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Senior Care (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Senior Care (HMO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Senior Care (HMO I-SNP) in 2025, please refer to our full plan details page.
Senior Care (HMO I-SNP) is a HMO I-SNP plan offered by Curana Health Holdings, LLC available for enrollment in 2025 to people living in Florida (partial). The overall rating for this plan is not yet available for 2025.
It's important to know that Senior Care (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:
Senior Care (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 Senior Care (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 Senior Care (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $20.30. 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 $590.00 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 $9350.00 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 Senior Care (HMO I-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and the pharmacy you use. The plan offers an enhanced alternative drug benefit. For example, for preferred generic drugs at a standard pharmacy, you will pay a $15 copay. Once your total yearly drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Senior Care (HMO I-SNP) plan offers a range of benefits with varying cost-sharing. Many services have a coinsurance of 20%, including outpatient services, ambulance services, and dental services. The plan also offers some services with no copay, such as primary care physical therapy, and home health services. Emergency services have a $90 copay, and urgently needed services have a $45 copay. Hearing and vision services are included, with a coinsurance for exams and eyewear. The plan covers prescription hearing aids up to a certain amount annually and offers coverage for various dental services, with a $3,000 annual maximum.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both of which require prior authorization and follow the cost sharing of Original Medicare; however, additional days, non-Medicare covered stays, and upgrades for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with 20% coinsurance, Observation Services with a $100 copay, Ambulatory Surgical Center (ASC) Services with 20% coinsurance, and Outpatient Substance Abuse Services with 20% coinsurance for individual and group sessions. Outpatient Blood Services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the Senior Care (HMO I-SNP) plan. You will pay 20% coinsurance for this benefit, and prior authorization is required.
Ambulance and Transportation Services See details
The Senior Care (HMO I-SNP) plan covers all ambulance services with a 20% coinsurance for both ground and air ambulance services, with no copay. Transportation Services - Any Health-related Location benefits are covered for up to 24 one-way trips per year, utilizing rideshare services, bus/subway, medical transport, and other modes of transportation. Transportation Services - Plan Approved Health-related Location is not covered.
Emergency Services See details
Emergency Services, including urgently needed services, are covered under the Senior Care (HMO I-SNP) plan. For emergency services, there is a $90 copay and no coinsurance. Urgently needed services have a $45 copay and no coinsurance. Worldwide emergency services, urgent coverage, and emergency transportation are not covered.
Primary Care See details
Under the Senior Care (HMO I-SNP) plan, primary care includes coverage for Primary Care Physician Services, Chiropractic Services with 20% coinsurance, Occupational Therapy Services with no copay or coinsurance, Physician Specialist Services with no copay and 0-20% coinsurance, Mental Health Specialty Services with 20% coinsurance, Podiatry Services with 20% coinsurance, Other Health Care Professional with 20% coinsurance, Psychiatric Services with 20% coinsurance, Physical Therapy and Speech-Language Pathology Services with no copay or coinsurance, Additional Telehealth Benefits with no copay and 20% coinsurance, and Opioid Treatment Program Services. Routine Chiropractic Care is not covered.
Preventive Services See details
The Senior Care (HMO I-SNP) plan covers preventive services, including glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit, but does not cover annual physical exams, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, fitness benefits, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, or counseling services. In-Home Support Services are covered.
Hearing Services See details
Hearing services include routine hearing exams with a 20% coinsurance, and fitting/evaluation for hearing aids. Prescription hearing aids (all types) are covered, and OTC hearing aids are covered. Prescription hearing aids are limited to a plan-specified amount of $1560.00 every year, and the plan does not cover prescription hearing aids for the inner or outer ear.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have a 20% coinsurance, and routine eye exams are covered once per year. Eyewear also has a 20% coinsurance, and the plan covers contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, with a combined maximum benefit of $300 per year for all eyewear.
Dental Services See details
Dental services include coverage for Medicare dental services with 20% coinsurance, along with other dental services with a $3,000 annual maximum. Specific services covered include oral exams (2 per year), dental x-rays (2 per year), other diagnostic dental services, prophylaxis (cleaning) (2 per year), fluoride treatment (1 every six months), implant services, and various other services with limited visits. Orthodontics are not covered and Maxillofacial Prosthetics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay, with a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Senior Care (HMO I-SNP) plan, with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance, while Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered. Diabetic Therapeutic Shoes/Inserts are covered with 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with no copay for any services. Diagnostic Procedures/Tests, Diagnostic Radiological Services, and Therapeutic Radiological Services have a coinsurance of at most 20%, but Lab Services and Outpatient X-Ray Services are not covered.
Home Health Services See details
Home Health Services are covered by the Senior Care (HMO I-SNP) plan with no copay or coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Senior Care (HMO I-SNP) plan. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Senior Care (HMO I-SNP) plan, but require prior authorization. There is no information about the copay, but coinsurance information is available. Additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items, but does not cover Acupuncture, Meal Benefit, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services. This plan offers Nicotine Replacement Therapy (NRT) as a Part C OTC benefit.
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