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Premier Care (HMO-POS I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Premier Care (HMO-POS I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Premier Care (HMO-POS I-SNP) in 2025, please refer to our full plan details page.
Premier Care (HMO-POS I-SNP) is a HMO-POS 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 Premier Care (HMO-POS I-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Premier Care (HMO-POS 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 Premier Care (HMO-POS 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 Premier Care (HMO-POS I-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 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 combined Maximum Out-Of-Pocket cost of $4700.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $4700.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 Premier Care (HMO-POS I-SNP) plan has an enhanced alternative drug benefit. The plan has a deductible of $590.00. In the initial coverage phase, after the deductible is met, you will pay a copay for your prescriptions, depending on the drug tier and pharmacy. For example, standard generic drugs have a $45.00 copay, while preferred brand drugs have a $95.00 copay. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase, where you pay nothing for your Part D covered drugs.
Additional Benefits
The Premier Care (HMO-POS I-SNP) plan offers a variety of benefits, including inpatient hospital stays with a copay, outpatient services with copays or coinsurance, and coverage for ambulance and emergency services. You'll also find coverage for primary care, hearing, vision, and dental services, with varying cost-sharing amounts like copays and coinsurance. This plan provides additional coverage for home health, home infusion, and dialysis services, as well as durable medical equipment and diagnostic services, all with specific cost-sharing structures. However, it's important to note that some services, such as cardiac rehabilitation, certain preventive services, and specific types of care like acupuncture and private duty nursing, are not covered by this plan.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with a copay of $230 per day for days 1-6 and no copay for days 7-90. Additional Days for Inpatient Hospital-Acute and Non-Medicare-covered Stay for Inpatient Hospital-Acute are covered, but Upgrades for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services with the Premier Care (HMO-POS I-SNP) plan include coverage for Outpatient Hospital Services with a copay between $0 and $225, and Observation Services with a $100 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services are also covered with a 20% coinsurance, while Outpatient Blood Services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the Premier Care (HMO-POS 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, with prior authorization required for all ambulance services. Ground ambulance services have a $250 copay, while air ambulance services have a 20% coinsurance; transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Premier Care (HMO-POS I-SNP) plan. For Emergency Services, there is a $90 copay and no coinsurance, while Urgently Needed Services have a $40 copay and no coinsurance. Worldwide Emergency Services are not covered.
Primary Care See details
The Premier Care (HMO-POS I-SNP) plan covers primary care services, including primary care physician services, with no coinsurance. Chiropractic services are covered with 20% coinsurance, and routine chiropractic care has a $30 copay. Occupational therapy and physical therapy/speech-language pathology services are covered with no copay or coinsurance, but authorization is required. Physician specialist services have a $10 copay, while individual and group mental health sessions have a $20 and $10 copay, respectively. Podiatry services and other healthcare professional services have 20% coinsurance. Additional telehealth benefits have a copay between $0 and $20, and Opioid Treatment Program Services are covered with prior authorization.
Preventive Services See details
Preventive Services are covered by the Premier Care (HMO-POS I-SNP) plan, but the annual physical exam, health education, in-home safety assessment, 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 benefit, home-based palliative care, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services are not covered. The plan covers Personal Emergency Response System (PERS), In-Home Support Services, and Fitness Benefit.
Hearing Services See details
Hearing Services includes coverage for routine hearing exams with a coinsurance of 20%, fitting and evaluation for hearing aids, and OTC hearing aids. The plan also covers prescription hearing aids up to a maximum of $130 per month.
Vision Services See details
Vision services are covered, including routine eye exams and eyewear. Eye exams and eyewear have a 20% coinsurance, and contact lenses and other eyewear have a combined maximum benefit of $130 per month.
Dental Services See details
The Premier Care (HMO-POS I-SNP) plan covers dental services, including Medicare Dental Services with 20% coinsurance after prior authorization. Other services like Oral Exams, Dental X-Rays, Prophylaxis (Cleaning), Fluoride Treatment, and Implant Services are covered, with some limitations on the number of visits and periodicity. Orthodontic services have a maximum benefit of $3,000 per year, while Maxillofacial Prosthetics and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Premier Care (HMO-POS I-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetics/Medical Supplies with a 20% coinsurance, while Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered. Diabetic Therapeutic Shoes/Inserts are covered with a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Premier Care (HMO-POS 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 Premier Care (HMO-POS I-SNP) plan, with no copay or 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 Premier Care (HMO-POS 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 by the Premier Care (HMO-POS I-SNP) plan, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. Prior authorization is required, and the plan follows the Medicare-defined cost share for tier 1, with coinsurance details available in the plan's documentation.
Other Services See details
The Premier Care (HMO-POS I-SNP) plan does not cover 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. Over-the-Counter (OTC) Items are covered by the plan.
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