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Texas Independence Community Plan (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Texas Independence Community Plan (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 Community Plan (HMO I-SNP) in 2025, please refer to our full plan details page.
Texas Independence Community Plan (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 Community Plan (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 Community Plan (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 Community Plan (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 Community Plan (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 Community Plan (HMO I-SNP) has a $590 deductible for prescription drugs. Once you meet your deductible, you will pay the costs for your drugs based on the tier and pharmacy you use until your total drug costs reach $2000. If you qualify for the low-income subsidy (LIS), you'll pay $18.30. After your yearly out-of-pocket drug costs reach $2000, you will pay nothing for covered drugs.
Additional Benefits
The Texas Independence Community Plan (HMO I-SNP) offers a variety of benefits, including coverage for inpatient and outpatient services, with a 20% coinsurance for many services. The plan also includes coverage for ambulance and transportation services, emergency services, primary care, preventive services, hearing, vision, dental, and home health services. Many services have a 20% coinsurance, and some services have no copay. Additional benefits include coverage for home infusion bundled services, dialysis services, medical equipment, and diagnostic and radiological services. The plan also offers an over-the-counter (OTC) items benefit with a maximum of $60.00 every three months, with no copay or coinsurance. However, some services, such as cardiac rehabilitation services, are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric care, are covered. Additional days, non-Medicare covered stays, and upgrades for Inpatient Hospital-Acute and additional days and non-Medicare covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center (ASC) Services, Outpatient Substance Abuse Services, and Outpatient Blood Services, are covered. Outpatient Hospital Services and Observation Services have a 20% coinsurance, while Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services have a minimum 20% and maximum 20% coinsurance. Outpatient Blood Services have a 20% coinsurance, with a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered with a 20% coinsurance, and requires prior authorization.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Texas Independence Community Plan (HMO I-SNP), including both ground and air ambulance services, each with a 20% coinsurance, and transportation services to any health-related location, with up to 12 one-way trips per year. Transportation services to plan-approved health-related locations are not covered.
Emergency Services See details
Emergency Services are covered with a 20% coinsurance, and there is no copay. Urgently Needed Services are covered with a 20% coinsurance, and there is no copay. Worldwide Emergency Services are not covered.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered, with coinsurance of 20% for most services. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive services are covered by the Texas Independence Community Plan (HMO I-SNP), including Medicare-covered services with no copay. An annual physical exam has a 20% coinsurance, and other preventive services such as Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit have a 20% coinsurance. However, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, fitness benefits, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
The Texas Independence Community Plan (HMO I-SNP) covers hearing exams with a coinsurance of at most 20%, and fitting/evaluation for hearing aids. Prescription hearing aids are covered, with a maximum plan benefit of $1000.00 every two years, but over-the-counter hearing aids are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have a 20% coinsurance and include routine eye exams once per year. Eyewear, including contact lenses, eyeglass lenses, and eyeglass frames, also has a 20% coinsurance, with a combined maximum benefit of $150 per year; however, eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services include coverage for Medicare dental services with 20% coinsurance, and other dental services with a $1,500 annual maximum. Additional services like oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services are covered. Restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are also covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay, and the coinsurance ranges from 0% to 20%. Other Medicare Part B drugs have a coinsurance that ranges from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by the Texas Independence Community Plan (HMO I-SNP), with a coinsurance of 20%.
Medical Equipment See details
Medical Equipment is covered by the Texas Independence Community Plan (HMO I-SNP), including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, and Durable Medical Equipment for use outside the home is not covered; Prosthetic Devices, Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts all have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Texas Independence Community Plan (HMO I-SNP). Diagnostic Procedures/Tests and Lab Services have a coinsurance of at most 20%, while Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services also have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Texas Independence Community Plan (HMO I-SNP) with no copay and no coinsurance, but 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 Community Plan (HMO I-SNP). While the plan covers Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered, but require prior authorization. The plan follows Original Medicare for SNF services, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Other Services with the Texas Independence Community Plan (HMO I-SNP) include Over-the-Counter (OTC) Items, with a maximum benefit of $60.00 every three months, and no copay or coinsurance. 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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