Optimum Diamond Savings (HMO C-SNP)

OPTIMUM HEALTHCARE, INC. · 2027 plan year

Plan ID H5594-030-000

HMO★ 4.5 CMS StarsChronic or Disabling Condition SNP
MOOP (in-network)
$5,000
MOOP (combined)
—
Monthly premium
$0/mo
Part C $0 + Part D $0
Prescription drugs
Included

This plan in 2026

Plan information

Contract / Plan / Segment
H5594-030-000
Medical deductible
$0 — no deductible
Part D premium
$0/mo (part of the monthly premium above)
Part D deductible
$0/yr
Also owed
Your Medicare Part B premium, paid separately

More OPTIMUM HEALTHCARE, INC. plans in FL

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — Acute$195/day for days 1–7, $0 after
Inpatient Hospital — Psychiatric$195/day for days 1–7, $0 after
Worldwide Urgent Care Coverage$500

Pharmacy

BenefitIn-network
Chemotherapy & Radiation Drugs (Part B)0%-20% coinsurance
Other Part B Drugs0%-20% coinsurance
Part B DrugsSee plan details

Mental Health

BenefitIn-network
Mental Health Specialty ServicesSee plan details
Mental Health — Individual Sessions$30
Mental Health — Group Sessions$30
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Diabetic Therapeutic Shoes & InsertsNo charge
X-Ray Services$0-$195
Primary Care Physician ServicesNo charge
Diabetic SuppliesNo charge
Skilled Nursing Facility (SNF)$0/day for days 1–20, $218/day for days 21–100
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional Sessions$30
Intensive Cardiac Rehabilitation — Additional Sessions$30
Pulmonary Rehabilitation — Additional Sessions$15
Supervised Exercise Therapy (SET)$25
Emergency Services$130
Urgently Needed Services$10
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$500
Worldwide Emergency Transportation$500
Partial Hospitalization Program$55
Intensive Outpatient Program (IOP)$55
Home Health ServicesNo charge
Chiropractic Services$15
Occupational Therapy Services$30
Physician Specialist Services$30
Podiatry Services$30
Other Health Care Professional Services$0-$30
Psychiatric ServicesSee plan details
Psychiatric Services — Individual Sessions$30
Psychiatric Services — Group Sessions$30
Physical Therapy & Speech-Language Pathology$30
Opioid Treatment Program Services$0-$30
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & Tests$0-$195 copay + 20% coinsurance
Laboratory Services$0-$50
Radiological ServicesSee plan details
Diagnostic Radiology$25-$195
Therapeutic Radiology20% coinsurance
Outpatient Hospital Services$195
Hospital Observation Services$195 per stay
Ambulatory Surgical Center (ASC)$25
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$30-$195
Substance Abuse — Group Sessions$30-$195
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground Ambulance$200
Air Ambulance20% coinsurance
Non-Emergency Transportation — Health FacilityNo charge
Durable Medical Equipment (DME)20% coinsurance
Prosthetics & OrthoticsSee plan details
Prosthetic Devices20% coinsurance
Medical Supplies20% coinsurance
Diabetic Supplies & ServicesSee plan details
Dialysis Services20% coinsurance
Over-the-Counter (OTC) ItemsNo charge
Meal BenefitNo charge
Medicare-Covered Preventive ServicesSee plan details
Fitness BenefitNo charge
Remote Access TechnologiesNo charge
Kidney Disease Education ServicesNo charge
Glaucoma ScreeningNo charge
Diabetes Self-Management TrainingNo charge
Digital Rectal ExamsNo charge
Welcome to Medicare EKGNo charge
Insulin (Part B)$35
Dental — Medicare-Covered ServicesNo charge
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge
Dental — Prophylaxis (Cleaning)No charge
Dental — Fluoride TreatmentNo charge
Dental — ComprehensiveSee plan details
Dental — Restorative ServicesNo charge
Dental — Periodontics (Gum Care)No charge
Dental — Oral & Maxillofacial SurgeryNo charge
Vision — Eye ExamsNo charge
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — EyewearNo charge
Vision — EyewearSee plan details
Vision — Contact Lenses$10
Vision — Eyeglasses (Lenses & Frames)$10
Vision — Eyewear Upgrades$30
Hearing — ExamsNo charge
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge
Hearing — Fitting & Evaluation for Hearing AidNo charge
Hearing — Prescription Hearing AidsSee plan details
Hearing — Hearing Aids (All Types)No charge
Diabetic Monitors20% coinsurance

Service area

  • FL: 18 counties

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