A non-government entity
Texas Independence Health Plan, Inc. (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Texas Independence Health Plan, Inc. (HMO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Texas Independence Health Plan, Inc. (HMO I-SNP) in 2026, please refer to our full plan details page.
Texas Independence Health Plan, Inc. (HMO I-SNP) is a HMO I-SNP plan offered by Regency ISNP Holdings LLC available for enrollment in 2025 to people living in Texas (Partial). This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that Texas Independence Health Plan, Inc. (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:
Texas Independence Health Plan, Inc. (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 Texas Independence Health Plan, Inc. (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 Texas Independence Health Plan, Inc. (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $4.80. 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 $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 Texas Independence Health Plan, Inc. (HMO I-SNP) prescription drug coverage includes an annual drug deductible of $615. Beneficiaries must pay this deductible amount out-of-pocket before the plan begins covering the costs of prescription medications. Knowing this deductible is a key step in calculating your overall healthcare expenses with this Medicare Advantage plan. Detailed information regarding drug coverage tiers, copays, and coinsurance amounts is not currently available for this plan. To determine your exact out-of-pocket costs, it is recommended to check the plan's specific formulary for your required medications. For the most accurate pricing, consult directly with the plan provider to see how your prescriptions are categorized.
Additional Benefits
The Texas Independence Health Plan, Inc. (HMO I-SNP) offers comprehensive medical coverage characterized primarily by no copays and a standard 20% coinsurance for many key services. This cost structure applies to primary and specialist care, outpatient hospital services, emergency care, and durable medical equipment. Notably, inpatient hospital stays feature no coinsurance, subject to Medicare-defined cost shares, while skilled nursing facility stays, home health services, and physical therapy require no copay and no coinsurance. For extra benefits, the plan provides valuable dental, vision, hearing, and transportation coverage to help reduce out-of-pocket expenses. You can access preventive and comprehensive dental care with no copay and no coinsurance up to a $2,000 annual limit, alongside a $1,000 hearing aid allowance every two years and a $150 annual vision allowance. Additionally, members benefit from up to 14 free one-way transportation trips per year and a $60 quarterly allowance for over-the-counter health items with no copay or coinsurance.
Inpatient Hospital See details
Texas Independence Health Plan, Inc. (HMO I-SNP) covers inpatient acute and psychiatric hospital services with no coinsurance, subject to Medicare-defined cost shares and prior authorization. Additional days, non-Medicare-covered stays, and room upgrades are not covered under this benefit.
Outpatient Services See details
Outpatient services under the Texas Independence Health Plan, Inc. (HMO I-SNP) are covered with no copays and a 20% coinsurance for outpatient hospital, ambulatory surgical center, outpatient substance abuse, and outpatient blood services. Prior authorization is required for outpatient hospital, ambulatory surgical center, and outpatient substance abuse services.
Partial Hospitalization See details
Partial hospitalization is covered by Texas Independence Health Plan, Inc. (HMO I-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Texas Independence Health Plan, Inc. (HMO I-SNP), featuring a 20% coinsurance and no copay for prior-authorized ground and air ambulance rides. Transportation benefits are partially covered with no copay and no coinsurance for up to 14 one-way trips per year to any health-related location, though trips to plan-approved health-related locations are not covered.
Emergency Services See details
Texas Independence Health Plan, Inc. (HMO I-SNP) covers emergency and urgently needed services with a 20% coinsurance and no copay, with the coinsurance waived if admitted to the hospital within 24 hours for emergencies or 3 days for urgent care. Worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered under this plan.
Primary Care See details
Texas Independence Health Plan, Inc. (HMO I-SNP) covers primary care, specialist, psychiatric, and mental health services with no copay and 20% coinsurance, while occupational, physical, and speech therapy services require no copay and no coinsurance. Some chiropractic services are covered with no copay and 20% coinsurance, but routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by Texas Independence Health Plan, Inc. (HMO I-SNP) with no copays, though a 20% coinsurance applies to annual physical exams, kidney disease education, glaucoma screenings, diabetes self-management, digital rectal exams, and EKGs. Additional preventive benefits, such as fitness programs, health education, in-home safety assessments, and nutritional therapy, are not covered under this plan.
Hearing Services See details
Hearing services offered by Texas Independence Health Plan, Inc. (HMO I-SNP) include hearing exams with no copay and a 20% coinsurance for routine exams, plus up to four hearing aid fitting evaluations every two years. Prescription hearing aids are covered with no copay and no coinsurance up to a $1,000 maximum benefit every two years for inner, outer, and over-the-ear types, though over-the-counter (OTC) hearing aids are not covered.
Vision Services See details
Texas Independence Health Plan, Inc. (HMO I-SNP) covers vision services with no copays, although a 20% coinsurance applies to routine eye exams (limited to one yearly) and contact lenses. The plan features a combined maximum benefit of $150 annually for covered contact lenses, eyeglass lenses, and frames, while upgrades, other eye exams, and complete eyeglasses are not covered.
Dental Services See details
Texas Independence Health Plan, Inc. (HMO I-SNP) covers Medicare-covered dental services with no copay and a 20% coinsurance. Preventive and comprehensive dental services, including cleanings, exams, x-rays, and reconstructive procedures, are covered with no copay and no coinsurance up to a maximum benefit of $2,000 every year.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Texas Independence Health Plan, Inc. (HMO I-SNP) with no copay, though prior authorization is required. Medicare Part B drugs under this benefit, including chemotherapy and insulin, carry a 0% to 20% coinsurance, with insulin specifically requiring a $35 copay.
Dialysis Services See details
Dialysis services are covered under the Texas Independence Health Plan, Inc. (HMO I-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
Texas Independence Health Plan, Inc. (HMO I-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with no copay and a 20% coinsurance. Prior authorization is required for durable medical equipment and prosthetics or medical supplies.
Diagnostic and Radiological Services See details
Texas Independence Health Plan, Inc. (HMO I-SNP) covers diagnostic and radiological services, including lab services, diagnostic procedures, therapeutic radiology, and outpatient X-rays, with no copay and a 20% coinsurance. Prior authorization is required for all of these covered diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered by Texas Independence Health Plan, Inc. (HMO I-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are not covered in practice under the Texas Independence Health Plan, Inc. (HMO I-SNP) since cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all not covered. These services are subject to a 20% coinsurance with no copay.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Texas Independence Health Plan, Inc. (HMO I-SNP) with no copay and no coinsurance, though prior authorization is required. The plan allows SNF admission without a prior three-day inpatient hospital stay, but additional days beyond the standard Medicare-covered days are not covered.
Other Services See details
Texas Independence Health Plan, Inc. (HMO I-SNP) partially covers other services, offering over-the-counter (OTC) items with no copay and no coinsurance up to a maximum benefit of $60 every three months. Acupuncture, meal benefits, nicotine replacement therapy, and naloxone are not covered under this plan.
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