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Elevate Medicare Choice (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Elevate Medicare Choice (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Elevate Medicare Choice (HMO D-SNP) in 2026, please refer to our full plan details page.
Elevate Medicare Choice (HMO D-SNP) is a HMO D-SNP plan offered by Denver Health and Hospital Authority available for enrollment in 2025 to people living in Adams, Arapahoe, Denver and Jefferson Counties. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Elevate Medicare Choice (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:
Elevate Medicare Choice (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 Elevate Medicare Choice (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 Elevate Medicare Choice (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $15.70. 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
This plan has a Maximum Out-Of-Pocket cost of $9250.00 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
The Elevate Medicare Choice (HMO D-SNP) plan features an annual prescription drug deductible of $615. This deductible must be met before the plan begins to pay its share of your prescription medication costs. Specific drug coverage tier details, including individual copayments and coinsurance rates, are not currently available for this plan. To understand your exact out-of-pocket costs for specific prescriptions, it is best to review the plan's formulary or contact the provider directly.
Additional Benefits
The Elevate Medicare Choice (HMO D-SNP) plan generally offers core medical services, including outpatient care, specialist visits, emergency services, and diagnostic tests, with no copay and a standard 20% coinsurance. Inpatient hospital stays require Medicare-defined copays but carry no coinsurance, while home health care and skilled nursing facility services are fully covered with no copay or coinsurance. For supplemental benefits, members enjoy no copay and no coinsurance for up to 24 one-way health-related transportation trips, alongside a $2,000 annual maximum for select dental services. Additionally, the plan provides coverage with no copays for routine vision and hearing services, featuring a $300 annual eyewear allowance and a $1,500 hearing aid limit every three years.
Inpatient Hospital See details
Inpatient hospital services are covered by Elevate Medicare Choice (HMO D-SNP) with no coinsurance, though Medicare-defined copays apply and prior authorization is required for acute care. This benefit is partially covered, as upgrades, additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Elevate Medicare Choice (HMO D-SNP) covers outpatient services—including outpatient hospital care, observation services, ambulatory surgical center visits, substance abuse sessions, and blood services—with no copay and a 20% coinsurance.
Partial Hospitalization See details
Elevate Medicare Choice (HMO D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance.
Ambulance and Transportation Services See details
Elevate Medicare Choice (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, with the coinsurance waived if you are admitted to the hospital. The plan also partially covers transportation services, offering up to 24 one-way trips per year to plan-approved health-related locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Elevate Medicare Choice (HMO D-SNP) covers emergency and urgently needed services with a 20% coinsurance and no copay, which is waived if you are admitted to the hospital within three days. These costs count toward your plan-level deductible, with maximum per-visit amounts of $115 for emergency care and $40 for urgent care, though worldwide emergency services are not covered.
Primary Care See details
Elevate Medicare Choice (HMO D-SNP) covers primary care, specialist, mental health, telehealth, and opioid treatment services with no copay and 20% coinsurance. Prior authorization is required for physical, occupational, and speech therapies, while chiropractic and podiatry services are not covered.
Preventive Services See details
Elevate Medicare Choice (HMO D-SNP) covers preventive services with no copay and no coinsurance for Medicare-covered zero-dollar services and remote access technologies, though annual physical exams, fitness benefits, and health education are not covered. Covered kidney disease education and other select screenings, including glaucoma and diabetes self-management, require no copay but carry a 20% coinsurance.
Hearing Services See details
Hearing services are partially covered by Elevate Medicare Choice (HMO D-SNP), featuring no copay for hearing exams and prescription hearing aids, though routine exams require a 20% coinsurance with no deductible. While prescription hearing aids have no coinsurance up to a $1,500 limit every three years, OTC hearing aids as well as inner ear, outer ear, and over-the-ear prescription aids are not covered.
Vision Services See details
Elevate Medicare Choice (HMO D-SNP) offers partially covered vision services with no copays, featuring a 20% coinsurance for routine eye exams (limited to one per year) and contact lenses, with a $300 annual limit on eyewear. Other eye exam services, individual eyeglass lenses, eyeglass frames, and upgrades are not covered under this plan.
Dental Services See details
Dental services are partially covered by Elevate Medicare Choice (HMO D-SNP), featuring Medicare-covered dental care with no copay and a 20% coinsurance, and other dental services with no copay and no coinsurance up to a $2,000 annual maximum. While preventive care, restorative services, endodontics, periodontics, and oral surgery are covered, this plan does not cover adjunctive general services, prosthodontics, maxillofacial prosthetics, implant services, or orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Elevate Medicare Choice (HMO D-SNP) with no copay, subject to prior authorization. Associated Medicare Part B drugs, including chemotherapy, radiation, and other drugs, carry a 0% to 20% coinsurance, while covered Part B insulin requires a $35 copay and 0% to 20% coinsurance that counts toward the plan's deductible.
Dialysis Services See details
Dialysis services are covered under the Elevate Medicare Choice (HMO D-SNP) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Elevate Medicare Choice (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with no copay and a 20% coinsurance. Prior authorization is required for these services, and there are no restrictions on preferred vendors or manufacturers.
Diagnostic and Radiological Services See details
Elevate Medicare Choice (HMO D-SNP) covers diagnostic and radiological services, including lab services, diagnostic procedures, therapeutic radiology, and outpatient X-rays, with no copay and a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Elevate Medicare Choice (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by Elevate Medicare Choice (HMO D-SNP) with no copay and some services are covered, though standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Elevate Medicare Choice (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, although prior authorization is required. The plan allows for admission without a prior three-day inpatient hospital stay, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Elevate Medicare Choice (HMO D-SNP) partially covers other services, offering a chronic illness meal benefit and over-the-counter (OTC) items up to $35 every three months via reimbursement with no copay and no coinsurance for both benefits. Acupuncture, naloxone, and highly integrated SNP services are not covered under this plan.
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