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HAP CareSource MI Coordinated Health (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HAP CareSource MI Coordinated Health (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HAP CareSource MI Coordinated Health (HMO D-SNP) in 2026, please refer to our full plan details page.
HAP CareSource MI Coordinated Health (HMO D-SNP) is a HMO D-SNP plan offered by Henry Ford Health System available for enrollment in 2026 to people living in HAP CareSource MI Coordinated Health. The overall rating for this plan is not yet available for 2026.
It's important to know that HAP CareSource MI Coordinated Health (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:
HAP CareSource MI Coordinated Health (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 HAP CareSource MI Coordinated Health (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 HAP CareSource MI Coordinated Health (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $8.80. 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 $9050.00 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 HAP CareSource MI Coordinated Health (HMO D-SNP) Medicare plan features an annual prescription drug deductible of $615. Beneficiaries must pay this deductible amount out-of-pocket before the plan begins covering prescription medication costs. Understanding this upfront deductible is a crucial first step in estimating your yearly out-of-pocket healthcare expenses. Because detailed drug tier information is not available, specific copay and coinsurance amounts for generic or brand-name medications cannot be determined from this data. To find out how your specific prescriptions are covered under the $615 deductible, we recommend verifying your formulary directly with the plan provider. This step ensures you get the most accurate and up-to-date drug cost estimates before choosing this plan.
Additional Benefits
The HAP CareSource MI Coordinated Health (HMO D-SNP) plan offers comprehensive coverage with no copays for most medical services, though a 20% coinsurance typically applies to outpatient care, primary care visits, emergency services, and medical equipment. Beneficiaries can access inpatient hospital stays, home health services, and skilled nursing facility care with no copay and no coinsurance. Prior authorization is required for several of these major medical services to ensure coverage. For supplemental care, the plan features robust dental benefits with no copay and no coinsurance up to a $5,000 annual limit, alongside no-copay hearing exams and prescription hearing aids. Vision services, diagnostic tests, and dialysis are also covered with no copay, though they generally require a 20% coinsurance. Additionally, members benefit from over-the-counter items and meal benefits for chronic illnesses with no copay and no coinsurance.
Inpatient Hospital See details
HAP CareSource MI Coordinated Health (HMO D-SNP) partially covers inpatient hospital services, providing acute and psychiatric hospital stays with no copay and no coinsurance, although prior authorization is required. However, additional hospital days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by HAP CareSource MI Coordinated Health (HMO D-SNP) with no copay and a 20% coinsurance, which applies to outpatient hospital, observation, ambulatory surgical center, substance abuse, and blood services. Prior authorization is required for most of these services, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
HAP CareSource MI Coordinated Health (HMO D-SNP) covers partial hospitalization with no copay and a 20% coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
HAP CareSource MI Coordinated Health (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, requiring prior authorization. While some transportation services are covered, transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
HAP CareSource MI Coordinated Health (HMO D-SNP) covers emergency and urgently needed services with a 20% coinsurance and no copay, which does not count toward the plan deductible and is waived if you are admitted to the hospital within three days. Worldwide emergency, urgent, and transportation services are also covered with a 20% coinsurance and no copay, up to a maximum plan benefit limit of $10,000.
Primary Care See details
Primary care benefits under HAP CareSource MI Coordinated Health (HMO D-SNP) are generally covered with no copay and 20% coinsurance, including doctor visits, therapies, mental health, telehealth, and opioid treatment. Podiatry is covered with no copay and 20% coinsurance for up to six routine visits per year, while chiropractic services are not covered in practice because routine and other chiropractic services are not covered.
Preventive Services See details
HAP CareSource MI Coordinated Health (HMO D-SNP) offers partially covered preventive services with no copay and no coinsurance for annual physical exams, fitness benefits, and personal emergency response systems. Kidney disease education, glaucoma screenings, and diabetes self-management training are covered with no copay and a 20% coinsurance, while sub-services like medical nutrition therapy, weight management, and in-home support are not covered.
Hearing Services See details
HAP CareSource MI Coordinated Health (HMO D-SNP) covers hearing exams with no copay and no deductible, requiring a 20% coinsurance for one annual routine exam and no coinsurance for unlimited fitting evaluations. Prescription hearing aids are partially covered with no copay or coinsurance for up to two devices every three years, though inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services are partially covered by HAP CareSource MI Coordinated Health (HMO D-SNP) with no copay, though a 20% coinsurance applies to routine eye exams and contact lenses. While routine exams, contact lenses, and eyeglasses are covered, other eye exam services and eyewear upgrades are not covered.
Dental Services See details
Dental services are partially covered by HAP CareSource MI Coordinated Health (HMO D-SNP), which offers most preventive and comprehensive dental care with no copay and no coinsurance up to a $5,000 annual limit. Medicare-covered dental services have no copay and a 20% coinsurance, while orthodontics, maxillofacial prosthetics, and other preventive dental services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by HAP CareSource MI Coordinated Health (HMO D-SNP) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, insulin, and other drugs are covered with coinsurance ranging from 0% (no coinsurance) to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis services are covered by HAP CareSource MI Coordinated Health (HMO D-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
HAP CareSource MI Coordinated Health (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic services, with no copay and a 20% coinsurance. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by HAP CareSource MI Coordinated Health (HMO D-SNP) with prior authorization required and no copays. Beneficiaries pay a 20% coinsurance for diagnostic procedures, diagnostic and therapeutic radiological services, and outpatient X-rays, while lab services are covered with no coinsurance.
Home Health Services See details
Home Health Services are covered under the HAP CareSource MI Coordinated Health (HMO D-SNP) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
HAP CareSource MI Coordinated Health (HMO D-SNP) offers Cardiac Rehabilitation Services with no copay, though only some services are covered. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
HAP CareSource MI Coordinated Health (HMO D-SNP) partially covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization is required and additional days beyond the Medicare-covered limit are not covered. Notably, the plan allows for admission to a skilled nursing facility without requiring a prior three-day inpatient hospital stay.
Other Services See details
HAP CareSource MI Coordinated Health (HMO D-SNP) partially covers other services, offering over-the-counter (OTC) items and meal benefits for chronic illnesses with no copay and no coinsurance. Acupuncture and other additional services under this benefit category are not covered.
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