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Imperial Courage Plan (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Imperial Courage Plan (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Imperial Courage Plan (HMO) in 2026, please refer to our full plan details page.
Imperial Courage 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 Courage Plan (HMO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Imperial Courage 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.
For Imperial Courage Plan (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. Additionally, this plan comes with a Part B Premium reduction of $75.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $2999.00 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
Prescription drugs are not covered by Imperial Courage Plan (HMO).
Additional Benefits
The Imperial Courage Plan (HMO) offers comprehensive coverage with predictable costs, including a $150 copay for days 1 through 5 of inpatient hospital stays and no copay for days 6 through 90. Outpatient hospital and ambulatory surgical services require a $200 copay with no coinsurance, while emergency room visits carry a $125 copay that is waived if you are admitted. Standard preventive services are highly accessible with no copay and no coinsurance. For everyday health needs, the plan features a low $5 copay for specialists and covers up to 100 one-way trips to plan-approved health locations. Beneficiaries also receive helpful allowances, such as $250 annually for routine vision eyewear, up to $500 for hearing aids, and a $75 quarterly reimbursement for over-the-counter items. Skilled nursing facility stays are also covered with no copay for the first 20 days and a $200 copay for days 21 through 100.
Inpatient Hospital See details
Imperial Courage Plan (HMO) partially covers inpatient hospital services, requiring prior authorization and a doctor referral for acute and psychiatric stays. Covered stays require a $150 copay for days 1 through 5, no copay for days 6 through 90, and no coinsurance, while additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Imperial Courage Plan (HMO) covers outpatient services, with outpatient hospital, observation, and ambulatory surgical center services requiring a $200 copay and no coinsurance. Outpatient substance abuse services are covered with a 20% coinsurance and no copay, while outpatient blood services are covered with no deductible.
Partial Hospitalization See details
Partial hospitalization benefits are covered by the Imperial Courage Plan (HMO) with no copay and a 20% coinsurance. These services require a doctor referral and prior authorization.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by the Imperial Courage Plan (HMO), requiring a $150 copay and no coinsurance for ground ambulance services, and a 20% coinsurance and no copay for air ambulance services. The plan covers up to 100 one-way trips per year to plan-approved health-related locations, but transportation to any health-related location is not covered.
Emergency Services See details
Imperial Courage Plan (HMO) covers emergency services with a $125 copay and no coinsurance, which is waived if you are admitted to the hospital within 48 hours, and urgently needed services with no copay or coinsurance. Worldwide emergency services are partially covered up to a $50,000 maximum, which includes worldwide urgent care with a $20 copay and no coinsurance, but excludes worldwide emergency transportation.
Primary Care See details
Primary Care benefits are covered by the Imperial Courage Plan (HMO), featuring a $5 copay for specialists and routine podiatry, a $10 copay for occupational therapy, and a 20% coinsurance for physical, speech-language, and mental health services. Routine chiropractic care and psychiatric services are not covered under this plan.
Preventive Services See details
Imperial Courage Plan (HMO) provides partial coverage for preventive services, offering Medicare-covered zero-dollar preventive services with no copay and no coinsurance. While fitness programs, kidney disease education, and glaucoma screenings are covered, several services are not covered, including annual physical exams, health education, in-home safety assessments, personal emergency response systems, and nutritional therapy.
Hearing Services See details
Hearing services are partially covered by the Imperial Courage Plan (HMO), which provides up to $250 annually for exams and $500 annually for prescription hearing aids with no deductible, though specific copay and coinsurance details are not specified. Under this plan, OTC hearing aids and prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Imperial Courage Plan (HMO) partially covers vision services with no deductible, offering one routine eye exam and a $250 annual limit for eyewear such as contact lenses or eyeglasses (lenses and frames). Individual eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by the Imperial Courage Plan (HMO), which includes other dental services up to $500 annually and orthodontic services up to $1,500 annually. While copay and coinsurance details are not specified, this plan does not cover adjunctive general services, maxillofacial prosthetics, implant services, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by the Imperial Courage Plan (HMO) with no copay and coinsurance ranging from no coinsurance to 20% for Medicare Part B chemotherapy, radiation, and other drugs. Prior authorization is required, and Part D home infusion drugs are not covered as part of this bundled service.
Dialysis Services See details
Imperial Courage Plan (HMO) covers Dialysis Services with a 20% coinsurance and no copay. Prior authorization and a doctor referral are required to access these covered services.
Medical Equipment See details
Imperial Courage Plan (HMO) covers durable medical equipment and prosthetic devices with no copay and a 20% coinsurance. Prosthetics and medical supplies are partially covered since medical supplies are not covered, and while some services are covered for diabetic equipment, diabetic supplies and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by the Imperial Courage Plan (HMO), with diagnostic procedures/tests, lab services, diagnostic radiological services, and outpatient X-ray services not covered. Covered therapeutic radiological services require no copay and a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the Imperial Courage Plan (HMO) with a $10.00 copay and no coinsurance. Prior authorization and a doctor referral are required to access this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are provided by the Imperial Courage Plan (HMO) where some services are covered, but in practice, Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services are not covered. Prior authorization and a doctor referral are required for these services, and while coinsurance is noted, no specific copay or coinsurance amounts are specified.
Skilled Nursing Facility (SNF) See details
Imperial Courage Plan (HMO) partially covers Skilled Nursing Facility (SNF) services, as additional days beyond the Medicare-covered limit are not covered. Covered stays require prior authorization and a doctor referral, featuring no copay and no coinsurance for days 1 to 20, and a $200 copay with no coinsurance for days 21 to 100.
Other Services See details
Other Services are partially covered by the Imperial Courage Plan (HMO), including acupuncture up to 20 treatments yearly and meal benefits up to $105 annually with prior authorization, though copay and coinsurance details are not specified. Over-the-counter (OTC) items are covered up to $75 every three months via reimbursement, but Nicotine Replacement Therapy (NRT) and Dual Eligible SNPs with Highly Integrated Services are not covered.
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