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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 2026, 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 2026.
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 $12.00. 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 a $615.00 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 $9250.00 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 features a defined standard drug benefit with an annual prescription drug deductible of $615.00. After meeting this deductible, you pay cost-sharing for drugs across five tiers until your total drug costs reach $2,100.00. If you qualify for the low-income subsidy, also known as LIS or Extra Help, your Part D premium is reduced to $12.00. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and will have no copay for Medicare Part D covered drugs. However, you may still pay a share of the costs for any excluded drugs covered under enhanced benefits. To ensure your specific prescriptions are covered, you should review the plan's formulary.
Additional Benefits
The Senior Care (HMO I-SNP) plan offers robust medical coverage with affordable cost-sharing, including no copay for primary care and specialist visits alongside coinsurance up to 20 percent. For hospital stays, members pay a $235 daily copay for the first 10 days of acute inpatient care and no copay for days 11 through 90, while skilled nursing facility stays feature no copay and no coinsurance for up to 100 days. Standard outpatient services and diagnostic testing generally require a 20 percent coinsurance and no copay. Supplemental benefits include routine dental, vision, and hearing care with no copay and 20 percent coinsurance, including a $275 annual eyewear allowance and a $1,550 limit for prescription hearing aids. Members also receive up to 24 one-way transportation trips per year to health-related locations, in-home support, and over-the-counter items with no maximum benefit limit. Durable medical equipment, dialysis, and Medicare Part B drugs are also covered, typically requiring a 20 percent coinsurance and no copay.
Inpatient Hospital See details
Senior Care (HMO I-SNP) inpatient hospital benefits are partially covered, excluding upgrades for acute care, as well as additional days and non-Medicare-covered stays for psychiatric care. Acute stays require a $235 daily copay for days 1 to 10, no copay for days 11 to 90, and no coinsurance, while psychiatric stays require Medicare-defined coinsurance and no copay.
Outpatient Services See details
Senior Care (HMO I-SNP) covers outpatient services, which generally require a 20% coinsurance and no copay for outpatient hospital, ambulatory surgical, substance abuse, and blood services. Observation services instead require a $100 copay per stay and no coinsurance, and prior authorization is required for most outpatient care.
Partial Hospitalization See details
Senior Care (HMO I-SNP) covers partial hospitalization benefits with no copay and a 20% coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by Senior Care (HMO I-SNP), which excludes transportation to plan-approved health-related locations. Ground and air ambulance services require a 20% coinsurance and no copay, while transportation to any health-related location is covered for up to 24 one-way trips per year.
Emergency Services See details
Senior Care (HMO I-SNP) provides partially covered emergency services, featuring a $90 copay and no coinsurance for emergency services and a $40 copay and no coinsurance for urgently needed services. Worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
Senior Care (HMO I-SNP) covers primary care, specialist, and therapy services with no copays and coinsurance ranging from no coinsurance to 20%. Chiropractic services are partially covered, excluding routine chiropractic care, while mental health specialty services are not covered.
Preventive Services See details
Preventive services are partially covered under Senior Care (HMO I-SNP), featuring Medicare-covered zero-dollar preventive services with no copay and no coinsurance, along with kidney disease education and glaucoma screenings. However, annual physical exams and most additional services—such as fitness benefits, health education, and weight management programs—are not covered, though in-home support services are provided.
Hearing Services See details
Hearing services are covered by Senior Care (HMO I-SNP), featuring one routine hearing exam and one fitting evaluation per year with no copay and up to 20% coinsurance. OTC hearing aids are covered, while prescription hearing aids are partially covered with a $1,550 annual limit, excluding inner ear, outer ear, and over-the-ear models.
Vision Services See details
Senior Care (HMO I-SNP) covers vision services, including one routine eye exam per year and eyewear with a combined maximum benefit of $275 annually. These covered services require a 20% coinsurance and no copay.
Dental Services See details
Dental Services are partially covered by Senior Care (HMO I-SNP) with no copay and a 20% coinsurance for Medicare-covered dental services. While preventive, diagnostic, and restorative treatments are included under the plan, maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Senior Care (HMO I-SNP) covers home infusion bundled services with prior authorization, offering Medicare Part B insulin drugs for a $35 copay and up to 20% coinsurance. Other covered Part B drugs, including chemotherapy and radiation, require no copay and carry a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by the Senior Care (HMO I-SNP) plan with no copay and a 20% coinsurance. This coverage helps you manage the costs of your dialysis treatments with clear, straightforward cost-sharing.
Medical Equipment See details
Senior Care (HMO I-SNP) covers medical equipment with no copay and a 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic equipment is partially covered, offering therapeutic shoes and inserts for no copay and a 20% coinsurance, while diabetic supplies are not covered.
Diagnostic and Radiological Services See details
Senior Care (HMO I-SNP) partially covers diagnostic and radiological services with a 20% coinsurance and no copay, subject to prior authorization. While diagnostic procedures and both diagnostic and therapeutic radiological services are covered, lab services and outpatient x-ray services are not covered.
Home Health Services See details
Home Health Services are covered under the Senior Care (HMO I-SNP) plan, though prior authorization is required. There are no copay or coinsurance costs specified for these covered services.
Cardiac Rehabilitation Services See details
Senior Care (HMO I-SNP) covers some services under Cardiac Rehabilitation Services, but Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. For covered services, prior authorization is required and coinsurance applies, though specific copay and coinsurance amounts are not provided.
Skilled Nursing Facility (SNF) See details
Senior Care (HMO I-SNP) covers Skilled Nursing Facility (SNF) services for days 1 through 100 with no copay and no coinsurance, though prior authorization is required. The benefit is partially covered as additional days beyond Medicare-covered SNF services are not covered.
Other Services See details
Other Services are partially covered by Senior Care (HMO I-SNP), which offers over-the-counter (OTC) items with no maximum benefit limit, but does not cover acupuncture, meal benefits, or highly integrated dual eligible services. Copay and coinsurance information is not specified for the covered OTC items, which are obtained via claims reimbursement.
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