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Perennial Advantage Strive (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Perennial Advantage Strive (HMO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Perennial Advantage Strive (HMO I-SNP) in 2026, please refer to our full plan details page.
Perennial Advantage Strive (HMO I-SNP) is a HMO I-SNP plan offered by Perennial Consortium, LLC available for enrollment in 2025 to people living in Ohio (partial). This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that Perennial Advantage Strive (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:
Perennial Advantage Strive (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 Perennial Advantage Strive (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 Perennial Advantage Strive (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $31.40. 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 $615.00 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 $9250.00 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 Perennial Advantage Strive (HMO I-SNP) Medicare plan features an annual prescription drug deductible of $615. This means you will need to pay this amount out of pocket for your covered medications before the plan begins to pay its share. Specific drug coverage tier details, including copayments and coinsurance rates for individual formulary tiers, are currently unavailable for this plan. To understand your exact prescription drug costs and find out which medications are covered, it is best to consult the plan's comprehensive formulary list.
Additional Benefits
The Perennial Advantage Strive (HMO I-SNP) plan offers robust medical coverage featuring no copay for primary care, home health, and skilled nursing facility services. Many outpatient services, specialist visits, and durable medical equipment are also available with no copay, though they generally require a twenty percent coinsurance. Emergency room visits carry a ninety dollar copay with no coinsurance, which is waived if you are admitted to the hospital. For extra wellness support, the plan includes up to three thousand dollars in annual dental benefits and up to one thousand seven hundred dollars every two years for hearing aids with no copay. Members also receive twenty-four one-way transportation trips to health-related destinations and covered over-the-counter items with no copay. Routine vision exams and eyewear are also covered, featuring a twenty percent coinsurance for exams and no copay for eyewear up to a three hundred dollar annual limit.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Perennial Advantage Strive (HMO I-SNP), offering acute and psychiatric care with no copay, though Medicare-defined deductibles and coinsurance apply and prior authorization is required. Additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Perennial Advantage Strive (HMO I-SNP) covers outpatient hospital services with no copay and 20% coinsurance, and observation services with a $100 copay per stay. Ambulatory surgical center, outpatient substance abuse, and outpatient blood services are covered with no copay and 20% coinsurance, with prior authorization required for most services.
Partial Hospitalization See details
Partial hospitalization services are covered under the Perennial Advantage Strive (HMO I-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Perennial Advantage Strive (HMO I-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. The plan also covers up to 24 one-way transportation trips per year to any health-related location with no copay and no coinsurance.
Emergency Services See details
Perennial Advantage Strive (HMO I-SNP) covers emergency services with a $90 copay and no coinsurance, and urgently needed services with a 20% coinsurance (up to $40 per visit) and no copay, both of which count toward your deductible and are waived if you are admitted to the hospital within three days. While some worldwide emergency services are covered, worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered in practice.
Primary Care See details
Perennial Advantage Strive (HMO I-SNP) covers primary care physician and opioid treatment services with no copay and no coinsurance. Other services, including specialist visits, physical, occupational, speech, and mental health therapies, are covered with no copay and a 20% coinsurance, though chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by Perennial Advantage Strive (HMO I-SNP) with no copay and no coinsurance for covered services like kidney disease education, glaucoma screenings, and in-home support. However, the plan does not cover the annual physical exam, fitness benefits, health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, caregiver support, smoking cessation, disease management, telemonitoring, remote access, home/bathroom safety, and counseling.
Hearing Services See details
Perennial Advantage Strive (HMO I-SNP) hearing services are covered with no copay for exams and hearing aids, though routine exams require a 20% coinsurance with no deductible. Prescription hearing aids are partially covered up to $1,700 every two years with no copay or coinsurance, but inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Perennial Advantage Strive (HMO I-SNP), featuring one routine eye exam per year with no copay and a 20% coinsurance, while other eye exam services are not covered. Covered eyewear options like contacts, lenses, and frames have no copay, a 20% coinsurance for contact lenses, and an annual combined maximum benefit of $300.
Dental Services See details
Dental services are partially covered by Perennial Advantage Strive (HMO I-SNP), offering up to a $3,000 annual maximum with no copay and no coinsurance for most preventive and comprehensive services. Medicare-covered dental services require a 20% coinsurance with no copay, while other preventive dental services, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Perennial Advantage Strive (HMO I-SNP) with no copay, though prior authorization is required. Medicare Part B chemotherapy and other infusion drugs require no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Perennial Advantage Strive (HMO I-SNP) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Perennial Advantage Strive (HMO I-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copay and a 20% coinsurance. Prior authorization is required for durable medical equipment and prosthetics or medical supplies.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by Perennial Advantage Strive (HMO I-SNP), requiring prior authorization and featuring no copay alongside a 20% coinsurance for covered services. While diagnostic procedures, diagnostic radiological services, and therapeutic radiological services are covered under this plan, lab services and outpatient x-ray services are not covered.
Home Health Services See details
Home health services are covered by Perennial Advantage Strive (HMO I-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Perennial Advantage Strive (HMO I-SNP) with no copay and no coinsurance, though prior authorization is required. While some services are covered, specific sub-services including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered in practice and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by Perennial Advantage Strive (HMO I-SNP) with no copay and no coinsurance, but prior authorization is required. Standard Medicare-covered days do not require a prior three-day inpatient hospital stay, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Perennial Advantage Strive (HMO I-SNP) partially covers other services, offering over-the-counter (OTC) items with no copay and no coinsurance, including nicotine replacement therapy. Acupuncture, meal benefits, and naloxone coverage are not covered under this benefit.
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