not yet available for 2025.
It's important to know that Senior Care (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:
Senior Care (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 Senior Care (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 Senior Care (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $29.70. 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 Senior Care (HMO I-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, 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, your Part D premium is $29.70.
Additional Benefits
The Senior Care (HMO I-SNP) plan offers a variety of benefits with varying cost-sharing. You can expect a $235 copay for inpatient hospital stays for days 1-10, and no copay for days 11-90. Many services have a coinsurance of 20%, including outpatient services, ambulance services, primary care, vision, dental, and medical equipment. This plan also includes coverage for hearing exams, hearing aids, emergency services, and home health services with no copay. However, some services such as outpatient blood services, and many other services, are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits with the Senior Care (HMO I-SNP) plan include coverage for Inpatient Hospital-Acute, with a copay of $235 for days 1-10 and no copay for days 11-90, and Inpatient Hospital Psychiatric, with coinsurance following Original Medicare guidelines. Additional days for Inpatient Hospital-Acute and Non-Medicare-covered stay for Inpatient Hospital-Acute are also covered, while upgrades for Inpatient Hospital-Acute and additional days and Non-Medicare-covered stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a 20% coinsurance, Observation Services with a $100 copay, Ambulatory Surgical Center (ASC) Services with a 20% coinsurance, and Outpatient Substance Abuse Services, including both individual and group sessions, with a 20% coinsurance. Outpatient Blood Services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the Senior Care (HMO I-SNP) plan, but requires prior authorization. You will pay a 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Senior Care (HMO I-SNP) plan. Ground and air ambulance services have a 20% coinsurance, while transportation services to a plan-approved health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services, are covered under the Senior Care (HMO I-SNP) plan. Emergency Services have a $90 copay with no coinsurance, and Urgently Needed Services have a $45 copay with no coinsurance. Worldwide Emergency Services are not covered.
Primary Care See details
The Senior Care (HMO I-SNP) plan covers primary care physician services, chiropractic services with 20% coinsurance, occupational therapy services with 20% coinsurance, physician specialist services with 0% - 20% coinsurance, individual and group sessions for psychiatric services with 20% coinsurance, and physical therapy and speech-language pathology services with 20% coinsurance. The plan also covers podiatry services and other health care professionals with a 20% coinsurance, as well as additional telehealth benefits with 0% - 20% coinsurance. Routine Chiropractic Care and Individual and Group Sessions for Mental Health Specialty Services are not covered.
Preventive Services See details
The Senior Care (HMO I-SNP) plan covers Medicare-covered preventive services, including some additional preventive services; however, the annual physical exam, health education, and several other services are not covered. Other covered preventive services include glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit.
Hearing Services See details
The Senior Care (HMO I-SNP) plan covers hearing exams with at most 20% coinsurance, and also covers routine hearing exams and fitting/evaluation for hearing aids once per year. Prescription hearing aids are covered up to a maximum of $1550 per year, and OTC hearing aids are also covered. However, prescription hearing aids for the inner and outer ear are not covered.
Vision Services See details
Vision Services includes coverage for eye exams and eyewear, with a 20% coinsurance for eye exams and eyewear. Eyewear has a combined maximum benefit of $275 per year.
Dental Services See details
The Senior Care (HMO I-SNP) plan covers dental services, including Medicare Dental Services with 20% coinsurance. Other covered services include oral exams (2 visits per year), dental x-rays (2 x-rays), other diagnostic dental services, prophylaxis (cleaning) (2 visits per year), fluoride treatment (1 treatment every six months), restorative services (1 visit), adjunctive general services (1 visit), endodontics (1 visit), periodontics (1 visit), prosthodontics (1 visit), implant services, prosthodontics fixed (1 visit), and oral and maxillofacial surgery (1 visit). Orthodontic services are covered up to a maximum of $3,000 per year. Maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. Medicare Part B Insulin Drugs have a $35 copay and coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Senior Care (HMO I-SNP) plan with a coinsurance of 20%.
Medical Equipment See details
The Senior Care (HMO I-SNP) plan covers durable medical equipment with 20% coinsurance and no copay, but does not cover durable medical equipment for use outside the home. Prosthetics and medical supplies, including prosthetic devices and medical supplies, are covered with 20% coinsurance and no copay. Diabetic equipment is covered, but diabetic supplies are not covered, and diabetic therapeutic shoes/inserts are covered with 20% coinsurance and no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Senior Care (HMO I-SNP) plan. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Lab Services and Outpatient X-Ray Services are not covered.
Home Health Services See details
Home Health Services are covered by the Senior Care (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 covered by the Senior Care (HMO I-SNP) plan, but the plan does not cover any of the sub-services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Senior Care (HMO I-SNP) plan, with no copay for days 1-100. Additional days beyond Medicare-covered for SNF, and non-Medicare-covered stays for SNF, are not covered.
Other Services See details
The Senior Care (HMO I-SNP) plan does not cover 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, or Self-Directed Personal Assistance Services. Over-the-Counter (OTC) Items are covered, including Nicotine Replacement Therapy (NRT) as a Part C OTC benefit, but Naloxone coverage is not offered, and not all drugs on the CMS OTC list are covered.
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