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Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP) in 2025, please refer to our full plan details page.
Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP) is a HMO C-SNP plan offered by Zing Health Consolidator, Inc available for enrollment in 2025 to people living in Northeast and Northern Illinois. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Zing Essential Wellness Diabetes & Heart IL (HMO C-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 Zing Essential Wellness Diabetes & Heart IL (HMO C-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 Zing Essential Wellness Diabetes & Heart IL (HMO C-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.
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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3650.00 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 Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you'll pay varying copays or coinsurance depending on the drug tier and pharmacy used. For example, you'll pay a $5 copay for a standard generic at a standard pharmacy, or no copay for a preferred generic through mail order. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for covered drugs. This plan is an enhanced alternative, and its premium may be reduced if you qualify for the low-income subsidy.
Additional Benefits
The Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP) plan provides comprehensive coverage, including inpatient hospital stays with a $275 copay for the first six days and no copay for subsequent days. Outpatient services have varying copays, and the plan also covers ambulance and transportation services, with no copay for transportation services. Preventive services, primary care, vision, and dental services generally have no copays, while hearing services have a $20 copay for exams. The plan also offers benefits for home health services, skilled nursing facilities, and medical equipment, with varying cost-sharing. Additional benefits include coverage for over-the-counter items and a meal benefit, with a monthly maximum for OTC items.
Inpatient Hospital See details
Inpatient Hospital services are covered, with a copay of $275 for days 1-6 and no copay for days 7-90. Additional days for Inpatient Hospital-Acute are covered, and Inpatient Hospital Psychiatric services are covered with a copay of $275 for days 1-6 and no copay for days 7-90; however, Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days 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 $300 copay, observation services with a $150 copay, ambulatory surgical center (ASC) services with a $200 copay, and outpatient substance abuse services with no copay for individual or group sessions. Outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP) plan, but requires prior authorization. The plan has a $70 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services, as well as transportation services to plan-approved health-related locations, with up to 30 one-way trips per year. Ground ambulance services have a $175 copay, air ambulance services have a 20% coinsurance, and transportation services have no copay.
Emergency Services See details
Emergency Services are covered under the Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP) plan with a $135 copay, and Urgently Needed Services have a copay between $0 and $10. Worldwide Emergency Coverage and Worldwide Urgent Coverage have no copay, while Worldwide Emergency Transportation is not covered.
Primary Care See details
For the Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP) plan, primary care physician services have no copay, while chiropractic services have a $20 copay. Occupational therapy has a $20 copay. Physician specialist services have a copay between $0 and $15, while mental health specialty services have no copay for individual and group sessions. Podiatry services have a $0 - $10 copay, with routine foot care covered. Other health care professional services have no copay. Individual and group psychiatric sessions have no copay. Physical therapy and speech-language pathology services have a $20 copay. Additional telehealth benefits have a $0 - $20 copay, while opioid treatment program services have a $20 copay.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and additional services, which include: Nutritional/Dietary Benefit, Fitness Benefit, Remote Access Technologies, Home and Bathroom Safety Devices and Modifications, Personal Emergency Response System (PERS), Weight Management Programs, In-Home Support Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit with no copay. Health Education, In-Home Safety Assessment, Medical Nutrition Therapy, Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Counseling Services, Home-Based Palliative Care, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, and Telemonitoring Services are not covered.
Hearing Services See details
Hearing Services include hearing exams with a $20 copay, and routine hearing exams and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered, but prescription hearing aids - inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision Services include eye exams with a copay of $0-$20 and eyewear, including contact lenses, eyeglasses, eyeglass lenses, and eyeglass frames, with no copay and a combined maximum benefit of $300 every year. Routine eye exams, contact lenses, eyeglasses, eyeglass lenses, and eyeglass frames are each limited to one per year. Upgrades are not covered.
Dental Services See details
The Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP) plan covers dental services with no copay, including Oral Exams, Dental X-Rays, Prophylaxis (Cleaning), Fluoride Treatment, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), and Oral and Maxillofacial Surgery. Orthodontic Services are covered under Diagnostic and Preventive Dental, and the plan has a maximum benefit of $2500 per year. Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP) plan. Insulin has a $35 copay and 0-20% coinsurance, and the plan also covers Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP) plan. The coinsurance for Dialysis Services is 20%.
Medical Equipment See details
Medical equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, and Prosthetic Devices and Medical Supplies have a 20% coinsurance, while Diabetic Supplies may have up to a 20% coinsurance and Diabetic Therapeutic Shoes/Inserts have no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests have a copay between $0 and $25, Lab Services have no copay, and Outpatient X-Ray Services have no copay. Diagnostic Radiological Services have a copay between $50 and $150, and Therapeutic Radiological Services have a coinsurance of at least 20%.
Home Health Services See details
Home Health Services are covered by the Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover any of the sub-services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by the Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP) plan, with a $0 copay for days 1-20 and a $214 copay for days 21-100. Additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) items and a Meal Benefit with no copay, while acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered. The OTC benefit has a maximum plan benefit coverage amount of $161.00 every month.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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