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Perennial Advantage Strive (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Perennial Advantage Strive (HMO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Perennial Advantage Strive (HMO I-SNP) in 2026, please refer to our full plan details page.
Perennial Advantage Strive (HMO I-SNP) is a HMO I-SNP plan offered by Perennial Consortium, LLC available for enrollment in 2025 to people living in Colorado (partial). The overall rating for this plan is not yet available for 2026.
It's important to know that Perennial Advantage Strive (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:
Perennial Advantage Strive (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 Perennial Advantage Strive (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 Perennial Advantage Strive (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $35.20. 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 Perennial Advantage Strive (HMO I-SNP) Medicare Advantage plan features an annual prescription drug deductible of $615. This deductible represents the amount you must pay out-of-pocket for your covered medications before the plan begins to cover its share of your prescription costs. Specific drug tier details, including individual copayments and coinsurance rates, are currently unavailable for this plan. To fully understand your potential out-of-pocket prescription costs under the Perennial Advantage Strive (HMO I-SNP), we recommend reviewing the plan's formulary directly.
Additional Benefits
The Perennial Advantage Strive (HMO I-SNP) plan offers comprehensive medical coverage, including inpatient hospital stays with no copay, though Medicare-defined deductibles and coinsurance apply. Primary care visits and home health services are available with no copay and no coinsurance, while specialist visits and outpatient hospital services generally carry a coinsurance ranging from 0% to 20%. Emergency care requires a $90 copay, which is waived upon hospital admission, and ambulance services are covered with a 20% coinsurance and no copay. This plan also features valuable supplemental benefits, such as dental coverage with no copay and no coinsurance up to a $2,300 annual maximum, and vision services with no copay and a 20% coinsurance. Additionally, members can access routine hearing exams with no copay, a $2,000 hearing aid allowance every two years, and up to 24 free one-way transportation trips annually. Over-the-counter items are also fully covered with no copay and no coinsurance to help manage your daily health needs.
Inpatient Hospital See details
Perennial Advantage Strive (HMO I-SNP) covers inpatient acute and psychiatric hospital services with no copay, though Medicare-defined deductibles and coinsurance apply and prior authorization is required. This benefit is partially covered because additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Perennial Advantage Strive (HMO I-SNP) covers outpatient hospital services with no coinsurance to 20% coinsurance, and observation services with a $100 copay per stay. Ambulatory surgical center, outpatient substance abuse, and blood services are covered with no copay and 20% coinsurance, with prior authorization required for most services.
Partial Hospitalization See details
Perennial Advantage Strive (HMO I-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization may be required for these services.
Ambulance and Transportation Services See details
Perennial Advantage Strive (HMO I-SNP) covers ambulance services with a 20% coinsurance and no copay, subject to prior authorization. The plan also covers up to 24 one-way transportation trips per year to any health-related location with no copay and no coinsurance, though transport to plan-approved health-related locations specifically is not covered.
Emergency Services See details
Perennial Advantage Strive (HMO I-SNP) covers emergency services with a $90 copay and no coinsurance, with the copay waived if you are admitted to the hospital within three days. Urgently needed services are covered with a $20 copay and 20% coinsurance (capped at $40), while worldwide emergency, urgent, and transportation services are not covered.
Primary Care See details
Perennial Advantage Strive (HMO I-SNP) covers primary care physician and opioid treatment services with no copay and no coinsurance, though chiropractic services are not covered in practice. Most other primary care benefits, including specialist visits, mental health services, physical therapy, and telehealth, are covered with no copay and 0% to 20% coinsurance.
Preventive Services See details
Preventive Services are partially covered by Perennial Advantage Strive (HMO I-SNP) with no copay and no coinsurance for covered services like Medicare-covered preventive care, kidney disease education, and therapeutic massage. However, multiple sub-services are not covered under this plan, including annual physical exams, fitness benefits, health education, and personal emergency response systems.
Hearing Services See details
Hearing services are covered by Perennial Advantage Strive (HMO I-SNP) with no copay for exams, though routine exams require a 20% coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to a $2,000 limit every two years, excluding inner ear, outer ear, and over-the-ear types, while over-the-counter hearing aids are covered with no copay or coinsurance.
Vision Services See details
Perennial Advantage Strive (HMO I-SNP) offers partially covered vision services with no copays, no deductibles, and a 20% coinsurance. Covered benefits include one routine eye exam per year and eyeglasses (lenses, frames, and upgrades) up to a $180 annual limit, while contact lenses and other eye exam services are not covered.
Dental Services See details
Dental services are partially covered by Perennial Advantage Strive (HMO I-SNP), featuring Medicare-covered dental with no copay and a 20% coinsurance, alongside other covered dental services with no copay and no coinsurance up to a $2,300 annual maximum. Other preventive dental services, maxillofacial prosthetics, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Perennial Advantage Strive (HMO I-SNP) with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and other infusion drugs, carry a 0% to 20% coinsurance, while Part B insulin has a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by Perennial Advantage Strive (HMO I-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
Perennial Advantage Strive (HMO I-SNP) covers medical equipment with no copays, though prior authorization and coinsurance may apply to certain items. Durable medical equipment, prosthetic devices, and medical supplies require a 20% coinsurance, while diabetic supplies have no coinsurance and diabetic therapeutic shoes or inserts have a 0% to 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by Perennial Advantage Strive (HMO I-SNP) with a 20% coinsurance and no copay, and prior authorization is required. While diagnostic procedures, diagnostic radiology, and therapeutic radiology are covered, outpatient lab services and outpatient X-ray services are not covered.
Home Health Services See details
Perennial Advantage Strive (HMO I-SNP) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Perennial Advantage Strive (HMO I-SNP) offers cardiac rehabilitation services with no copay and prior authorization, meaning some services are covered. However, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered and carry a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Perennial Advantage Strive (HMO I-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance and no prior three-day hospital stay requirement, though prior authorization is required. There is no copay for days 1 through 20, a $100 copay per day for days 21 through 100, and additional days beyond Medicare-covered limits are not covered.
Other Services See details
Perennial Advantage Strive (HMO I-SNP) partially covers other services, offering over-the-counter (OTC) items with no copay and no coinsurance, while acupuncture and meal benefits are not covered. This OTC benefit includes nicotine replacement therapy, but naloxone and some CMS OTC list drugs are not covered.
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