Gold Dialysis & Kidney (HMO-POS C-SNP)

Gold Dialysis & Kidney (HMO-POS C-SNP) is a HMO-POS C-SNP plan offered by Gold Kidney Health Plan available for enrollment in 2025 to people living in Counties: GA, MA, PA, PL. This plan received an overall rating of 3 out of 5 stars in 2026.

It's important to know that Gold Dialysis & Kidney (HMO-POS C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about Gold Dialysis & Kidney (HMO-POS 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.

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:

Drug Coverage

The Gold Dialysis & Kidney (HMO-POS C-SNP) plan offers an enhanced alternative drug benefit with no prescription drug deductible. During the initial coverage phase, which lasts until total drug costs reach $2,100, you will pay a $5 copay for preferred generics and a $40 to $47 copay for standard generics. Preferred brand drugs require a $100 copay, non-preferred drugs carry a 33% coinsurance, and specialty tier drugs feature no copay. Individuals who qualify for Extra Help or the low-income subsidy will pay nothing for their Part D coverage. Once your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and pay nothing for covered Medicare Part D drugs.

Additional Benefits

The Gold Dialysis & Kidney (HMO-POS C-SNP) plan offers comprehensive medical coverage, including inpatient hospital stays with a $175 daily copay for the first five days and no copay for days six through 90. Primary care visits range from no copay to $25, while specialist visits require a copay of up to $15. Emergency services are available for a $120 copay, which is waived if you are admitted, and urgent care visits require a $10 copay. For additional care, the plan features a $5,000 annual dental limit and a $300 eyewear allowance, alongside routine hearing exams for a $15 copay. Members also benefit from up to 24 one-way transportation trips per year with no copay, though cardiac rehabilitation and diabetic supplies are not covered. Durable medical equipment and therapeutic radiological services are covered with a 20% coinsurance and no deductible.