Health Choice Pathway (HMO D-SNP)

Health Choice Pathway (HMO D-SNP) is a HMO D-SNP plan offered by Blue Cross Blue Shield of Arizona available for enrollment in 2025 to people living in Arizona: APA, CCN, GIL, MAR, MOH, NAV, PIN, YAV. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that Health Choice Pathway (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 Health Choice Pathway (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 Health Choice Pathway (HMO D-SNP) Medicare plan features a prescription drug deductible of $615.00. If you qualify for the low-income subsidy, also known as LIS or Extra Help, your Part D cost is reduced to $7.50. After meeting your deductible, you will pay standard cost-sharing rates 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 enter the catastrophic coverage phase. During this phase, you will have no copay and pay nothing for Medicare Part D covered drugs. To ensure your specific medications are covered under this plan, please check the Health Choice Pathway formulary.

Additional Benefits

Health Choice Pathway (HMO D-SNP) provides robust coverage for essential medical needs, with most primary care, outpatient, emergency, and diagnostic services requiring no copay and a 20% coinsurance. Inpatient hospital stays and skilled nursing facility care are covered under Medicare-defined copays and coinsurance, though prior authorization is generally required. Additionally, members can benefit from zero-dollar preventive services and annual physical exams with no copay and no coinsurance. The plan also features key specialty benefits, including dental care with a $3,500 annual limit and vision services with a $350 allowance for eyewear. Members can also take advantage of routine hearing care, up to 24 one-way transportation trips per year, and a $50 quarterly over-the-counter allowance. Most of these supplemental services are designed to minimize out-of-pocket expenses by requiring no copay and a 20% coinsurance.