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Premier Care (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Premier 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 Premier Care (HMO I-SNP) in 2025, please refer to our full plan details page.
Premier 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 Premier 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:
Premier 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 Premier 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 Premier Care (HMO I-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.
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 $400.00 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 $3500.00 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 Premier Care (HMO I-SNP) plan has a $400 deductible for prescription drugs. After you meet your deductible, your cost will vary depending on the drug tier and the pharmacy you use. In the initial coverage phase, you will pay a copay for each prescription. For example, you will pay a $10 copay for preferred generic drugs at a standard pharmacy. Non-preferred drugs have a 25% coinsurance. After your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The Premier Care (HMO I-SNP) plan offers comprehensive coverage including inpatient hospital stays with a $200 copay for the first 6 days, and no copay thereafter. Outpatient services have varying copays and coinsurance, and emergency services have a $90 copay. The plan also covers a wide range of primary care services, hearing, vision, and dental services with varying cost-sharing, and home health services at no cost. Additional benefits include ambulance and transportation services, along with medical equipment, diagnostic services, and home infusion. The plan also provides coverage for dialysis services, skilled nursing facility stays, and offers acupuncture. However, some services such as cardiac rehabilitation, certain outpatient services, and additional hours of care, are not covered.
Inpatient Hospital See details
Inpatient hospital stays are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a $200 copay for days 1-6, and no copay for days 7-90; for Inpatient Hospital Psychiatric, you will pay a $200 copay for days 1-6, and no copay for days 7-90.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay of $0-$225, Observation Services with a $100 copay, Ambulatory Surgical Center (ASC) Services with 20% coinsurance, Individual and Group Sessions for Outpatient Substance Abuse with a $30 copay, and Outpatient Blood Services are not covered. Prior authorization is required for many of these services.
Partial Hospitalization See details
Partial Hospitalization is covered by the Premier Care (HMO I-SNP) plan, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Premier Care (HMO I-SNP), with a $250 copay for ground ambulance services and 20% coinsurance for air ambulance services. Transportation Services to any health-related location are covered for up to 24 one-way trips per year. Transportation Services to plan-approved health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Premier Care (HMO I-SNP) plan. Emergency Services have a $90 copay and no coinsurance, while Urgently Needed Services have a $40 copay and no coinsurance. Worldwide Emergency Services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, are not covered.
Primary Care See details
The Premier Care (HMO I-SNP) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Chiropractic services have a 20% coinsurance, and routine chiropractic care has a $30 copay. Physician specialist services have a copay between $0 and $10, and individual mental health sessions have a $20 copay, while group sessions have a $10 copay. Routine foot care has a 20% coinsurance, and individual and group psychiatric sessions have a 20% coinsurance. Additional telehealth benefits have a copay between $0 and $20.
Preventive Services See details
The Premier Care (HMO I-SNP) plan covers a variety of preventive services, including Medicare-covered preventive services, kidney disease education services, and other preventive services like glaucoma screening and diabetes self-management training. However, annual physical exams, health education, in-home safety assessments, 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, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
Hearing Services includes coverage for hearing exams with a coinsurance of at most 20%, and also covers routine hearing exams and fitting/evaluation for hearing aids once per year. Prescription hearing aids are covered, but not for inner ear, outer ear, or over the ear hearing aids, and OTC hearing aids are also covered.
Vision Services See details
Vision Services include coverage for eye exams with a 20% coinsurance. Eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, are covered with a 20% coinsurance, and a combined maximum benefit of $130.00 every month.
Dental Services See details
The Premier Care (HMO I-SNP) plan covers dental services with 20% coinsurance for Medicare dental services, and other dental services are covered up to a maximum of $1500 per year. Oral exams, dental x-rays, cleaning, and fluoride treatments are covered, but each have visit limits and varied periodicity. Implant services are covered. Maxillofacial Prosthetics and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for this benefit.
Dialysis Services See details
Dialysis Services are covered by the Premier Care (HMO I-SNP) plan. The coinsurance for this benefit is 20%.
Medical Equipment See details
Medical Equipment is covered by Premier Care (HMO I-SNP), with Durable Medical Equipment (DME) subject to 20% coinsurance and requiring authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetics and Medical Supplies are covered with a 20% coinsurance for Medicare-covered devices and supplies. Diabetic Equipment is covered, but Diabetic Supplies are not covered, while Diabetic Therapeutic Shoes/Inserts are covered with 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests, Diagnostic Radiological Services, and Therapeutic Radiological Services have a coinsurance of at most 20%, while Lab Services and Outpatient X-Ray Services are not covered.
Home Health Services See details
Home Health Services are covered by the Premier Care (HMO I-SNP) plan with no copay and no coinsurance, but prior authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Premier Care (HMO I-SNP) plan, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Premier Care (HMO I-SNP) plan and require prior authorization. You will pay the Medicare-defined cost share for tier 1, and additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The "Other Services" benefit covers acupuncture with a $30 copay, and Over-the-Counter (OTC) Items. 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 are not covered.
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