Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Align Kidney Care (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Align Kidney Care (HMO C-SNP) in 2025, please refer to our full plan details page.
Align Kidney Care (HMO C-SNP) is a HMO C-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 Align Kidney Care (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:
Align Kidney Care (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.
Below are a few key facts and commonly-asked questions about Align Kidney Care (HMO C-SNP).
The cost of a Medicare Advantage Plan is made up of four main parts.
For Align Kidney Care (HMO C-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.
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
The Align Kidney Care (HMO C-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. For a 30-day supply, the copays are $15 for preferred generic drugs at a standard pharmacy or mail order, $45 for standard generic drugs, and $95 for preferred brand drugs. Non-preferred drugs have a 25% coinsurance, and specialty tier drugs have no copay. After your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
The Align Kidney Care (HMO C-SNP) plan offers a range of benefits, including coverage for inpatient and outpatient services, ambulance, emergency services, and primary care. Many services, like home health and diagnostic services, have no copay, while others have coinsurance, with rates varying from 0% to 20% depending on the service. This plan also includes coverage for hearing, vision, and dental services, and additional benefits such as medical equipment and dialysis services.
Inpatient Hospital benefits, including acute and psychiatric care, are covered under the Align Kidney Care (HMO C-SNP) plan. However, additional days, non-Medicare covered stays, and upgrades for both acute and psychiatric care are not covered.
Outpatient Services include coverage for outpatient hospital services with 20% coinsurance, and observation services with a $100 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services are covered, with a minimum and maximum coinsurance of 20%. Outpatient blood services are not covered.
Partial Hospitalization is covered by the Align Kidney Care (HMO C-SNP) plan, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services are covered by the Align Kidney Care (HMO C-SNP) plan. Ground and air ambulance services have a 20% coinsurance, and transportation services to any health-related location are covered.
Emergency Services are covered by the Align Kidney Care (HMO C-SNP) plan with a $90 copay and no coinsurance, while Urgently Needed Services have a $25 copay and no coinsurance. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
The Align Kidney Care (HMO C-SNP) plan covers Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Chiropractic Services are covered with 20% coinsurance, and Routine Chiropractic Care is not covered. Individual and Group Sessions for Mental Health Specialty Services have a 20% coinsurance. Podiatry services, including Routine Foot Care, have a 20% coinsurance. Other Health Care Professional and Psychiatric Services have a 20% coinsurance. Physical Therapy and Speech-Language Pathology Services have a 20% coinsurance. Additional Telehealth Benefits have between 0% and 20% coinsurance.
The Align Kidney Care (HMO C-SNP) plan covers preventive services, with the exception of annual physical exams, health education, in-home safety assessments, Personal Emergency Response Systems (PERS), Medical Nutrition Therapy (MNT), 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 benefit, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, fitness benefit, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services. Some services, such as Glaucoma screenings, are covered.
Hearing Services include hearing exams with a coinsurance of at most 20% and routine hearing exams and fitting/evaluation for hearing aids with one visit every two years. Prescription hearing aids are covered up to a maximum of $2,000 every two years, but inner ear, outer ear, and over the ear hearing aids are not covered. OTC hearing aids are also covered.
Vision services are covered, including routine eye exams and eyewear. Eye exams have a 20% coinsurance, while eyewear, including contact lenses, also has a 20% coinsurance with a combined maximum plan benefit of $150 per year.
The Align Kidney Care (HMO C-SNP) plan covers dental services, with a 20% coinsurance for Medicare dental services, and other dental services are covered as well. Oral exams and prophylaxis (cleaning) are limited to 2 visits per year, while fluoride treatment is limited to 1 visit every six months. Orthodontic services have a maximum benefit of $2000 per year, and implant services are unlimited. Maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required.
Dialysis Services are covered by the Align Kidney Care (HMO C-SNP) plan with a coinsurance of 20%.
Medical equipment, including durable medical equipment (DME), prosthetics, and diabetic therapeutic shoes/inserts, is covered. DME has a 20% coinsurance and requires authorization, while durable medical equipment for use outside the home, diabetic supplies, and Medicare-covered diabetic supplies are not covered.
Diagnostic and Radiological Services are covered by Align Kidney Care (HMO C-SNP). Diagnostic Procedures/Tests, Diagnostic Radiological Services, and Therapeutic Radiological Services have a coinsurance of at most 20%, and there is no copay. Lab Services and Outpatient X-Ray Services are not covered.
Home Health Services are covered by Align Kidney Care (HMO C-SNP) with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services are covered, but the plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. Prior authorization is required, and there is coinsurance for some services.
Skilled Nursing Facility (SNF) services are covered by Align Kidney Care (HMO C-SNP), but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. The cost sharing information for coinsurance is available in the plan details.
Other Services include coverage for Over-the-Counter (OTC) Items and a Meal Benefit, but acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered. The plan offers OTC items as a supplemental benefit, including Nicotine Replacement Therapy (NRT), but does not cover Naloxone.
SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
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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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