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Verda Noble Chronic Care (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Verda Noble Chronic Care (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Verda Noble Chronic Care (HMO C-SNP) in 2025, please refer to our full plan details page.
Verda Noble Chronic Care (HMO C-SNP) is a HMO C-SNP 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 Chronic Care (HMO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Verda Noble Chronic Care (HMO C-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 Verda Noble Chronic Care (HMO C-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 Verda Noble Chronic Care (HMO C-SNP), 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 $1099.00 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 Chronic Care (HMO C-SNP) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you will pay different amounts depending on the drug tier and pharmacy type. For example, you'll pay no copay for preferred generic drugs at standard or mail-order pharmacies, while standard generic drugs have a $30 copay. For preferred brand drugs, you'll pay 28% coinsurance, and for non-preferred drugs, you'll pay 33% coinsurance. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The Verda Noble Chronic Care (HMO C-SNP) plan offers a wide array of benefits with varying cost structures. It provides coverage for inpatient and outpatient services, including mental health, with copays ranging from $20 to $100. Emergency services, hearing, vision, and dental services are included, with specific copays and coverage limits. This plan also offers additional benefits such as transportation, home health services, and various preventive services, including hearing aids, eyewear, and dental care. Prescription hearing aids have a copay between $99 and $599. There are copays or coinsurance amounts associated with many of the services, so be sure to review the plan details.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital Psychiatric, are covered by the Verda Noble Chronic Care (HMO C-SNP) plan. For Inpatient Hospital Psychiatric, the plan has a $100 copay for days 1-5, and no copay for days 6-90.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center services, and outpatient substance abuse services. Outpatient hospital services have a copay between $50 and $90, and observation services have a copay of $90. Individual sessions for outpatient substance abuse have a $40 copay, and group sessions have a $20 copay. Outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Verda Noble Chronic Care (HMO C-SNP) plan, and requires prior authorization and a doctor's referral. You will have a $25 copay for this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Verda Noble Chronic Care (HMO C-SNP) plan. Ground ambulance services have a $99 copay, while air ambulance services have a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered, but transportation to any health-related location is not.
Emergency Services See details
Emergency Services are covered, with a $90 copay and no coinsurance. Urgently Needed Services are covered with no copay and no coinsurance, while Worldwide Emergency Services are covered with a $90 copay for Worldwide Emergency Coverage and no copay for Worldwide Urgent Coverage; Worldwide Emergency Transportation is not covered.
Primary Care See details
The Verda Noble Chronic Care (HMO C-SNP) plan covers primary care physician services, chiropractic services (with a limit of 30 visits per year), occupational therapy services, physician specialist services, mental health specialty services (with a $40 copay for individual sessions and a $20 copay for group sessions), psychiatric services (with a $40 copay for individual sessions and a $20 copay for group sessions), physical therapy and speech-language pathology services (with no copay or coinsurance), additional telehealth benefits, and opioid treatment program services (with a $25 copay). Podiatry services are not covered.
Preventive Services See details
The Verda Noble Chronic Care (HMO C-SNP) plan covers various preventive services, including Personal Emergency Response System (PERS), Therapeutic Massage (30 sessions per year), Nutritional/Dietary Benefit (6 visits per year), In-Home Support Services ($1200 per year), and Fitness Benefit (Memory Fitness). Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are also covered, but require prior authorization and a doctor's referral. 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 are not covered.
Hearing Services See details
Hearing Services include routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids. Routine hearing exams and fitting/evaluation for hearing aids are covered once per year, while prescription hearing aids (all types) are covered twice per year with a copay between $99 and $599. Prescription hearing aids - inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision Services include coverage for routine eye exams once per year, and no deductible is required. Eyewear is covered with a combined maximum plan benefit of $300 per year, and contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
The Verda Noble Chronic Care (HMO C-SNP) plan covers a variety of dental services. This includes oral exams, dental x-rays, other diagnostic dental services, prophylaxis, fluoride treatments, other preventive dental services, restorative services with a copay of $22.00 - $530.00, adjunctive general services with a copay of $0.00 - $165.00, endodontics with a copay of $22.00 - $535.00, periodontics with a copay of $0.00 - $435.00, removable prosthodontics with a copay of $0.00 - $1102.00, maxillofacial prosthetics with a copay of $0.00 - $1102.00, implant services, prosthodontics fixed with a copay of $0.00 - $1196.00, and oral and maxillofacial surgery with a copay of $0.00 - $1615.00, but orthodontics is not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. Medicare Part B Insulin Drugs have a copay between $0 and $30. 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 under the Verda Noble Chronic Care (HMO C-SNP) plan, but require prior authorization and a doctor referral. The coinsurance for Dialysis Services is 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 0-20% coinsurance and no copay, and Prosthetics/Medical Supplies with no copay and 20% coinsurance. Diabetic Equipment is covered with no copay and a coinsurance that ranges from 0-20% depending on the service. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are partially covered by the Verda Noble Chronic Care (HMO C-SNP) plan. Diagnostic services, including diagnostic procedures and lab services, are not covered. Diagnostic Radiological Services have a copay of up to $25, while Therapeutic Radiological Services have a coinsurance of 20%.
Home Health Services See details
Home Health Services are covered by the Verda Noble Chronic Care (HMO C-SNP) plan with no copay and no coinsurance, but require authorization and a referral. However, 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 Chronic Care (HMO C-SNP) plan. Prior authorization and a doctor's referral are required to receive coverage for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization and a doctor referral. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Verda Noble Chronic Care (HMO C-SNP) plan covers acupuncture, over-the-counter (OTC) items, and a meal benefit. Acupuncture is covered for up to 30 treatments per year, and OTC items are covered up to $335 every three months. The meal benefit requires a doctor's referral and prior authorization.
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