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Verda Noble Care (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Verda Noble Care (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Verda Noble Care (HMO) in 2026, please refer to our full plan details page.
Verda Noble Care (HMO) is a HMO plan offered by Verda Healthcare, Inc. available for enrollment in 2025 to people living in Houston Area. The overall rating for this plan is not yet available for 2026.
It's important to know that Verda Noble Care (HMO) 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 Verda Noble Care (HMO).
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 Verda Noble Care (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 $300.00 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 $1599.00 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 Verda Noble Care (HMO) medicare plan features a $300 annual drug deductible. Under this plan, you will enjoy no copay for Tier 1 (Preferred Generic), Tier 2 (Generic), and Tier 6 (Select Care Drugs) prescriptions filled at standard pharmacies or via standard mail order. This makes managing everyday maintenance medications highly affordable. For Tier 3 (Preferred Brand) drugs, copays start at $35 for a one-month supply at a standard pharmacy, with a reduced $70 copay for a three-month standard mail order. Higher-tier medications require coinsurance, with Tier 4 (Non-Preferred) drugs carrying a 30% coinsurance and Tier 5 (Specialty) drugs carrying a 29% coinsurance for a one-month supply.
Additional Benefits
Verda Noble Care (HMO) offers robust coverage with no copay for primary care, specialist visits, telehealth, and covered preventive services. Members also benefit from no copay on acute inpatient hospital stays, routine eye and hearing exams, and preventive dental care. For outpatient hospital services and emergency care, the plan features affordable copays, such as a ninety dollar copay for emergency room visits which is waived if admitted. The plan also includes valuable extra benefits like a one hundred dollar monthly over-the-counter item allowance, up to twenty-four free one-way transportation trips to plan-approved locations, and routine acupuncture. While many essential services feature no copay, members should expect a twenty percent coinsurance for dialysis and prosthetic devices, up to twenty percent coinsurance for durable medical equipment, and daily copays for psychiatric hospitalizations and extended skilled nursing facility stays.
Inpatient Hospital See details
Verda Noble Care (HMO) inpatient hospital services are partially covered, offering acute care with no copay and no coinsurance, though additional days, non-Medicare-covered stays, and upgrades are not covered. Psychiatric stays have no coinsurance and require a $150 copay per day for days 1 through 5, followed by no copay for days 6 through 90. Both services require prior authorization and referrals.
Outpatient Services See details
Verda Noble Care (HMO) covers outpatient services with no coinsurance, offering no copay for ambulatory surgical center and blood services. Medicare-covered outpatient hospital services require a $50 to $90 copay, observation services carry a $90 daily copay, and outpatient substance abuse sessions have a copay of $20 to $40.
Partial Hospitalization See details
Verda Noble Care (HMO) covers partial hospitalization services with a $25.00 copay and no coinsurance. Some of these covered services require a referral and prior authorization.
Ambulance and Transportation Services See details
Verda Noble Care (HMO) covers ground ambulance services with a $119 copay and air ambulance services with a 20% coinsurance. Transportation services are partially covered with no copay and no coinsurance for up to 24 one-way trips per year to plan-approved locations, while transportation to any other health-related locations is not covered.
Emergency Services See details
Verda Noble Care (HMO) covers emergency services with a $90 copay (waived if admitted within 48 hours) and no coinsurance, while urgently needed services are available with no copay and no coinsurance. Worldwide emergency services are partially covered up to a $50,000 limit with no coinsurance and a $90 copay for emergency care, though worldwide emergency transportation is not covered.
Primary Care See details
Verda Noble Care (HMO) provides primary care, specialist, therapy, and telehealth services with no copay and no coinsurance. Chiropractic care is partially covered for up to 24 routine visits per year with no copay or coinsurance, though other chiropractic services and podiatry are not covered. Mental health, psychiatric, and opioid treatment services feature no coinsurance, but require copays ranging from $20 to $40 depending on the service.
Preventive Services See details
Preventive services are partially covered under Verda Noble Care (HMO) with no copay and no coinsurance for covered services. Sub-services that are not covered include annual physical exams, health education, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, adult day health, nutritional benefits, palliative care, caregiver support, smoking cessation, disease management, telemonitoring, remote access, home safety devices, and counseling.
Hearing Services See details
Hearing services are covered by Verda Noble Care (HMO), which offers routine hearing exams and fitting evaluations once per year with no copay and no coinsurance. Prescription hearing aids are partially covered with a copay ranging from $299.00 to $599.00 and no coinsurance for up to two devices per year, though inner ear, outer ear, over-the-ear, and over-the-counter (OTC) hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Verda Noble Care (HMO) with no copay, no coinsurance, and no deductible for covered services. The plan includes one routine eye exam per year and up to a $250 annual combined maximum for eyewear like contacts and glasses, though other eye exam services are not covered.
Dental Services See details
Dental services are partially covered by Verda Noble Care (HMO), offering preventive care like exams and cleanings with no copay and no coinsurance. Comprehensive services are covered with no coinsurance and copays ranging from $0 to $1,615 depending on the procedure, though orthodontics is not covered.
Home Infusion bundled Services See details
Verda Noble Care (HMO) covers home infusion bundled services with no copay, though prior authorization and step therapy may apply. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance of 0% to 20%.
Dialysis Services See details
Dialysis services are covered by Verda Noble Care (HMO) with no copay and a 20% coinsurance. Prior authorization and a referral are required for these services.
Medical Equipment See details
Medical equipment is covered by Verda Noble Care (HMO) with no copay, though prior authorization is required. Plan members will pay between no coinsurance and 20% coinsurance for durable medical equipment and diabetic supplies, and a flat 20% coinsurance for prosthetic devices and medical supplies.
Diagnostic and Radiological Services See details
Verda Noble Care (HMO) partially covers diagnostic and radiological services, requiring prior authorization and referrals for all covered care. Covered diagnostic services have no copay and no coinsurance, and diagnostic radiological services have no copay, while therapeutic radiological services require a copay and 20% coinsurance; however, lab services, diagnostic procedures, and outpatient X-rays are not covered.
Home Health Services See details
Verda Noble Care (HMO) offers fully covered Home Health Services with no copay and no coinsurance. Please note that both prior authorization and a referral are required to access these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Verda Noble Care (HMO) plan. This lack of coverage applies to all related sub-services, including intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD).
Skilled Nursing Facility (SNF) See details
Verda Noble Care (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, although prior authorization and referrals are required. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, with no coverage provided for additional days beyond the Medicare-covered limit.
Other Services See details
Verda Noble Care (HMO) provides coverage for other services with no copay and no coinsurance, including acupuncture up to 24 treatments per year, a $100 monthly over-the-counter item allowance, and meal benefits for chronic illnesses. Prior authorization and referrals are required for meals, and some other miscellaneous services are not covered.
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