A non-government entity
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 2026, 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 2026.
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 $4000.00 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) prescription drug plan features a $0 drug deductible, meaning your coverage begins immediately without any out-of-pocket deductible costs. Under this plan, there is no copay for Tier 1 (Preferred Generic), Tier 2 (Generic), and Tier 6 (Select Diabetic Drugs) prescriptions filled through standard pharmacies or standard mail order. This ensures highly affordable access to everyday medications and essential diabetic supplies. For brand-name and specialty medications, costs vary depending on the drug tier and how you fill your prescription. Tier 3 (Preferred Brand) copays start at $30 for mail order and $35 at standard pharmacies, while Tier 4 (Non-Preferred) drugs range from $90 to $285. Tier 5 (Specialty) drugs require a 33% coinsurance for all supply durations through both standard pharmacy and standard mail order channels.
Additional Benefits
The Liberty Medicare Advantage (HMO C-SNP) plan offers comprehensive medical coverage with highly competitive cost-sharing, including no copay for primary care visits and specialist copays ranging from no copay to $10. For inpatient hospital stays, members pay a $250 daily copay for days one through six, with no copay for days 7 to 90. Outpatient hospital services require a 20% coinsurance with no copay, while home health care, cardiac rehabilitation, and skilled nursing facility stays are covered with no copay or coinsurance. In addition to core medical care, the plan provides generous supplemental benefits, including no copay or coinsurance for routine dental, vision, and hearing services, each featuring a high annual coverage limit of up to $3,000. Members also enjoy no copay and no coinsurance for unlimited one-way transportation to plan-approved health locations and a monthly allowance of up to $80 for over-the-counter items. Emergency care is accessible with a $100 copay, and urgently needed services require a low $25 copay, with no coinsurance for either service.
Inpatient Hospital See details
Inpatient hospital services are covered by Liberty Medicare Advantage (HMO C-SNP), featuring acute care with no coinsurance and a $250 daily copay for days 1 to 6, followed by no copay for days 7 to 90. Psychiatric stays feature no copay but apply Medicare-defined cost sharing; both services require prior authorization, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Liberty Medicare Advantage (HMO C-SNP) outpatient services include outpatient hospital and observation services with no copay and 20% coinsurance, alongside ambulatory surgical center services for a $250 copay and no coinsurance. Outpatient substance abuse sessions are covered with no copay and 20% coinsurance, while outpatient blood services require no copay and no coinsurance.
Partial Hospitalization See details
Liberty Medicare Advantage (HMO C-SNP) covers partial hospitalization services with a $75.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Liberty Medicare Advantage (HMO C-SNP), featuring a $175 copay for ground ambulance and a $200 copay for air ambulance with no coinsurance for either service. Transportation services are partially covered, offering unlimited one-way rides 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 (HMO C-SNP) covers emergency services with a $100 copay, which is waived if you are admitted to the hospital within one day, and no coinsurance. Urgently needed services have a $25 copay, waived if admitted within three days, and no coinsurance. Although some worldwide emergency services are covered, worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
Liberty Medicare Advantage (HMO C-SNP) provides primary care physician services, opioid treatment, and routine podiatry visits with no copay and no coinsurance, while specialist visits require a $0 to $10 copay and no coinsurance. Physical, occupational, and speech therapies have a $25 copay with no coinsurance, mental health and psychiatric services have a $50 copay with no coinsurance, and chiropractic services are not covered.
Preventive Services See details
Liberty Medicare Advantage (HMO C-SNP) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and glaucoma screenings. Additional preventive services are partially covered with a referral, which includes benefits like a personal emergency response system (PERS) and memory fitness, but excludes services such as health education, in-home safety assessments, and medical nutrition therapy.
Hearing Services See details
Liberty Medicare Advantage (HMO C-SNP) covers routine hearing exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance up to a $3,000 annual limit, excluding OTC hearing aids as well as inner ear, outer ear, and over the ear prescription devices.
Vision Services See details
Vision services are covered by Liberty Medicare Advantage (HMO C-SNP) with no copay, no coinsurance, and no deductible, including one routine eye exam per year and up to $3,000 annually for contacts, lenses, and frames. This benefit is partially covered, as other eye exam services are not covered.
Dental Services See details
Dental Services are partially covered by Liberty Medicare Advantage (HMO C-SNP), offering an annual maximum of $3,000 for preventive and comprehensive dental care with no copay and no coinsurance. While Medicare-covered dental services require a 20% coinsurance and no copay, adjunctive general services and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Liberty Medicare Advantage (HMO C-SNP) covers Home Infusion bundled Services with no copay, though prior authorization and step therapy may apply. Under this benefit, Medicare Part B insulin is covered with no copay and no coinsurance, while chemotherapy and other Part B drugs carry a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under Liberty Medicare Advantage (HMO C-SNP) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Liberty Medicare Advantage (HMO C-SNP) covers durable medical equipment and prosthetics with no copay and 20% coinsurance, subject to prior authorization. Diabetic equipment, supplies, and therapeutic shoes are also covered with no copay and no coinsurance, requiring prior authorization.
Diagnostic and Radiological Services See details
Liberty Medicare Advantage (HMO C-SNP) covers diagnostic and radiological services, with prior authorization required for these benefits. Lab services and diagnostic radiological services feature no copay or coinsurance, while outpatient x-rays require a $10 copay, therapeutic radiological services have a 20% coinsurance, and other diagnostic tests carry a copay ranging from $0 to $275 with no coinsurance.
Home Health Services See details
Home Health Services are covered by Liberty Medicare Advantage (HMO C-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Liberty Medicare Advantage (HMO C-SNP) offers Cardiac Rehabilitation Services with no copay and no coinsurance, though prior authorization is required. While some services are covered, the plan does not cover cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, or supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services.
Skilled Nursing Facility (SNF) See details
Liberty Medicare Advantage (HMO C-SNP) partially covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization is required. While the plan allows SNF admission without a prior three-day inpatient hospital stay, additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Liberty Medicare Advantage (HMO C-SNP) provides covered other services with no copay and no coinsurance, including a meal benefit for certain medical conditions and up to $80 monthly for over-the-counter (OTC) items. However, acupuncture is not covered under this plan, and the meal benefit requires a referral.
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* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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