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Prominence Diabetes and Heart Giveback (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Prominence Diabetes and Heart Giveback (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Prominence Diabetes and Heart Giveback (HMO C-SNP) in 2026, please refer to our full plan details page.
Prominence Diabetes and Heart Giveback (HMO C-SNP) is a HMO C-SNP plan offered by Universal Health Services, Inc. available for enrollment in 2026 to people living in Palm Beach County. The overall rating for this plan is not yet available for 2026.
It's important to know that Prominence Diabetes and Heart Giveback (HMO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Prominence Diabetes and Heart Giveback (HMO 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 Prominence Diabetes and Heart Giveback (HMO 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 Prominence Diabetes and Heart Giveback (HMO 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 $155.00. 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 a $150.00 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 $2000.00 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 Prominence Diabetes and Heart Giveback (HMO C-SNP) plan features an annual drug deductible of $150. Under this plan, you will pay no copay for Tier 1 preferred generic, Tier 2 generic, and Tier 6 select care drugs filled at standard pharmacies or through standard three-month mail order. This ensures that many of your essential everyday medications are available at no cost to you. For brand-name and specialty drugs, standard pharmacy copays for Tier 3 preferred brands start at $47 for a one-month supply, while Tier 4 non-preferred drugs start at a $97 copay. Tier 5 specialty drugs require a 31% coinsurance for a one-month standard pharmacy supply. Three-month standard mail order options are also available for Tier 3 and Tier 4 drugs, costing $141 and $281 respectively.
Additional Benefits
The Prominence Diabetes and Heart Giveback (HMO C-SNP) plan offers affordable medical coverage, featuring no copays for primary care visits, preventive services, and outpatient hospital care. Specialist visits require no copay to a $10 copay, while inpatient hospital stays have a $100 daily copay for the first five days and no copay for days six through 90. Emergency room visits carry a $150 copay that is waived if admitted, while urgently needed services require no copay. For extra health needs, the plan provides dental coverage with no copays and a $4,000 annual maximum, alongside a $300 yearly allowance for eyewear. Members also receive routine hearing exams with no copay, up to 24 one-way transportation trips per year to approved locations, and a $125 over-the-counter allowance every three months. Durable medical equipment and home health services are also fully covered with no copays or coinsurance.
Inpatient Hospital See details
Prominence Diabetes and Heart Giveback (HMO C-SNP) covers inpatient acute hospital stays with no coinsurance and a daily copay of $100 for days 1 through 5, and no copay for days 6 through 90. Inpatient psychiatric care is covered with no copay and no coinsurance, though the benefit is partially covered as upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
Prominence Diabetes and Heart Giveback (HMO C-SNP) covers outpatient services, including outpatient hospital, ambulatory surgical center, and blood services, with no copay and no coinsurance. Some outpatient substance abuse services are covered, but individual and group sessions are not covered.
Partial Hospitalization See details
Partial hospitalization services are covered by the Prominence Diabetes and Heart Giveback (HMO C-SNP) with no copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Prominence Diabetes and Heart Giveback (HMO C-SNP) covers ground and air ambulance services with a $175 copay and no coinsurance, which is waived if you are admitted to the hospital. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved locations with no copay and no coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Prominence Diabetes and Heart Giveback (HMO C-SNP) covers emergency services with a $150 copay (waived if admitted within three days) and no coinsurance, alongside urgently needed services with no copay or coinsurance. Worldwide emergency services are partially covered up to a $25,000 maximum with no coinsurance, featuring a $150 copay for emergency care and a $30 copay for urgent care, though worldwide emergency transportation is not covered.
Primary Care See details
Prominence Diabetes and Heart Giveback (HMO C-SNP) covers primary care, therapy, podiatry, telehealth, and opioid treatment with no copay and no coinsurance. Specialist visits have a $0 to $10 copay and no coinsurance, while chiropractic care is partially covered with a $10 copay and no coinsurance for routine care, excluding other chiropractic services. Some psychiatric and mental health specialty services are covered with no copay and no coinsurance, but individual and group sessions are not covered.
Preventive Services See details
Preventive services are covered by the Prominence Diabetes and Heart Giveback (HMO C-SNP) with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management training. Additional preventive benefits are partially covered with no copay or coinsurance (prior authorization required), though several sub-services such as health education, medical nutrition therapy, weight management programs, and personal emergency response systems are not covered.
Hearing Services See details
Prominence Diabetes and Heart Giveback (HMO C-SNP) partially covers hearing services, offering one routine hearing exam and fitting evaluation per year with no copay and no coinsurance. Prescription hearing aids are covered with no coinsurance and a copay between $0 and $1,725 up to a $600 annual maximum per ear, while inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision Services are partially covered by the Prominence Diabetes and Heart Giveback (HMO C-SNP) with no copay, no coinsurance, and no deductible, though other eye exam services are not covered. Covered benefits include one routine eye exam per year and a $300 annual maximum allowance for eyewear, which covers one pair of contact lenses or eyeglasses (including frames, lenses, and upgrades) every year.
Dental Services See details
Dental services are partially covered by the Prominence Diabetes and Heart Giveback (HMO C-SNP) plan, featuring no copays and a $4,000 annual maximum benefit. Preventive care has no coinsurance, while covered comprehensive services carry a 0% to 50% coinsurance; however, implants, orthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Prominence Diabetes and Heart Giveback (HMO C-SNP) with no copay and no coinsurance, subject to prior authorization. Related Medicare Part B chemotherapy and other drugs have no copay and no coinsurance to 20% coinsurance, while Part B insulin requires a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Prominence Diabetes and Heart Giveback (HMO C-SNP) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Prominence Diabetes and Heart Giveback (HMO C-SNP) covers Durable Medical Equipment (DME) with no copay and no coinsurance, though prior authorization is required. While some prosthetics, medical supplies, and diabetic equipment services are covered with no copay and no coinsurance, specific items including prosthetic devices, medical supplies, diabetic supplies, and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Prominence Diabetes and Heart Giveback (HMO C-SNP) partially covers Diagnostic and Radiological Services with no coinsurance, requiring prior authorization for these services. While diagnostic services have no copay, diagnostic radiological services require a $25 copay and therapeutic radiological services require a $20 copay, with diagnostic procedures, lab services, and outpatient X-ray services not covered.
Home Health Services See details
Home Health Services are covered by the Prominence Diabetes and Heart Giveback (HMO C-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Prominence Diabetes and Heart Giveback (HMO C-SNP) plan, as none of the individual rehabilitation sub-services are covered in practice.
Skilled Nursing Facility (SNF) See details
Prominence Diabetes and Heart Giveback (HMO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Prominence Diabetes and Heart Giveback (HMO C-SNP) offers partial coverage for other services, featuring meal benefits for chronic illnesses (prior authorization required) and over-the-counter (OTC) items up to $125 every three months with no copay and no coinsurance. Acupuncture, Naloxone OTC coverage, and other miscellaneous services are not covered.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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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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