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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 2026, 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 2 out of 5 stars in 2026.
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) Medicare plan features a $0 drug deductible, meaning your prescription drug coverage begins immediately. Under this plan, you will pay no copay for Tier 1 preferred generic and Tier 6 select care drugs at standard pharmacies or through standard mail order. Generic drugs in Tier 2 are also highly affordable, requiring just an $8 copay for a 1-month supply or a $16 copay for a 3-month supply. For higher-tier medications, Tier 3 preferred brands carry a $47 copay for a 1-month supply, while Tier 4 non-preferred drugs require a $100 copay. Ordering a 3-month supply of these drugs through standard pharmacy or standard mail order options costs $94 for Tier 3 and $200 for Tier 4. Specialty medications in Tier 5 are subject to a 33% coinsurance for a 1-month supply at standard pharmacies.
Additional Benefits
The ATRIO Support Rx (PPO C-SNP) plan offers comprehensive medical coverage with no copay or coinsurance for primary care visits, preventive services, and home health care. For inpatient hospital stays, members pay a daily copay of $375 for the first five days and no copay for additional days, while emergency room visits carry a $125 copay. Specialist visits feature low copays ranging from no copay to $40 with no coinsurance, making routine medical management highly affordable. This plan also includes valuable supplemental benefits, such as dental care with no copay up to a $300 limit every six months and no-copay eyewear coverage up to annual limits. Routine hearing and eye exams require a $45 copay, while up to 24 one-way transportation trips and a $40 quarterly over-the-counter allowance are provided with no copay. Skilled nursing facility stays are also covered with no copay for the first 20 days, ensuring robust support for recovery.
Inpatient Hospital See details
ATRIO Support Rx (PPO C-SNP) covers inpatient hospital services with no coinsurance, requiring prior authorization. For acute care, there is a $375 daily copay for days 1 to 5 and no copay for additional days, while psychiatric stays require a $350 daily copay for days 1 to 5 and no copay for days 6 to 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
ATRIO Support Rx (PPO C-SNP) covers outpatient hospital and observation services with a $375 copay and no coinsurance, and ambulatory surgical center services with a $225 copay and no coinsurance. Outpatient substance abuse services have a $40 copay per session with no coinsurance, while outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by ATRIO Support Rx (PPO C-SNP) with a $55 copay and no coinsurance.
Ambulance and Transportation Services See details
ATRIO Support Rx (PPO C-SNP) covers ground and air ambulance services with a $250 copay and no coinsurance. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved health-related locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency services under the ATRIO Support Rx (PPO C-SNP) are covered with a $125 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $50 copay and no coinsurance, though worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
ATRIO Support Rx (PPO C-SNP) covers primary care visits with no copay and no coinsurance, and specialist services with a $0 to $40 copay and no coinsurance. Chiropractic care is partially covered, offering routine services for a $15 copay and no coinsurance (other chiropractic services are not covered), while podiatry is not covered. Therapy services require a $20 copay and no coinsurance, and psychiatric, mental health, and opioid treatments carry a $40 copay and no coinsurance.
Preventive Services See details
Preventive services are covered by ATRIO Support Rx (PPO C-SNP) with no copay and no coinsurance, including annual physical exams, kidney disease education, and routine screenings. Additional preventive services are partially covered with no copay and no coinsurance (prior authorization required) for memory fitness, alternative therapies, and personal emergency response systems, while sub-services such as health education, weight management, nutritional benefits, in-home safety assessments, and counseling are not covered.
Hearing Services See details
ATRIO Support Rx (PPO C-SNP) covers hearing exams with a $45 copay and no coinsurance, and prescription hearing aids with a copay between $699 and $999 and no coinsurance. Hearing services are partially covered, as OTC hearing aids and prescription inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
ATRIO Support Rx (PPO C-SNP) offers partially covered vision services with no deductibles, featuring routine eye exams for a $45 copay and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance, providing up to $100 annually for contact lenses and $200 for eyeglasses (lenses and frames), while separate eyeglass lenses and frames are not covered.
Dental Services See details
Dental services are covered by ATRIO Support Rx (PPO C-SNP) with no copay and no coinsurance for preventive, diagnostic, restorative, surgical, and orthodontic care. This benefit has a maximum coverage limit of $300 every six months, which applies to both in-network and out-of-network services.
Home Infusion bundled Services See details
ATRIO Support Rx (PPO C-SNP) covers home infusion bundled services with no copay, although prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs require from no coinsurance up to 20% coinsurance, while Part B insulin is covered with a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the ATRIO Support Rx (PPO C-SNP) plan with no copay and a 20% coinsurance.
Medical Equipment See details
ATRIO Support Rx (PPO C-SNP) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance, subject to prior authorization. Diabetic equipment is partially covered with no copay and no coinsurance, though diabetic supplies and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by ATRIO Support Rx (PPO C-SNP), as lab services and outpatient X-ray services are not covered. Covered diagnostic procedures and tests require no coinsurance with a copay ranging from $0 to $20, while therapeutic radiological services require a copay and 20% coinsurance, with prior authorization required for all services.
Home Health Services See details
Home Health Services are covered under the ATRIO Support Rx (PPO C-SNP) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered with no coinsurance under the ATRIO Support Rx (PPO C-SNP) plan, though in practice only some services are covered as standard cardiac, intensive cardiac, pulmonary, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
ATRIO Support Rx (PPO C-SNP) covers skilled nursing facility (SNF) services with no coinsurance, requiring prior authorization and no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, a $150 daily copay for days 21 through 100, and additional days beyond the standard Medicare-covered period are not covered.
Other Services See details
Other services are partially covered by ATRIO Support Rx (PPO C-SNP) with no copay and no coinsurance, which includes unlimited acupuncture, an annual wellness exam, and meal benefits. Over-the-counter (OTC) items are also covered up to $40 every three months with no copay and no coinsurance, excluding nicotine replacement therapy and naloxone.
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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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