Mercy Care Advantage (HMO D-SNP)

Mercy Care Advantage (HMO D-SNP) is a HMO D-SNP plan offered by Mercy Care available for enrollment in 2025 to people living in Maricopa, Gila, Pinal, and Pima Counties. This plan received an overall rating of 3 out of 5 stars in 2026.

It's important to know that Mercy Care Advantage (HMO D-SNP) 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 Mercy Care Advantage (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.

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 Mercy Care Advantage (HMO D-SNP) plan offers a defined standard drug benefit with an annual prescription drug deductible of $615.00. For individuals who qualify for the low-income subsidy, also known as LIS or Extra Help, the monthly Part D premium is reduced to $17.00. After meeting your deductible, you will pay for your tiered prescriptions during the initial coverage phase until total drug costs reach $2,100.00. Once your yearly out-of-pocket drug costs reach $2,100.00, you will enter the catastrophic coverage phase and have no copay for covered Medicare Part D prescriptions. Although you pay nothing for standard covered drugs in this final phase, you may still be responsible for a share of the costs for any excluded drugs. This plan design helps limit your annual out-of-pocket drug expenses.

Additional Benefits

The Mercy Care Advantage (HMO D-SNP) offers comprehensive coverage for core medical needs, with most outpatient, emergency, specialist, and diagnostic services requiring no copay and a 20% coinsurance. Inpatient hospital stays and skilled nursing facility care utilize Medicare-defined copays, while many standard preventive services are fully covered with no copay and no coinsurance. Prior authorization is required for several key benefits, including inpatient care, home health services, and medical equipment. This plan also includes valuable supplemental benefits such as dental care with up to a $5,000 annual limit, hearing aid coverage up to $1,900 every four years, and a $300 annual allowance for eyewear, all generally requiring no copay and 20% coinsurance. Additionally, members can access up to 12 one-way health-related transportation trips per year and a $100 monthly allowance for over-the-counter items. Cardiac rehabilitation services and worldwide emergency care are not covered under this plan.