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Premier Care (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Premier 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 Premier Care (HMO I-SNP) in 2025, please refer to our full plan details page.
Premier 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 Premier 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:
Premier 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 Premier 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 Premier Care (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $10.00. You must continue to pay paying your reduced 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $1900.00 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 Premier Care (HMO I-SNP) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you will pay a copay based on the drug tier and the pharmacy you use. For example, standard generics have a $10 copay and preferred brands have a $95 copay. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs. If you qualify for the low-income subsidy, you may have reduced premiums.
Additional Benefits
The Premier Care (HMO I-SNP) plan offers comprehensive coverage with a variety of benefits. This plan includes inpatient hospital stays with no copay, outpatient services with varying copays and coinsurance, and coverage for emergency services with a copay. The Premier Care plan also covers primary care physician services, preventive services with no copay, hearing and vision services with coinsurance, and dental services with coinsurance. Additionally, the plan offers home health services with no copay, skilled nursing facility stays with no copay for the first 100 days, and other services such as acupuncture and over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute, Inpatient Hospital Psychiatric, Additional Days, and Non-Medicare-covered stays. Inpatient Hospital-Acute has no copay for a Medicare-covered stay, while Inpatient Hospital Psychiatric has no copay for days 1-3 and days 11-90, and a $100 copay for days 4-10. However, Upgrades for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, 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 copay between $0 and $225, and observation services with a $100 copay. Ambulatory Surgical Center (ASC) Services and outpatient substance abuse services are covered with 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered by Premier Care (HMO I-SNP), but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Premier Care (HMO I-SNP), with both ground and air ambulance services covered, but air ambulance services have a 20% coinsurance. Ground ambulance services have a $125 copay. Transportation Services to any health-related location are covered, but are limited to 0 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Premier Care (HMO I-SNP) plan. Emergency Services have a $90 copay and no coinsurance, while Urgently Needed Services have a $40 copay and no coinsurance. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
The Premier Care (HMO I-SNP) plan covers primary care physician services, chiropractic services with a 20% coinsurance (routine care has a $30 copay for 12 visits per year), occupational therapy services, physician specialist services, podiatry services with 20% coinsurance for routine foot care (6 visits per year), other health care professional services with a 20% coinsurance, psychiatric services with 20% coinsurance for individual and group sessions, physical therapy and speech-language pathology services, additional telehealth benefits with no copay, and opioid treatment program services. Mental health specialty services are partially covered, and individual and group sessions are not covered.
Preventive Services See details
The Premier Care (HMO I-SNP) plan covers Medicare-covered preventive services, including no copay for services and additional preventive services, but does not cover annual physical exams. The plan does not cover health education, in-home safety assessments, personal emergency response systems, 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, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, fitness benefits, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, or counseling services.
Hearing Services See details
Hearing services are partially covered by the Premier Care (HMO I-SNP) plan, with some services not covered. The plan covers hearing exams with a coinsurance of at most 20% and no deductible, while routine hearing exams and fitting/evaluation for hearing aids are not covered. Prescription hearing aids and OTC hearing aids are not covered.
Vision Services See details
The Premier Care (HMO I-SNP) plan covers vision services, including routine eye exams and eyewear. Eye exams have a 20% coinsurance, and eyewear has a 20% coinsurance with a combined maximum benefit of $225 per year.
Dental Services See details
The Premier Care (HMO I-SNP) plan covers Medicare Dental Services with 20% coinsurance and other dental services, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, orthodontics, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), implant services, and oral and maxillofacial surgery. Maxillofacial prosthetics and orthodontics are not covered, and some services have visit limits.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered under the Premier Care (HMO I-SNP) plan. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment benefits are covered by the Premier Care (HMO I-SNP) plan, with a 20% coinsurance for Durable Medical Equipment (DME), Prosthetic Devices, Medical Supplies, and Diabetic Therapeutic Shoes/Inserts; Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered. There is no copay for medical equipment.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Premier Care (HMO I-SNP) plan. Diagnostic Procedures/Tests, Diagnostic Radiological Services, and Therapeutic Radiological Services have at most 20% coinsurance, while Lab Services and Outpatient X-Ray Services are not covered.
Home Health Services See details
Home Health Services are covered by the Premier Care (HMO I-SNP) plan, with no copay and no coinsurance, but authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Premier Care (HMO I-SNP) plan. 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) See details
Skilled Nursing Facility (SNF) services are covered by the Premier Care (HMO I-SNP) plan, with no copay for days 1-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Under the Premier Care (HMO I-SNP) plan, acupuncture has a $30 copay, and over-the-counter (OTC) items are covered, including nicotine replacement therapy and Naloxone. Other services such as meals, and home healthcare are not covered.
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