A non-government entity
RiverSpring Star (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for RiverSpring Star (HMO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on RiverSpring Star (HMO I-SNP) in 2025, please refer to our full plan details page.
RiverSpring Star (HMO I-SNP) is a HMO I-SNP plan offered by RiverSpring Living Holding Corp. available for enrollment in 2025 to people living in Counties: Brx, Ki, Na, NY, Qu, Ri, Wes. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that RiverSpring Star (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:
RiverSpring Star (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 RiverSpring Star (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 RiverSpring Star (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $26.30. 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 $590.00 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 $9350.00 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:
Sign up for RiverSpring Star (HMO I-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The RiverSpring Star (HMO I-SNP) plan has a $590 deductible for prescription drugs. If you qualify for the low-income subsidy, your monthly premium for Part D is $26.30. After the deductible, you will pay the costs for your drugs based on the tier until your total drug costs reach $2000. Once you reach that amount, you enter the next coverage phase, where you will pay nothing for your drugs.
Additional Benefits
The RiverSpring Star (HMO I-SNP) plan offers a variety of benefits with varying cost-sharing. Many services have a 20% coinsurance, including outpatient services, ambulance services, emergency services, and primary care services. Additionally, the plan covers home infusion services with a $35 copay for Medicare Part B Insulin Drugs. Preventive, hearing, vision, and dental services are partially covered, with coinsurance applying to some exams and services. The plan also covers medical equipment and diagnostic services with 20% coinsurance. Other services, such as over-the-counter items, are covered up to a monthly limit.
Inpatient Hospital See details
Inpatient Hospital benefits are covered by the RiverSpring Star (HMO I-SNP) plan. However, additional days, non-Medicare-covered stays, and upgrades for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered by the RiverSpring Star (HMO I-SNP) plan, with 20% coinsurance for Outpatient Hospital Services and Observation Services. Ambulatory Surgical Center Services and Outpatient Substance Abuse Services are covered, and also have 20% coinsurance. Outpatient Blood Services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the RiverSpring Star (HMO I-SNP) plan. Both ground and air ambulance services have a 20% coinsurance, but there is no copay. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services, are covered by the RiverSpring Star (HMO I-SNP) plan, with a 20% coinsurance and no copay; however, Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered. The coinsurance is waived if you are admitted to the hospital within 3 days.
Primary Care See details
The RiverSpring Star (HMO I-SNP) plan covers primary care physician services with no copay, and also covers chiropractic, occupational therapy, physician specialist, mental health specialty, other health care professional, psychiatric, physical therapy, speech-language pathology, additional telehealth, and opioid treatment program services, with a 20% coinsurance for most services. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
Preventive Services are covered under the RiverSpring Star (HMO I-SNP) plan, but annual physical exams, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, fitness benefits, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services are not covered. Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit have a coinsurance of 20%.
Hearing Services See details
Hearing Services are partially covered by the RiverSpring Star (HMO I-SNP) plan. Hearing exams have a coinsurance of at most 20%, while routine hearing exams and fitting/evaluation for hearing aids are not covered, and prescription and OTC hearing aids are not covered.
Vision Services See details
Vision services are covered, but routine eye exams and eyewear are not covered. Eye exams have a 20% coinsurance.
Dental Services See details
Dental Services are covered by the RiverSpring Star (HMO I-SNP) plan, with a 20% coinsurance for Medicare Dental Services. Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable), Maxillofacial Prosthetics, Implant Services, Prosthodontics (fixed), Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are also covered, with coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the RiverSpring Star (HMO I-SNP) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered by the RiverSpring Star (HMO I-SNP) plan, with Durable Medical Equipment (DME), Prosthetic Devices, and Medical Supplies covered, and 20% coinsurance for DME and Prosthetic Devices, and 20% coinsurance for Medical Supplies. Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered, and Diabetic Therapeutic Shoes/Inserts are covered with 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the RiverSpring Star (HMO I-SNP) plan. Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services all have at most 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the RiverSpring Star (HMO I-SNP), with no copay or coinsurance; however, Additional Hours of Care and Personal Care Services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but none of the sub-services are covered, including Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the RiverSpring Star (HMO I-SNP) plan, but prior authorization is required. The plan does not cover additional days beyond Medicare-covered SNF stays or non-Medicare-covered SNF stays.
Other Services See details
Other Services includes Over-the-Counter (OTC) Items, covered up to $150.00 per month. However, acupuncture, meal benefits, 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.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* 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.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved