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Senior Care (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Senior Care (HMO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Senior Care (HMO I-SNP) in 2025, please refer to our full plan details page.
Senior Care (HMO I-SNP) is a HMO I-SNP plan offered by Curana Health Holdings, LLC available for enrollment in 2025 to people living in Michigan (partial). This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Senior Care (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:
Senior Care (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 Senior Care (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 Senior Care (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $26.60. 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 $6500.00 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 Senior Care (HMO I-SNP) plan has an enhanced alternative drug benefit. The plan has a deductible of $590.00. Once you meet your deductible, you will pay a copay or coinsurance for your prescriptions. For example, you will pay a $15 copay for preferred generic drugs at a standard pharmacy, or 25% coinsurance for non-preferred drugs. Once your total drug costs reach $2000.00, you will enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The Senior Care (HMO I-SNP) plan offers a wide range of benefits, including coverage for inpatient and outpatient services, primary care, preventive services, and more. Many services have a coinsurance of 20%, while others, such as emergency services, have a copay. The plan also covers vision, dental, and hearing services with varying cost-sharing amounts. Additional benefits include home health services with no copay, durable medical equipment, and over-the-counter items. The plan also provides coverage for home infusion bundled services, dialysis, and various diagnostic and radiological services. However, some services like cardiac rehabilitation and additional hours of home health care are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered, but additional days, non-Medicare-covered stays, and upgrades for both are not covered. The plan uses the Medicare-defined cost share for tier 1, and you should refer to the plan documents for specific details on coinsurance and deductibles.
Outpatient Services See details
Outpatient Services includes coverage for Outpatient Hospital Services with a 20% coinsurance, Observation Services with a $100 copay, Ambulatory Surgical Center (ASC) Services with a 20% coinsurance, and Outpatient Substance Abuse Services with a 20% coinsurance for individual and group sessions. Outpatient Blood Services are not covered.
Partial Hospitalization See details
Partial hospitalization is covered under the Senior Care (HMO I-SNP) plan, 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 Senior Care (HMO I-SNP) plan. Ground and Air Ambulance Services have a 20% coinsurance, and there is no copay. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered by the Senior Care (HMO I-SNP) plan with a $90 copay, and no coinsurance. Urgently Needed Services are covered with a 20% coinsurance and no copay, while Worldwide Emergency Services are not covered.
Primary Care See details
The Senior Care (HMO I-SNP) plan covers Primary Care Physician Services, Chiropractic 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 have a 20% coinsurance, and Routine Chiropractic Care is not covered. Occupational Therapy Services have a 20% coinsurance. Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services, and Additional Telehealth Benefits have a 20% coinsurance. Mental Health Specialty Services have a $20 copay for individual sessions and a $10 copay for group sessions. Individual and group sessions for psychiatric services have a 20% coinsurance. Additional Telehealth Benefits have a copay between $0 and $20.
Preventive Services See details
Preventive Services are covered by the Senior Care (HMO I-SNP) plan, but annual physical exams, health education, in-home safety assessments, personal emergency response systems (PERS), medical nutrition therapy (MNT), 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, 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. In-Home Support Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are covered.
Hearing Services See details
The Senior Care (HMO I-SNP) plan covers hearing exams with a coinsurance of at most 20% and offers 1 routine hearing exam and 1 fitting/evaluation for hearing aids per year. Prescription hearing aids are covered up to a plan-specified amount of $2750.00 per year, while OTC hearing aids are also covered.
Vision Services See details
Vision Services includes coverage for eye exams and eyewear. Eye exams have a 20% coinsurance, and routine eye exams are limited to one visit every year. Eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, also have a 20% coinsurance and a combined maximum benefit of $300 per year.
Dental Services See details
The Senior Care (HMO I-SNP) plan covers dental services with a 20% coinsurance for Medicare dental services, while other dental services are covered with no maximum plan benefit coverage. Oral exams are covered for 2 visits every year, and dental x-rays are covered for 2.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and coinsurance between 0-20%, Medicare Part B Chemotherapy/Radiation Drugs with coinsurance between 0-20%, and Other Medicare Part B Drugs with coinsurance between 0-20%. Prior authorization is required.
Dialysis Services See details
Dialysis services are covered by the Senior Care (HMO I-SNP) plan, with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance. Diabetic Equipment includes Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts, both with 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Senior Care (HMO I-SNP) plan. Diagnostic Procedures/Tests, Diagnostic Radiological Services, and Therapeutic Radiological Services have a coinsurance of at most 20%, while Lab Services and Outpatient X-Ray Services are not covered.
Home Health Services See details
Home Health Services are covered by the Senior Care (HMO I-SNP) plan with no copay and no coinsurance, but 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 not covered by the Senior Care (HMO I-SNP) plan. This includes 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.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but prior authorization is required. The plan does not cover additional days beyond Medicare-covered SNF services or non-Medicare-covered SNF stays, and coinsurance information is available within the plan details.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items, with no maximum plan benefit coverage, and nicotine replacement therapy. Acupuncture, meal benefits, and several other services are not covered.
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