Contra Costa Health Care Plus (HMO D-SNP)

Contra Costa Health Care Plus (HMO D-SNP) is a HMO D-SNP plan offered by Contra Costa Health Services available for enrollment in 2026 to people living in Contra Costa County. The overall rating for this plan is not yet available for 2026.

It's important to know that Contra Costa Health Care Plus (HMO D-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 Contra Costa Health Care Plus (HMO D-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 Contra Costa Health Care Plus (HMO D-SNP) plan features an Enhanced Alternative drug benefit with an annual prescription drug deductible of $615.00. After meeting this deductible, you will pay a 25% coinsurance for Tier 1 through Tier 4 drugs at standard retail pharmacies and standard mail order. For Tier 5 specialty drugs, this plan offers the advantage of no copay during the initial coverage phase. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs. Additionally, if you qualify for the low-income subsidy, your Part D premium is reduced to $12.00.

Additional Benefits

The Contra Costa Health Care Plus (HMO D-SNP) plan generally offers coverage with no copay and a standard 20% coinsurance for many essential medical services. This cost-sharing structure applies to outpatient care, primary and specialist doctor visits, emergency services, dialysis, and durable medical equipment. Additionally, diagnostic lab services are covered with no copay and no coinsurance, while other diagnostic and radiological tests require a 20% coinsurance. For supplemental benefits, the plan provides a $20 monthly over-the-counter allowance and up to $200 annually for routine vision care with no copay and a 20% coinsurance. However, several services are excluded from coverage, including most dental services, hearing exams, hearing aids, and health-related transportation. Inpatient hospital stays and skilled nursing facility care are partially covered and subject to Medicare-defined copays and coinsurance.