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The Health Plan SecureCare SNP (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for The Health Plan SecureCare SNP (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on The Health Plan SecureCare SNP (HMO D-SNP) in 2026, please refer to our full plan details page.
The Health Plan SecureCare SNP (HMO D-SNP) is a HMO D-SNP plan offered by The Health Plan of West Virginia, Inc. available for enrollment in 2025 to people living in Ohio, West Virginia. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that The Health Plan SecureCare SNP (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
The Health Plan SecureCare SNP (HMO D-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 The Health Plan SecureCare SNP (HMO D-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 The Health Plan SecureCare SNP (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $17.70. 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 Health Plan SecureCare SNP (HMO D-SNP) features an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are covered with no copay for one-month, two-month, and three-month supplies at standard pharmacies and through standard mail order. For Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, members pay a consistent 25% coinsurance. This 25% coinsurance applies to standard pharmacies and standard mail order options, covering up to a three-month supply for Tiers 2 through 4 and a one-month supply for Tier 5 specialty medications.
Additional Benefits
The Health Plan SecureCare SNP (HMO D-SNP) offers comprehensive coverage with many benefits featuring no copayments, though several services require a 20% coinsurance. Members enjoy no copays and no coinsurance for inpatient hospital stays, home health care, and skilled nursing facility services. However, outpatient procedures, specialist visits, emergency care, and durable medical equipment will typically require a 20% coinsurance with no copay. This plan also provides valuable supplemental benefits to support daily wellness, including up to $3,000 annually for dental services and up to $2,000 every two years for hearing aids with no copays or coinsurance. Additionally, members receive routine vision care with a $200 yearly eyewear limit, up to 25 round-trip transportation rides to approved locations, and a $100 monthly allowance for over-the-counter items, all with no copays.
Inpatient Hospital See details
The Health Plan SecureCare SNP (HMO D-SNP) provides partially covered inpatient acute and psychiatric hospital services with no copay or coinsurance, although prior authorization is required. This benefit does not cover upgrades, additional days, or non-Medicare-covered stays.
Outpatient Services See details
Outpatient services are covered by The Health Plan SecureCare SNP (HMO D-SNP) with no copays, though a 20% coinsurance and prior authorization apply to outpatient hospital, observation, ambulatory surgical center, and outpatient substance abuse services. Outpatient blood services are fully covered with no copay and no coinsurance.
Partial Hospitalization See details
The Health Plan SecureCare SNP (HMO D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
The Health Plan SecureCare SNP (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services are partially covered, offering up to 25 round trips per year (up to an $850 limit) to plan-approved health-related locations with no copay and no coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
The Health Plan SecureCare SNP (HMO D-SNP) covers emergency services with a 20% coinsurance (up to $115 per visit) and no copay, and urgently needed services with a 20% coinsurance (up to $40 per visit) and no copay, with coinsurance waived if you are admitted to the hospital within 3 days. For worldwide emergency services, some services are covered but worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
Primary care and specialist services under The Health Plan SecureCare SNP (HMO D-SNP) are covered with no copay and a 20% coinsurance, which also applies to mental health, physical therapy, and podiatry services. Telehealth benefits offer coverage with no copay and no coinsurance, while chiropractic services are not covered in practice.
Preventive Services See details
Preventive Services are partially covered by The Health Plan SecureCare SNP (HMO D-SNP) with no copay and no coinsurance for covered benefits including annual physical exams, kidney disease education, and glaucoma screenings. While select supplemental benefits like health education and fitness programs are included, several services such as in-home safety assessments, medical nutrition therapy, and weight management programs are not covered.
Hearing Services See details
Hearing services are covered by The Health Plan SecureCare SNP (HMO D-SNP) with no copay for exams and prescription hearing aids, although routine hearing exams require a 20% coinsurance with no deductible. While prescription hearing aids are covered up to $2,000 every two years with no copay or coinsurance, OTC hearing aids as well as inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
The Health Plan SecureCare SNP (HMO D-SNP) provides partially covered vision services with no copays, no deductibles, and a $200 yearly limit for eyewear. Routine eye exams and contact lenses carry a 20% coinsurance, while eyeglass lenses and frames have no coinsurance, but upgrades, other eye exam services, and packaged eyeglasses (lenses and frames) are not covered.
Dental Services See details
The Health Plan SecureCare SNP (HMO D-SNP) partially covers dental services, offering Medicare-covered dental with no copay and 20% coinsurance, and other dental benefits up to $3,000 annually with no copay and no coinsurance. Under this plan, other diagnostic, other preventive, adjunctive general, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
The Health Plan SecureCare SNP (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require a 0% to 20% coinsurance and no copay.
Dialysis Services See details
The Health Plan SecureCare SNP (HMO D-SNP) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
The Health Plan SecureCare SNP (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copay and a 20% coinsurance. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
The Health Plan SecureCare SNP (HMO D-SNP) partially covers diagnostic and radiological services with prior authorization, requiring no copay and a 20% coinsurance. Covered services include diagnostic procedures, therapeutic and diagnostic radiological services, and outpatient X-rays, but lab services are not covered.
Home Health Services See details
Home Health Services are covered under The Health Plan SecureCare SNP (HMO D-SNP) with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under The Health Plan SecureCare SNP (HMO D-SNP), as the plan does not provide coverage for cardiac, intensive cardiac, pulmonary, or supervised exercise therapy (SET) services.
Skilled Nursing Facility (SNF) See details
The Health Plan SecureCare SNP (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, requiring prior authorization but allowing admission without a prior three-day inpatient hospital stay. Additional days beyond the standard Medicare-covered limit are not covered under this plan.
Other Services See details
The Health Plan SecureCare SNP (HMO D-SNP) provides partial coverage for other services, including over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and the OTC benefit is limited to a maximum of $100 per month.
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