Prominence Plus (HMO)

PROMINENCE HEALTHFIRST OF TEXAS · 2027 plan year

Plan ID H7680-002-000

HMO★ 4 CMS Stars
MOOP (in-network)
$3,000
MOOP (combined)
—
Monthly premium
$0/mo
Part C $0 + Part D $0
Prescription drugs
Included

This plan in 2026

Plan information

Contract / Plan / Segment
H7680-002-000
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 PROMINENCE HEALTHFIRST OF TEXAS plans in TX

Benefits & cost sharing

Primary Care

BenefitIn-network
Chiropractic — Routine CareNo charge

Hospital

BenefitIn-network
Worldwide Urgent Care Coverage$30
Inpatient Hospital — AcuteTier 1: $50/day for days 1–5, $0 after; Tier 2: $100/day for days 1–5, $0 after
Inpatient Hospital — Additional Days (Acute)No charge
Inpatient Hospital — PsychiatricNo charge

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
Supplemental Health BenefitsSee plan details
Mental Health Specialty ServicesSee plan details
Mental Health — Individual SessionsNo charge
Mental Health — Group SessionsNo charge

Other

BenefitIn-network
Annual Physical ExamNo charge
Dental — Diagnostic ServicesNo charge
Dental — Periodontics (Gum Care)0%-50% coinsurance
Dental — Removable Prosthodontics (Dentures)0%-50% coinsurance
Dental — Fixed Prosthodontics (Bridges)0%-50% coinsurance
Dental — Oral & Maxillofacial Surgery0%-50% coinsurance
Dental — Adjunctive General Services0%-50% coinsurance
Vision — Eye ExamsNo charge
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — EyewearNo charge
Vision — EyewearSee plan details
Vision — Contact LensesNo charge
Vision — Eyeglasses (Lenses & Frames)No charge
Vision — Eyeglass LensesNo charge
Vision — Eyeglass FramesNo charge
Vision — Eyewear UpgradesNo charge
Hearing — ExamsNo charge
Hearing — ExamsSee plan details
Physical Therapy & Speech-Language PathologyNo charge
Dental — Prophylaxis (Cleaning)No charge
Dental — Fluoride TreatmentNo charge
Dental — Other Preventive ServicesNo charge
Dental — Restorative Services0%-50% coinsurance
Hearing — Routine ExamsNo charge
Hearing — Fitting & Evaluation for Hearing AidNo charge
Hearing — Prescription Hearing AidsSee plan details
Hearing — Hearing Aids (All Types)$0-$1,725
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$150
Ground Ambulance$275
Air Ambulance$275
Partial Hospitalization ProgramNo charge
Chiropractic ServicesSee plan details
Dental — ComprehensiveSee plan details
Dental — Endodontics (Root Canal)0%-50% coinsurance
Ambulance ServicesSee plan details
Intensive Outpatient Program (IOP)No charge
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic ServicesNo charge
Occupational Therapy ServicesNo charge
Physician Specialist Services$20
Podiatry ServicesNo charge
Other Health Care Professional Services$0-$20
Psychiatric ServicesSee plan details
Psychiatric Services — Individual SessionsNo charge
Psychiatric Services — Group SessionsNo charge
Skilled Nursing Facility (SNF)$0/day for days 1–20, $50/day for days 21–100
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional SessionsNo charge
Intensive Cardiac Rehabilitation — Additional SessionsNo charge
Pulmonary Rehabilitation — Additional SessionsNo charge
Supervised Exercise Therapy (SET)No charge
Emergency Services$150
Urgently Needed ServicesNo charge
Additional Telehealth Services (Part B)No charge
Opioid Treatment Program Services$10
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & TestsNo charge
Laboratory ServicesNo charge
Radiological ServicesSee plan details
Diagnostic RadiologyNo charge
Therapeutic Radiology$20
X-Ray ServicesNo charge
Outpatient Hospital Services$25-$200
Hospital Observation ServicesNo charge
Ambulatory Surgical Center (ASC)No charge
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual SessionsNo charge
Substance Abuse — Group SessionsNo charge
Outpatient Blood ServicesNo charge
Non-Emergency Transportation — Health FacilityNo charge
Durable Medical Equipment (DME)No charge
Prosthetics & OrthoticsSee plan details
Prosthetic DevicesNo charge
Medical SuppliesNo charge
Diabetic Supplies & ServicesSee plan details
Diabetic SuppliesNo charge
Diabetic Therapeutic Shoes & InsertsNo charge
Diabetic MonitorsNo charge
Dialysis Services20% coinsurance
Over-the-Counter (OTC) ItemsNo charge
Meal BenefitNo charge
Medicare-Covered Preventive ServicesSee plan details
Dental — X-RaysNo charge
Fitness BenefitNo charge
In-Home Safety AssessmentNo 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 ServicesNo charge
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge

Service area

  • TX: 8 counties

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