Imperial Dynamic Plan (HMO)

Imperial Dynamic Plan (HMO) is a HMO plan offered by Imperial Health Plan of California available for enrollment in 2025 to people living in Northern, Central, Southern California. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that Imperial Dynamic Plan (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 Imperial Dynamic Plan (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.

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 Imperial Dynamic Plan (HMO) offers an Enhanced Alternative drug benefit with no prescription drug deductible, meaning your coverage starts right away. Individuals who qualify for the low-income subsidy may also see their premium reduced to $0.00. Once your yearly out-of-pocket drug costs reach $2,100.00, you will enter the catastrophic coverage phase and pay nothing for covered Part D drugs. During the initial coverage phase, standard retail pharmacy copays for a 30-day supply are $6.00 for Tier 1 preferred generics and $45.00 for Tier 2 standard generics. Tier 3 preferred brand drugs require a $90.00 copay, while Tier 4 non-preferred drugs require a 33% coinsurance. These cost-sharing rates apply until your total drug costs reach $2,100.00.

Additional Benefits

The Imperial Dynamic Plan (HMO) offers comprehensive medical coverage with competitive cost-sharing, featuring no copay or coinsurance for inpatient hospital stays up to 90 days and zero-dollar preventive services. Emergency care is available with a 125 dollar copay, which is waived if admitted, while urgent care and up to 100 one-way transportation trips to plan-approved locations require no copay. Outpatient services generally carry a 100 dollar copay, whereas services like dialysis, durable medical equipment, and partial hospitalization require a 20 percent coinsurance with no copay. For supplemental care, the plan provides routine vision and hearing benefits with no deductibles, including annual allowances for prescription hearing aids, contacts, and eyeglasses, alongside dental coverage for preventive and restorative treatments. Members also benefit from a quarterly over-the-counter allowance of 140 dollars, acupuncture treatments, and home health services, though many specialty services require prior authorization and a doctor referral. Skilled nursing facility stays are also covered with no copay for the first 20 days, followed by daily copays for longer stays.