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VNS Health Total (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for VNS Health Total (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on VNS Health Total (HMO D-SNP) in 2026, please refer to our full plan details page.
VNS Health Total (HMO D-SNP) is a HMO D-SNP plan offered by Visiting Nurse Service of New York available for enrollment in 2025 to people living in NYC, Albany, Buffalo and Rochester Metro Areas. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that VNS Health Total (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
VNS Health Total (HMO D-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 VNS Health Total (HMO D-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 VNS Health Total (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $58.80. 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 $615.00 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
We don't have information on the Maximum Out-Of-Pocket cost for this plan. You can call our licensed insurance specialists by clicking "Call to Enroll" below for more information.
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 VNS Health Total (HMO D-SNP) prescription drug plan features an annual drug deductible of $615. This deductible is the amount you must pay out-of-pocket for your medications before your plan coverage begins to pay. Specific drug coverage tier details, including copays and coinsurance for individual tiers, are currently not available for this plan. To determine your exact costs for specific medications, you will need to consult the plan's formulary or contact the provider directly.
Additional Benefits
The VNS Health Total (HMO D-SNP) plan offers comprehensive healthcare coverage with no copays, no coinsurance, and no deductibles for most covered services. This includes essential medical care such as inpatient and outpatient hospital stays, primary and specialist doctor visits, emergency services, and skilled nursing facility care. However, members should be aware that ground, air, and health-related ambulance and transportation services are not covered under this plan. For supplemental care, members receive robust benefits with no copays, including a $3,500 annual dental limit, a $350 yearly eyewear allowance, and up to $1,000 per ear every three years for prescription hearing aids. Additionally, the plan features a generous $310 monthly over-the-counter allowance, home health care, and up to 55 acupuncture visits per year. This plan is designed to maximize coverage while eliminating out-of-pocket costs for key medical and wellness services.
Inpatient Hospital See details
VNS Health Total (HMO D-SNP) covers inpatient acute and psychiatric hospital stays with no copay and no coinsurance, subject to prior authorization. Unlimited additional days are covered for acute care, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
VNS Health Total (HMO D-SNP) covers outpatient hospital, ambulatory surgical center, and blood services with no copay and no coinsurance. Some outpatient substance abuse services are covered, but individual and group sessions are not covered.
Partial Hospitalization See details
Partial hospitalization services are covered by VNS Health Total (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are not covered under the VNS Health Total (HMO D-SNP) plan, as ground ambulance, air ambulance, and health-related transportation services are all excluded from coverage.
Emergency Services See details
VNS Health Total (HMO D-SNP) covers emergency and urgently needed services with no copay and no coinsurance. Worldwide emergency and urgent care are also covered with no copay or coinsurance up to a $50,000 maximum benefit, though worldwide emergency transportation is not covered.
Primary Care See details
VNS Health Total (HMO D-SNP) offers primary care, specialist visits, physical, occupational, and speech therapy, podiatry, and telehealth services with no copay and no coinsurance. While some services are covered under the plan, routine and other chiropractic care, as well as individual and group sessions for mental health and psychiatric services, are not covered.
Preventive Services See details
Preventive Services are partially covered by VNS Health Total (HMO D-SNP) with no copay and no coinsurance for covered services like kidney disease education, diabetes self-management, and memory fitness. However, several benefits are not covered under this plan, including annual physical exams, health education, personal emergency response systems, and in-home safety assessments.
Hearing Services See details
VNS Health Total (HMO D-SNP) covers hearing services with no copay and no coinsurance for routine exams, fittings, and over-the-counter hearing aids. Prescription hearing aids are partially covered with a $1,000 maximum benefit per ear every three years, but inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
VNS Health Total (HMO D-SNP) offers partially covered vision services with no copay, no coinsurance, and no deductible. This benefit includes one routine eye exam annually and a $350 yearly allowance for eyewear, though eyewear upgrades are not covered.
Dental Services See details
VNS Health Total (HMO D-SNP) features partially covered dental services with no copay and no coinsurance for covered preventive and comprehensive treatments, with a maximum annual benefit of $3,500. Not covered under this plan are endodontics, periodontics, orthodontics, adjunctive general services, maxillofacial prosthetics, and other preventive dental services.
Home Infusion bundled Services See details
VNS Health Total (HMO D-SNP) partially covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. While Medicare Part B insulin drugs are covered with no copay or coinsurance under this benefit, Medicare Part B chemotherapy, radiation, and other Part B drugs are not covered.
Dialysis Services See details
Dialysis Services are covered by VNS Health Total (HMO D-SNP) with no copay and no coinsurance.
Medical Equipment See details
VNS Health Total (HMO D-SNP) covers durable medical equipment with no copay and no coinsurance, subject to prior authorization. While some prosthetic and diabetic equipment services are covered under the plan with no copay or coinsurance, specific sub-services including prosthetic devices, medical supplies, diabetic supplies, and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by VNS Health Total (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required. While some services are covered, diagnostic procedures, lab services, diagnostic and therapeutic radiological services, and outpatient X-rays are not covered in practice.
Home Health Services See details
Home Health Services are covered by VNS Health Total (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
VNS Health Total (HMO D-SNP) covers some services under Cardiac Rehabilitation Services with no copay and no coinsurance, subject to prior authorization. However, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
VNS Health Total (HMO D-SNP) covers skilled nursing facility (SNF) services with no copay and no coinsurance, though prior authorization is required. The plan allows for SNF admission without a prior three-day inpatient hospital stay, but additional days beyond standard Medicare coverage are not covered.
Other Services See details
Other services are partially covered by VNS Health Total (HMO D-SNP) with no copay and no coinsurance, excluding nicotine replacement therapy and highly integrated services for dual eligible SNPs. Covered benefits include up to 55 acupuncture treatments per year, a $310 monthly over-the-counter allowance, and meals for chronic illnesses.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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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.
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