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Liberty Medicare Advantage (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Liberty Medicare Advantage (HMO C-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 (HMO C-SNP) in 2025, please refer to our full plan details page.
Liberty Medicare Advantage (HMO C-SNP) is a HMO C-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 2025.
It's important to know that Liberty Medicare Advantage (HMO C-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 (HMO C-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 (HMO C-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 (HMO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3500.00 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 (HMO C-SNP) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you'll pay varying copays or coinsurance depending on the drug tier and pharmacy used. For example, standard generic drugs have a $35 copay, and preferred brand drugs have a $95 copay. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs. This plan may reduce your premium if you qualify for the low-income subsidy, known as LIS or "Extra Help".
Additional Benefits
The Liberty Medicare Advantage (HMO C-SNP) plan offers a variety of benefits, including inpatient hospital stays with a $250 copay for the first 6 days, and no copay for days 7-90. It also covers outpatient services with coinsurance, ambulance services with copays, and emergency services with copays. Primary care, preventive, hearing, vision, and dental services are also covered, with varying copays, coinsurance, and annual maximums. Additional benefits include home health services with no copay, and coverage for durable medical equipment, and diagnostic and radiological services with copays and coinsurance. The plan also provides coverage for over-the-counter items with a monthly allowance, and meal benefits with a doctor's referral. However, it's important to note that some services like cardiac rehabilitation, additional days in skilled nursing facilities, and certain other services are not covered.
Inpatient Hospital See details
Inpatient Hospital coverage with the Liberty Medicare Advantage (HMO C-SNP) plan includes Inpatient Hospital-Acute with a $250 copay for days 1-6, and no copay for days 7-90, and Inpatient Hospital Psychiatric with coinsurance costs as defined by Original Medicare. Additional days, non-Medicare stays, and upgrades for Inpatient Hospital-Acute and additional days and non-Medicare stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services include coverage for outpatient hospital services, observation services, ambulatory surgical center (ASC) services, and outpatient substance abuse services. Outpatient hospital and observation services have a 20% coinsurance and a service-specific out-of-pocket maximum of $350, while ASC services have a $250 copay. Outpatient substance abuse services are covered with a 20% coinsurance. Outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the Liberty Medicare Advantage (HMO C-SNP) plan, with a $75 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Liberty Medicare Advantage (HMO C-SNP) plan. Ground ambulance services have a $275 copay, while air ambulance services have a $300 copay; both have no coinsurance. Transportation services to a plan-approved health-related location are covered, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services, are covered by the Liberty Medicare Advantage (HMO C-SNP) plan. Emergency Services have a $100 copay with no coinsurance, while Urgently Needed Services have a $25 copay with no coinsurance; however, Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
The Liberty Medicare Advantage (HMO C-SNP) plan covers Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Chiropractic Services are covered with a $15 copay, while Routine Chiropractic Care is not covered. Individual and Group Sessions for Mental Health Specialty Services and Psychiatric Services have a $50 copay. Medicare-covered Podiatry Services have no copay, and Routine Foot Care is covered. Physical Therapy and Speech-Language Pathology Services have a $25 copay. Additional Telehealth Benefits have a copay between $0 and $50.
Preventive Services See details
Preventive Services, including Medicare-covered and additional services, are covered by the Liberty Medicare Advantage (HMO C-SNP) plan. This includes coverage for annual physical exams, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a Welcome Visit, with no copay or coinsurance. Some services such as Health Education, In-Home Safety Assessment, Medical Nutrition Therapy, and others are not covered.
Hearing Services See details
Hearing services for Liberty Medicare Advantage (HMO C-SNP) include hearing exams and fitting/evaluation for hearing aids, with no copay or coinsurance, and routine hearing exams are covered for one visit per year. Prescription hearing aids are covered up to $2,000 per year, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
The Liberty Medicare Advantage (HMO C-SNP) plan covers vision services including routine eye exams with one visit per year, and eyewear with a combined maximum of $2000 per year. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services, and a $2,000 annual maximum for other dental services. Oral exams, dental x-rays, prophylaxis (cleaning), and fluoride treatments are limited to a certain number of visits per year, while other diagnostic dental services, other preventative dental services, restorative services, endodontics, periodontics, prosthodontics (removable), maxillofacial prosthetics, implant services, prosthodontics (fixed), and oral and maxillofacial surgery are unlimited. Adjunctive general services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with no copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Liberty Medicare Advantage (HMO C-SNP) plan, but require prior authorization. You will pay 20% coinsurance for dialysis services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies (non-Medicare benefit) with 20% coinsurance, and Diabetic Equipment. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including all diagnostic services and radiological services, are covered by the Liberty Medicare Advantage (HMO C-SNP) plan. Diagnostic Procedures/Tests have a copay between $0 and $275, Lab Services have no copay, Diagnostic Radiological Services have a copay up to $125, Therapeutic Radiological Services have a coinsurance of at least 20%, and Outpatient X-Ray Services have a $10 copay.
Home Health Services See details
Home Health Services are covered by the Liberty Medicare Advantage (HMO C-SNP) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Liberty Medicare Advantage (HMO C-SNP) plan. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. Prior authorization is required, and you will pay the Medicare-defined cost share for tier 1 with no coinsurance.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items with a $75 monthly allowance, and Meal Benefits, which requires a doctor's referral. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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