Senior Care Plus Enriched Duals Plan (HMO D-SNP)

HOMETOWN HEALTH PLAN, INC. · 2026 plan year

Plan ID H2960-026-000

HMO★ 5 CMS StarsDual-Eligible SNP

MOOP (in-network): $8,300
MOOP (combined): —
Monthly premium: $9.50/mo; Part C $0 + Part D $9.50, before Extra Help
Prescription drugs: Included

Plan information

Contract / Plan / Segment: H2960-026-000
Medical deductible: $0 — no deductible
Part D premium: $9.50/mo (part of the monthly premium above)Before Extra Help, which can lower or remove it for people with limited income.
Part D deductible: $615/yr
Also owed: Your Medicare Part B premium, paid separately

More HOMETOWN HEALTH PLAN, INC. plans in NV

Senior Care Plus Patriot Plan (HMO)Senior Care Plus Essential plan (HMO)Senior Care Plus Select Plan (HMO)Senior Care Plus Extensive Duals Plan (HMO D-SNP)Senior Care Plus: Value Group Plan (HMO)

Benefits & cost sharing

Hospital

Benefit	In-network
Inpatient Hospital — Acute	8% for days 1–6, 0% after
Inpatient Hospital — Additional Days (Acute)	No charge
Inpatient Hospital — Psychiatric	10% for days 1–6, 0% after
Inpatient Hospital — Additional Days (Psychiatric)	No charge
Worldwide Urgent Care Coverage	17% coinsurance

Pharmacy

Benefit	In-network
Part B Drugs	See plan details
Chemotherapy & Radiation Drugs (Part B)	0%-17% coinsurance
Other Part B Drugs	0%-17% coinsurance

Mental Health

Benefit	In-network
Mental Health Specialty Services	See plan details
Mental Health — Individual Sessions	17% coinsurance
Mental Health — Group Sessions	17% coinsurance
Supplemental Health Benefits	See plan details

Other

Benefit	In-network
Insulin (Part B)	$35
Diabetic Supplies	17% coinsurance
Skilled Nursing Facility (SNF)	0% for days 1–20, 19% for days 21–100
Cardiac & Pulmonary Rehabilitation	See plan details
Cardiac Rehabilitation — Additional Sessions	17% coinsurance
Intensive Cardiac Rehabilitation — Additional Sessions	17% coinsurance
Pulmonary Rehabilitation — Additional Sessions	17% coinsurance
Supervised Exercise Therapy (SET)	17% coinsurance
Emergency Services	17% coinsurance (max $110)
Urgently Needed Services	17% coinsurance (max $40)
Worldwide Emergency & Urgent Coverage	See plan details
Worldwide Emergency Coverage	17% coinsurance
Partial Hospitalization Program	17% coinsurance
Intensive Outpatient Program (IOP)	17% coinsurance
Home Health Services	No charge
Primary Care Physician Services	17% coinsurance
Chiropractic Services	17% coinsurance
Occupational Therapy Services	17% coinsurance
Physician Specialist Services	17% coinsurance
Podiatry Services	17% coinsurance
Other Health Care Professional Services	17% coinsurance
Psychiatric Services	See plan details
Psychiatric Services — Individual Sessions	17% coinsurance
Psychiatric Services — Group Sessions	17% coinsurance
Physical Therapy & Speech-Language Pathology	17% coinsurance
Opioid Treatment Program Services	17% coinsurance
Diagnostic Tests & Lab Services	See plan details
Diagnostic Procedures & Tests	17% coinsurance
Laboratory Services	17% coinsurance
Radiological Services	See plan details
Diagnostic Radiology	17% coinsurance
Therapeutic Radiology	17% coinsurance
X-Ray Services	17% coinsurance
Outpatient Hospital Services	17% coinsurance
Hospital Observation Services	17% coinsurance
Ambulatory Surgical Center (ASC)	17% coinsurance
Outpatient Substance Abuse Services	See plan details
Substance Abuse — Individual Sessions	17% coinsurance
Substance Abuse — Group Sessions	17% coinsurance
Outpatient Blood Services	17% coinsurance
Ambulance Services	See plan details
Ground Ambulance	17% coinsurance
Air Ambulance	17% coinsurance
Non-Emergency Transportation — Health Facility	No charge
Durable Medical Equipment (DME)	17% coinsurance
Prosthetics & Orthotics	See plan details
Prosthetic Devices	17% coinsurance
Medical Supplies	17% coinsurance
Diabetic Supplies & Services	See plan details
Diabetic Therapeutic Shoes & Inserts	17% coinsurance
Dialysis Services	17% coinsurance
Over-the-Counter (OTC) Items	No charge
Meal Benefit	No charge
Medicare-Covered Preventive Services	See plan details
Annual Physical Exam	No charge
Fitness Benefit	No charge
Remote Access Technologies	No charge
Counseling Services	No charge
Personal Emergency Response System (PERS)	No charge
Kidney Disease Education Services	No charge
Glaucoma Screening	17% coinsurance
Diabetes Self-Management Training	17% coinsurance
Digital Rectal Exams	17% coinsurance
Welcome to Medicare EKG	17% coinsurance
Dental — Medicare-Covered Services	17% coinsurance
Dental — Preventive	See plan details
Dental — Oral Exams	No charge
Dental — X-Rays	No charge
Dental — Prophylaxis (Cleaning)	No charge
Dental — Comprehensive	See plan details
Dental — Restorative Services	No charge
Dental — Endodontics (Root Canal)	No charge
Dental — Periodontics (Gum Care)	No charge
Dental — Removable Prosthodontics (Dentures)	No charge
Dental — Oral & Maxillofacial Surgery	No charge
Vision — Eye Exams	17% coinsurance
Vision — Eye Exams	See plan details
Vision — Routine Eye Exams	No charge
Vision — Eyewear	17% coinsurance
Vision — Eyewear	See plan details
Vision — Contact Lenses	No charge
Vision — Eyeglasses (Lenses & Frames)	No charge
Vision — Eyeglass Lenses	No charge
Vision — Eyeglass Frames	No charge
Vision — Eyewear Upgrades	No charge
Hearing — Exams	17% coinsurance
Hearing — Exams	See plan details
Hearing — Routine Exams	No charge
Hearing — Fitting & Evaluation for Hearing Aid	No charge
Hearing — Prescription Hearing Aids	See plan details
Hearing — Hearing Aids (All Types)	$495-$1,970

Service area

NV: 1 county

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