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 2025, 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 4.5 out of 5 stars in 2025.
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 $18.30. 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 $590.00 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 $9350.00 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) has a $590.00 deductible for prescription drugs. After you meet your deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000.00, at which point you enter the next coverage phase. If you qualify for the low-income subsidy (LIS), your monthly Part D premium is $18.30. After your yearly out-of-pocket drug costs reach $2000.00, you will pay nothing for your Medicare Part D covered drugs.
Additional Benefits
The Texas Independence Health Plan, Inc. (HMO I-SNP) offers coverage for a range of services, including inpatient and outpatient care, with cost-sharing typically involving a 20% coinsurance. Many services, such as emergency services and home health services, have no copay, while others like hearing exams and eyewear have associated coinsurance costs. This plan also includes benefits for transportation, hearing, and vision, alongside dental coverage with a $1,500 annual maximum. Additional benefits include coverage for home infusion, dialysis, medical equipment, and diagnostic services, with specific cost-sharing for each service, and a quarterly allowance for over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered, but the plan does not cover additional days, non-Medicare covered stays, or upgrades for either type of care. The cost-sharing for Inpatient Hospital services follows the Medicare-defined cost share.
Outpatient Services See details
Outpatient services are covered, including all outpatient hospital services, observation services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services, observation services, individual sessions for outpatient substance abuse, group sessions for outpatient substance abuse, and outpatient blood services have a 20% coinsurance. Ambulatory Surgical Center (ASC) services also have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered under the Texas Independence Health Plan, Inc. (HMO I-SNP) with prior authorization required. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services include coverage for ground and air ambulance services with a 20% coinsurance, and Transportation Services to any health-related location with 12 one-way trips per year. Transportation Services to a plan-approved health-related location is not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services, are covered under this plan, with a 20% coinsurance, and no copay. Worldwide Emergency Services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
The Texas Independence Health Plan covers primary care physician services with a 20% coinsurance, and chiropractic services with a 20% coinsurance, but routine chiropractic care is not covered. Occupational therapy services, and physical therapy and speech-language pathology services are covered with no coinsurance and no copay. Mental health specialty services, physician specialist services, additional telehealth benefits, and Opioid Treatment Program Services have a 20% coinsurance.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, annual physical exams with 20% coinsurance, and other services like Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, each with a 20% coinsurance. The plan does not cover Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), and other services.
Hearing Services See details
Hearing Services includes coverage for Routine Hearing Exams with a 20% coinsurance, fitting/evaluation for hearing aids, and prescription hearing aids including inner ear and outer ear hearing aids. Prescription hearing aids have a maximum plan benefit of $1000.00 every two years, but prescription hearing aids - all types are not covered.
Vision Services See details
Vision services include coverage for eye exams and eyewear. Eye exams have a 20% coinsurance, and routine eye exams are covered once per year. Eyewear, including contact lenses, has a 20% coinsurance, and the plan covers up to $150 per year for all eyewear, with contact lenses, eyeglass lenses, and eyeglass frames covered. Eyeglasses frames and upgrades are not covered.
Dental Services See details
The Texas Independence Health Plan, Inc. (HMO I-SNP) plan covers dental services with a 20% coinsurance. There is also a $1,500 annual maximum for other dental services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%; for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Texas Independence Health Plan, Inc. (HMO I-SNP). The coinsurance for Dialysis Services is 20%.
Medical Equipment See details
Medical Equipment is covered by the Texas Independence Health Plan, Inc. (HMO I-SNP), including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Diabetic Supplies have a 20% coinsurance, and Medical Supplies have a 20% coinsurance. Diabetic Therapeutic Shoes/Inserts also have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with no copay. Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Texas Independence Health Plan, Inc. (HMO I-SNP) with no copay and no coinsurance, but prior authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Texas Independence Health Plan, Inc. (HMO I-SNP). This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. Prior authorization is required.
Other Services See details
Other Services for the Texas Independence Health Plan, Inc. (HMO I-SNP) includes Over-the-Counter (OTC) Items, with a maximum benefit of $60 every three months. However, acupuncture, meal benefits, 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.
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