IEHP DualChoice (HMO D-SNP)

IEHP DualChoice (HMO D-SNP) is a HMO D-SNP plan offered by INLAND EMPIRE HEALTH PLAN available for enrollment in 2025 to people living in Riverside and San Bernardino Counties. This plan received an overall rating of 3 out of 5 stars in 2026.

It's important to know that IEHP DualChoice (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about IEHP DualChoice (HMO D-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.

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:

Drug Coverage

IEHP DualChoice (HMO D-SNP) offers an Enhanced Alternative prescription drug benefit with a $615 annual deductible. If you qualify for the low-income subsidy, your cost is reduced to $12. During the initial coverage phase, you will pay a 25% coinsurance for generic and non-preferred drugs, a 30% coinsurance for preferred brands, and no copay for specialty tier drugs at standard pharmacies. After your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase. During this phase, you pay nothing for your covered Medicare Part D prescription drugs.

Additional Benefits

The IEHP DualChoice (HMO D-SNP) plan offers comprehensive coverage where most outpatient services, primary care visits, emergency care, and medical equipment feature no copay and a standard twenty percent coinsurance. Inpatient hospital stays and skilled nursing facility care are subject to Original Medicare-defined deductibles, copays, and coinsurance, and typically require prior authorization. Additionally, many preventive services and home health care visits are available with no copay or coinsurance. For specialty care, the plan provides a three hundred and fifty dollar annual allowance for vision hardware alongside routine eye exams with no copay and a twenty percent coinsurance. While Medicare-covered dental and select hearing services are covered, routine dental procedures, hearing aids, and cardiac rehabilitation are not covered. Beneficiaries also receive an over-the-counter allowance of up to sixty dollars every three months with no copay or coinsurance.