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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 2026 to people living in Pennsylvania (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 $32.70. 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 $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) prescription drug coverage features an annual drug deductible of $615. You will need to pay this deductible amount out-of-pocket before the plan begins paying its share for your covered medications. Specific drug coverage tier details, including individual copays and coinsurance rates, are currently unavailable for this plan. To determine your exact out-of-pocket costs, you should consult the plan's formulary to see how your specific prescription drugs are classified.
Additional Benefits
The Perennial Advantage Strive (HMO I-SNP) plan offers comprehensive medical coverage featuring no copays and no coinsurance for inpatient hospital stays, primary care visits, home health services, and skilled nursing facility care. For outpatient hospital services, specialist visits, diagnostic radiology, and durable medical equipment, members generally pay no copay and a 20% coinsurance. Emergency room visits require a $90 copay, which is waived if admitted within three days, while urgently needed care carries a $20 copay plus 20% coinsurance. In addition to medical care, the plan provides valuable extra benefits including dental services with no copay or coinsurance up to a $3,000 annual maximum. Routine hearing and vision exams are covered with no copay and a 20% coinsurance, alongside allowances for eyewear and hearing aids. Members also enjoy no copays and no coinsurance for over-the-counter items and up to 24 one-way transportation trips per year to health-related locations.
Inpatient Hospital See details
Perennial Advantage Strive (HMO I-SNP) covers inpatient acute and psychiatric hospital services with no copay and no coinsurance, though Medicare-defined deductibles apply and prior authorization is required. Some sub-services, including additional hospital days, non-Medicare-covered stays, and upgrades, are not covered.
Outpatient Services See details
Perennial Advantage Strive (HMO I-SNP) covers outpatient services, with ambulatory surgical, outpatient substance abuse, and outpatient blood services requiring no copay and a 20% coinsurance. Outpatient hospital services require a 20% coinsurance and no copay, while observation services require a $100 copay per stay, with prior authorization required for most outpatient care.
Partial Hospitalization See details
Partial hospitalization is covered by Perennial Advantage Strive (HMO I-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Perennial Advantage Strive (HMO I-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered with no copay and no coinsurance, offering up to 24 one-way trips per year to any health-related location, though transportation to plan-approved health-related locations is not covered.
Emergency Services See details
Perennial Advantage Strive (HMO I-SNP) covers emergency services with a $90 copay and no coinsurance, which is waived if you are admitted to the hospital within three days. Urgently needed services require a $20 copay and 20% coinsurance (up to $40), but worldwide emergency, urgent, and transportation services are not covered.
Primary Care See details
Perennial Advantage Strive (HMO I-SNP) provides primary care and opioid treatment services with no copay and no coinsurance, whereas specialist visits, physical, occupational, and speech therapies, podiatry, and mental health services have no copay and a 20% coinsurance. Telehealth benefits are available with no copay and 0% to 20% coinsurance, and while some chiropractic services are covered, routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by Perennial Advantage Strive (HMO I-SNP) with no copay and no coinsurance for covered options like Medicare-covered zero-dollar services, kidney disease education, and in-home support. Annual physical exams and various additional services—including fitness benefits, health education, in-home safety assessments, PERS, and nutritional training—are not covered.
Hearing Services See details
Perennial Advantage Strive (HMO I-SNP) covers hearing exams with no copay and a 20% coinsurance for routine visits, as well as unlimited OTC hearing aids with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to a $1,200 maximum every two years, excluding inner ear, outer ear, and over the ear prescription hearing aids.
Vision Services See details
Perennial Advantage Strive (HMO I-SNP) provides partially covered vision services, as contact lenses and other eye exam services are not covered. Covered services, including one routine eye exam per year and eyewear (lenses, frames, and upgrades up to a $300 annual limit), feature no copay and a 20% coinsurance with no deductible.
Dental Services See details
Perennial Advantage Strive (HMO I-SNP) partially covers dental services with a $3,000 annual maximum, featuring no copay and no coinsurance for most preventive and comprehensive care, while Medicare-covered dental services require no copay and a 20% coinsurance. Specific sub-services including other preventive dental services, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Perennial Advantage Strive (HMO I-SNP) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Medicare Part B chemotherapy, insulin, and other drugs under this benefit have a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Perennial Advantage Strive (HMO I-SNP) covers Dialysis Services with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is covered by Perennial Advantage Strive (HMO I-SNP) with no copays, but a 20% coinsurance applies to durable medical equipment, prosthetic devices, and medical supplies. This benefit is partially covered because diabetic supplies are not covered, though diabetic therapeutic shoes and inserts are covered with no copay and up to 20% coinsurance.
Diagnostic and Radiological Services See details
Perennial Advantage Strive (HMO I-SNP) partially covers Diagnostic and Radiological Services, as lab services and outpatient X-ray services are not covered. Covered diagnostic procedures, diagnostic radiology, and therapeutic radiology services require prior authorization and have a 20% coinsurance with no copay.
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
Cardiac rehabilitation services are not covered under the Perennial Advantage Strive (HMO I-SNP) plan.
Skilled Nursing Facility (SNF) See details
Perennial Advantage Strive (HMO I-SNP) partially covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, although prior authorization is required. While the plan allows SNF admission without a prior three-day inpatient hospital stay, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered under the Perennial Advantage Strive (HMO I-SNP) plan, which features coverage for over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, and other additional services under this benefit category are not covered.
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