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Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) in 2026, please refer to our full plan details page.
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) is a HMO I-SNP plan offered by Liberty Healthcare Insurance available for enrollment in 2025 to people living in North Carolina (partial). This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Liberty Medicare Advantage Nursing Home Plan (HMO I-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 Liberty Medicare Advantage Nursing Home Plan (HMO I-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 Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $36.20. 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 $6800.00 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 Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) features an annual prescription drug deductible of $615. This deductible represents the amount you must pay out-of-pocket for covered medications before the plan begins to cover its portion of your drug costs. Specific drug coverage tier details, including individual copayments and coinsurance amounts, are not available for this plan. To determine your exact medication costs and coverage levels, it is recommended to review the plan's comprehensive formulary.
Additional Benefits
The Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) offers comprehensive medical coverage featuring no copays for inpatient hospital stays, primary care visits, and preventive services. Most outpatient services, emergency care, specialist visits, and durable medical equipment require no copay and a 20% coinsurance. Additionally, the plan covers home health care and skilled nursing facility stays with no copay and no coinsurance. Supplemental benefits include routine hearing and vision exams with no copay, alongside a $3,450 hearing aid allowance every two years and a $450 annual eyewear limit. Dental services are covered with no copay, offering up to a $2,500 annual maximum for non-Medicare dental care. Members also benefit from a $350 quarterly over-the-counter allowance and up to 60 free one-way trips per year to plan-approved health locations.
Inpatient Hospital See details
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) covers inpatient acute and psychiatric hospital stays with no copay, though Medicare-defined coinsurance and deductibles apply and prior authorization is required. This benefit is partially covered, as additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) covers outpatient services, including hospital, ambulatory surgical center, substance abuse, and blood services, with no copay and a 20% coinsurance. Prior authorization is required for outpatient hospital, observation, ambulatory surgical center, and substance abuse services.
Partial Hospitalization See details
Partial hospitalization is covered under the Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) partially covers ambulance and transportation services, offering air ambulance services with a 20% coinsurance and no copay, while ground ambulance services are not covered. The plan also covers up to 60 one-way trips per year to plan-approved health-related locations with no copay and no coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
Liberty Medicare Advantage Nursing Home Plan (HMO I-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. Worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) primary care benefits feature no copays for all services, with no coinsurance for primary care provider and opioid treatment services. Specialist visits, mental health, podiatry, and physical therapies require a 20% coinsurance, while chiropractic services are not covered in practice.
Preventive Services See details
Preventive services are covered by the Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) with no copay and no coinsurance, which includes annual physical exams, kidney disease education, and glaucoma screenings. However, this benefit is partially covered because health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, additional smoking cessation, fitness, disease management, telemonitoring, remote access, bathroom safety modifications, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by the Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) with no copay and no coinsurance, offering one routine exam per year and up to $3,450 every two years for prescription hearing aids. However, OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered under this plan.
Vision Services See details
Vision services are partially covered by the Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP), which features one routine eye exam per year with no copay and 0% to 20% coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and a $450 combined annual limit for contacts, frames, lenses, and upgrades.
Dental Services See details
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) provides partially covered dental services, featuring Medicare-covered dental with no copay and 20% coinsurance, alongside other covered dental services with no copay and no coinsurance up to a $2,500 annual maximum. Adjunctive general services and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) covers Home Infusion bundled Services with no copay and no coinsurance, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, require no coinsurance to 20% coinsurance, with insulin also carrying a $35 copay.
Dialysis Services See details
Dialysis Services are covered under the Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment with no copay and a 20% coinsurance. Prior authorization is required for these covered services, which do not have manufacturer or vendor restrictions.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) with no copays, though prior authorization is required. There is no coinsurance for diagnostic procedures and tests, but a 20% coinsurance applies to lab services, diagnostic and therapeutic radiological services, and outpatient X-ray services.
Home Health Services See details
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required for these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) with no copay, but prior authorization is required. While some services are covered, 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
Skilled Nursing Facility (SNF) services are partially covered by the Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) with no copay and no coinsurance, though additional days beyond the Medicare-covered limit are not covered. Prior authorization is required, and the plan conveniently allows for admission without a prior three-day inpatient hospital stay.
Other Services See details
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) partially covers Other Services, providing Over-the-Counter (OTC) items with no copay and no coinsurance up to a maximum benefit of $350 every three months. Acupuncture, meal benefits, nicotine replacement therapy, and naloxone are not covered under this benefit.
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