HealthSpring Premier (HMO-POS)

BRAVO HEALTH PENNSYLVANIA, INC. · 2026 plan year

Plan ID H9725-018-000

HMOPOS★ 4 CMS StarsNew for 2026
MOOP (in-network)
$3,850
MOOP (combined)
—
Monthly premium
$22/mo
Part C $0 + Part D $22, before Extra Help
Prescription drugs
Included

This plan in 2027

Plan information

Contract / Plan / Segment
H9725-018-000
Medical deductible
$0 — no deductible
Part D premium
$22/mo (part of the monthly premium above)Before Extra Help, which can lower or remove it for people with limited income.
Part D deductible
$250/yr
Also owed
Your Medicare Part B premium, paid separately

More BRAVO HEALTH PENNSYLVANIA, INC. plans in VA

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — Acute$295/day for days 1–6, $0 after
Inpatient Hospital — Psychiatric$295/day for days 1–6, $0 after
Worldwide Urgent Care Coverage$150

Pharmacy

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

Mental Health

BenefitIn-network
Mental Health Specialty ServicesSee plan details
Mental Health — Individual Sessions$25
Mental Health — Group Sessions$25
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Cardiac & Pulmonary RehabilitationSee plan details
Medicare-Covered Preventive ServicesSee plan details
Dental — ComprehensiveSee plan details
Vision — EyewearSee plan details
Vision — Contact LensesNo charge
Vision — Eyeglasses (Lenses & Frames)No charge
Diabetic SuppliesNo charge
Skilled Nursing Facility (SNF)$20/day for days 1–20, $218/day for days 21–100
Cardiac Rehabilitation — Additional Sessions$50
Intensive Cardiac Rehabilitation — Additional Sessions$65
Pulmonary Rehabilitation — Additional Sessions$40
Supervised Exercise Therapy (SET)$30
Emergency Services$150
Urgently Needed Services$50
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$150
Worldwide Emergency Transportation$150
Partial Hospitalization Program$175
Intensive Outpatient Program (IOP)$175
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic Services$20
Occupational Therapy Services$25
Physician Specialist Services$25
Podiatry Services$25
Other Health Care Professional Services$0-$25
Psychiatric ServicesSee plan details
Psychiatric Services — Individual Sessions$25
Psychiatric Services — Group Sessions$25
Physical Therapy & Speech-Language Pathology$25
Additional Telehealth Services (Part B)$0-$25
Opioid Treatment Program Services$25
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & Tests$0-$150
Laboratory Services$0-$50
Radiological ServicesSee plan details
Diagnostic Radiology$0-$200
Therapeutic Radiology$85
X-Ray Services$0-$50
Outpatient Hospital Services$0-$295
Hospital Observation Services$295 per stay
Ambulatory Surgical Center (ASC)$0-$275
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$25
Substance Abuse — Group Sessions$25
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground Ambulance$245
Air Ambulance20% coinsurance
Durable Medical Equipment (DME)20% coinsurance
Prosthetics & OrthoticsSee plan details
Prosthetic Devices20% coinsurance
Medical Supplies20% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic Therapeutic Shoes & Inserts20% coinsurance
Dialysis Services20% coinsurance
Meal BenefitNo charge
Annual Physical ExamNo charge
Fitness BenefitNo charge
Caregiver Support ServicesNo 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)0%-20% coinsurance (max $35)
Dental — Medicare-Covered Services$25
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge
Dental — Diagnostic ServicesNo charge
Dental — Prophylaxis (Cleaning)No charge
Dental — Fluoride TreatmentNo charge
Dental — Other Preventive ServicesNo charge
Dental — Restorative ServicesNo charge
Dental — Endodontics (Root Canal)No charge
Dental — Periodontics (Gum Care)No charge
Dental — Removable Prosthodontics (Dentures)No charge
Dental — Maxillofacial ProstheticsNo charge
Dental — Implant ServicesNo charge
Dental — Fixed Prosthodontics (Bridges)No charge
Dental — Oral & Maxillofacial SurgeryNo charge
Dental — OrthodonticsNo charge
Dental — Adjunctive General ServicesNo charge
Vision — Eye Exams$0-$30
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — EyewearNo charge
Vision — Eyeglass LensesNo charge
Vision — Eyeglass FramesNo charge
Vision — Eyewear UpgradesNo charge
Hearing — Exams$25
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)$399-$1,800
Hearing — OTC Hearing Aids$399

Service area

  • VA: 11 counties

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