A non-government entity
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 2025, 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 2025.
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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $1699.00 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:
Sign up for Verda Noble Care (HMO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Verda Noble Care (HMO) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you will pay either a copay or coinsurance depending on the drug tier and the pharmacy you use. For example, you will pay no copay for preferred generic drugs at standard mail pharmacies, and a $35 copay for standard generic drugs. For preferred brand drugs, you will pay 30% coinsurance at standard pharmacies, and 33% coinsurance for non-preferred drugs. After your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for covered drugs.
Additional Benefits
The Verda Noble Care (HMO) plan offers a range of benefits with varying costs. This plan includes coverage for inpatient and outpatient services, with copays for some services like emergency care and outpatient substance abuse. The plan also covers preventive services with no copay, as well as vision and dental services. Additional benefits include hearing exams, and coverage for durable medical equipment, home health services, and skilled nursing facilities. There is also coverage for ambulance services, and various therapies. This plan also provides over-the-counter (OTC) items, and meal benefits.
Inpatient Hospital See details
Inpatient Hospital benefits with the Verda Noble Care (HMO) plan include coverage for Inpatient Hospital Psychiatric services, with a $150 copay for days 1-5 and no copay for days 6-90, but additional days and non-Medicare-covered stays are not covered. Inpatient Hospital-Acute services are covered, but additional days, non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
Outpatient Services are covered, including all outpatient hospital services, observation services, ambulatory surgical center services, and outpatient substance abuse services. Outpatient hospital services have a copay of $50-$90, observation services have a $90 copay, individual outpatient substance abuse sessions have a $40 copay, and group outpatient substance abuse sessions have a $20 copay. Outpatient blood services are not covered.
Partial Hospitalization See details
Verda Noble Care (HMO) covers partial hospitalization with a $25 copay, and requires prior authorization and a doctor referral.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a $119 copay for ground ambulance services and 20% coinsurance for air ambulance services. Transportation Services to a plan-approved health-related location are covered, while transportation to any other health-related location is not covered.
Emergency Services See details
Emergency Services are covered by the Verda Noble Care (HMO) plan, with a $90 copay and no coinsurance. Worldwide Emergency Coverage also has a $90 copay, while Worldwide Urgent Coverage has a copay. Worldwide Emergency Transportation is not covered.
Primary Care See details
The Verda Noble Care (HMO) plan covers primary care physician services, chiropractic services (with prior authorization and referral), occupational therapy, physician specialist services (with prior authorization and referral), mental health specialty services (with copays of $40 for individual sessions and $20 for group sessions, and with prior authorization and referral), psychiatric services (with copays of $40 for individual sessions and $20 for group sessions, and with prior authorization and referral), physical therapy and speech-language pathology services (with no copay or coinsurance, and with prior authorization and referral), additional telehealth benefits (with prior authorization and referral), and opioid treatment program services (with a $25 copay and with prior authorization and referral). Podiatry services are not covered.
Preventive Services See details
The Verda Noble Care (HMO) plan covers preventive services, including Medicare-covered services with no copay. Additional preventive services are partially covered, with some services not covered including annual physical exams, health education, in-home safety assessments, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, adult day health services, home-based palliative care, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services. The plan also covers Personal Emergency Response System (PERS), therapeutic massage (30 sessions per year), nutritional/dietary benefit (6 visits per year), in-home support services (up to $600 per year), fitness benefits (memory fitness), kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following the Welcome Visit.
Hearing Services See details
Hearing Services include hearing exams, routine hearing exams, fitting/evaluation for hearing aids, prescription hearing aids, and OTC hearing aids. Routine hearing exams and fitting/evaluation for hearing aids are covered once per year, while prescription hearing aids are covered for two per year with a copay between $299 and $599, depending on the type. OTC hearing aids, prescription hearing aids - inner ear, prescription hearing aids - outer ear, and prescription hearing aids - over the ear are not covered.
Vision Services See details
The Verda Noble Care (HMO) plan covers vision services including routine eye exams once per year, and eyewear with a combined maximum benefit of $250 per year. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
The Verda Noble Care (HMO) plan covers a variety of dental services, including oral exams, dental x-rays, and cleanings, with copays ranging from $0 to $1196 depending on the service. Orthodontics is not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered and require prior authorization. The plan has a $35 copay for Medicare Part B Insulin Drugs. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Verda Noble Care (HMO) plan, but require prior authorization and a doctor referral. You will be responsible for 20% coinsurance for these services.
Medical Equipment See details
Medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, is covered by the Verda Noble Care (HMO) plan. Durable Medical Equipment (DME) has a coinsurance between 0% and 20% with no copay, while Durable Medical Equipment for use outside the home is not covered. Prosthetic devices have a 20% coinsurance, and medical supplies have a 20% coinsurance with no copay. Diabetic supplies and diabetic therapeutic shoes/inserts have a coinsurance between 0% and 20%.
Diagnostic and Radiological Services See details
The Verda Noble Care (HMO) plan covers diagnostic and radiological services. Diagnostic services, including diagnostic procedures/tests and lab services, are not covered. Diagnostic Radiological Services have a copay of up to $50, and Therapeutic Radiological Services have a coinsurance of 20%.
Home Health Services See details
Home Health Services are covered by the Verda Noble Care (HMO) plan with no copay and no coinsurance, although authorization and a referral are 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 Verda Noble Care (HMO) plan. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Verda Noble Care (HMO) plan, but require prior authorization and a doctor's referral. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Under the "Other Services" benefit, Verda Noble Care (HMO) covers acupuncture, with a limit of 30 treatments per year, and over-the-counter (OTC) items, with a maximum benefit of $375 every three months. Meal benefits are also covered, but require prior authorization and a doctor's referral. Other services like Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and others are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved