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ATRIO Support Rx (PPO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for ATRIO Support Rx (PPO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on ATRIO Support Rx (PPO C-SNP) in 2025, please refer to our full plan details page.
ATRIO Support Rx (PPO C-SNP) is a PPO C-SNP plan offered by ATRIO Health Plans available for enrollment in 2025 to people living in Marion and Polk. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that ATRIO Support Rx (PPO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
ATRIO Support Rx (PPO 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 ATRIO Support Rx (PPO 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 ATRIO Support Rx (PPO 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. Additionally, this plan comes with a Part B Premium reduction of $20.00. You must continue to pay paying your reduced 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 combined Maximum Out-Of-Pocket cost of $4900.00 (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 $4900.00 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 ATRIO Support Rx (PPO C-SNP) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you'll pay varying copays depending on the drug tier and pharmacy. For example, you'll pay an $8 copay for preferred generic drugs at a standard pharmacy, and a $47 copay for standard generic drugs at a standard pharmacy. After your total drug costs reach $2000, you enter the catastrophic coverage phase where you will pay nothing for your Part D drugs.
Additional Benefits
The ATRIO Support Rx (PPO C-SNP) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services, including observation and ambulatory surgical centers, also have associated copays. Emergency services will cost you a copay, and ambulance services have a copay as well, along with transportation services to a plan-approved location, up to 24 one-way trips per year. This plan covers primary care, including specialist visits, with copays ranging from $0 to $40. Additionally, the plan covers hearing exams and hearing aids with associated copays, along with vision and dental services, and home health services with no cost to you. You can also expect coverage for home infusion, dialysis, medical equipment, and diagnostic services, with associated copays or coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, there is a $375 copay for days 1-5, and no copay for days 6-90; for Inpatient Hospital Psychiatric, there is a $350 copay for days 1-5, and no copay for days 6-90. Additional Days for Inpatient Hospital-Acute are covered with no copay, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered, as are Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital and observation services have a copay of $375, while ambulatory surgical center services have a copay of $225. Individual and group sessions for outpatient substance abuse have a copay between $40 and $40.
Partial Hospitalization See details
Partial Hospitalization is covered under the ATRIO Support Rx (PPO C-SNP) plan. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the ATRIO Support Rx (PPO C-SNP) plan, including both ground and air ambulance services with a $250 copay, and transportation services to a plan-approved health-related location with 24 one-way trips per year. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services, are covered by the ATRIO Support Rx (PPO C-SNP) plan, with a $125 copay for Emergency Services and a $55 copay for Urgently Needed Services, and no coinsurance. Worldwide Emergency Services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, are not covered.
Primary Care See details
The ATRIO Support Rx (PPO C-SNP) plan covers Primary Care Physician Services, Chiropractic Services with a $20 copay, Occupational Therapy Services with a $20 copay, Physician Specialist Services with a $0-$40 copay, Mental Health Specialty Services with a $40 copay, Other Health Care Professional services with a $40 copay, Psychiatric Services with a $40 copay, Physical Therapy and Speech-Language Pathology Services with a $20 copay, Additional Telehealth Benefits, and Opioid Treatment Program Services with a $40 copay. Podiatry Services are not covered.
Preventive Services See details
The ATRIO Support Rx (PPO C-SNP) plan covers preventive services, including annual physical exams, additional preventive services, kidney disease education services, and other preventive services such as glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit. This plan also covers personal emergency response systems, alternative therapies, and fitness benefits, but does not cover health education, in-home safety assessments, medical nutrition therapy, post-discharge in-home medication reconciliation, readmission prevention, wigs for hair loss related to chemotherapy, weight management programs, 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, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, or counseling services.
Hearing Services See details
Hearing services include hearing exams with a $45 copay, and fitting/evaluation for hearing aids. Prescription hearing aids are covered with a copay between $699 and $999 for all types, but not for inner ear, outer ear, or over the ear hearing aids. OTC hearing aids are not covered.
Vision Services See details
Vision services include routine eye exams with a $45 copay, and eyewear benefits. The plan covers contact lenses with a $100 maximum benefit, eyeglasses (lenses and frames) with a $200 maximum benefit, and upgrades with a $200 maximum benefit. Eyeglass lenses and frames are not covered.
Dental Services See details
The ATRIO Support Rx (PPO C-SNP) plan covers a variety of dental services, including oral exams, dental x-rays, other diagnostic dental services, and more, with a maximum benefit of $300 every six months. Additional dental services like orthodontics are also covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay, with coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the ATRIO Support Rx (PPO C-SNP) plan. You will pay 20% coinsurance.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a 0-20% coinsurance and no copay, though Durable Medical Equipment for use outside the home is not covered. Prosthetics and Medical Supplies have no copay, and a 20% coinsurance, while Diabetic Equipment is covered, and Diabetic Supplies and Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services includes coverage for diagnostic procedures and therapeutic radiological services. Diagnostic Procedures/Tests have a maximum copay of $20, while Diagnostic Radiological Services and Therapeutic Radiological Services have a coinsurance of at most 20%. Lab Services and Outpatient X-Ray Services are not covered.
Home Health Services See details
Home Health Services are covered by the ATRIO Support Rx (PPO C-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the ATRIO Support Rx (PPO C-SNP) plan, with a prior authorization requirement. For days 1-20, there is no copay, and for days 21-100, the copay is $150 per day; there is no coinsurance. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The ATRIO Support Rx (PPO C-SNP) plan covers acupuncture with a maximum plan benefit coverage of $200 every six months, and over-the-counter (OTC) items with a maximum plan benefit coverage of $40 every three months. The plan also offers a meal benefit and covers some other services, while many services are not covered.
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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.
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