Imperial Dynamic Plan (HMO)
Imperial Health Plan of California, Inc. · HMO · 2027 coverage
The big numbers
The plan premium is on top of your Part B premium.
- Monthly premium
- $0
- Most you pay in a year for covered care in network
- $295
- Lowest of 19 plans here
- Drug deductible
- $0
- Medicare star rating
- No rating yet
In plain English
Compared with the 18 other plans in Fresno County that the same person could join.
What stands out
- No monthly premium
- At most $295 a year for covered care, lowest of 19 plans here
- $0 for a 5-day hospital stay, tied for lowest here
- $125 for the emergency room, lower than most plans here
Watch out for
- Dental: plan pays up to $500 a year, less than most plans here
- You need a referral to see a specialist
- Covers only the plan’s own doctors and hospitals, except in an emergency or for urgent care
What a year could cost
Premiums plus the plan’s copays for three example years. Medicines are not included.
- A light year$0$0 in premiums + $0 for care2 checkups and 2 lab tests.
- A busier year$0$0 in premiums + $0 for careTied for lowest here4 checkups, 4 specialist visits, 4 lab tests, 1 X-ray and 1 urgent care visit.
- A hard year$275$0 in premiums + $275 for careLower than most plans here6 checkups, 12 specialist visits, 6 lab tests, 2 scans, an ambulance ride, an ER visit and a 5-day hospital stay.
The visit counts are examples we chose to show how costs add up, not a prediction. Your costs depend on the care you get.
What you pay for care
Your cost each time, at doctors and hospitals in the plan’s network.
- Primary care visit$0
- Specialist visit$0Referral neededPlan approval may be needed
- Urgent care$0
- Emergency room$125Lower than most plans hereNot charged if you stay in the hospital within 48 hours
- Hospital stay$0 for days 1 to 90Tied for lowest hereReferral neededPlan approval may be needed
- Lab tests$0Referral neededPlan approval may be needed
More care: surgery, X-rays, scans, ambulance, nursing home
- Outpatient surgery center$100Referral neededPlan approval may be needed
- Outpatient hospital care$100Lower than most plans here
- X-rays$0Referral neededPlan approval may be needed
- MRI, CT and other scans$0Referral neededPlan approval may be needed
- Ground ambulance$150Lower than most plans herePlan approval may be needed
- Skilled nursing facility$0 for days 1 to 20, then $100 a day for days 21 to 50, then $200 a day for days 51 to 100Referral neededPlan approval may be needed
From the costs the plan filed with Medicare for 2027. A range like “$0 to $100” means the cost depends on the service or the place. “Lower than most” compares this plan with the 18 other plans in Fresno County that the same person could join. Read the plan’s 2027 booklet (PDF)
What medicines cost
| Drug tier | Network pharmacy |
|---|---|
| 1Preferred Generic | $0 |
| 2Generic | $6 |
| 3Preferred Brand | $45 |
| 4Non-Preferred Drug | $90 |
| 5Specialty Tier | 33% of the price |
| 6Select Care Drugs | $0 |
For a 1-month supply. Covered insulin costs at most $0 for a month’s supply. Your medicine’s tier is on the plan’s drug list; check it below.
Check my medicines
See if this plan covers each medicine you take in 2027, and what a month costs.
Type the name on the bottle. Add the strength to narrow it down.
Add each medicine once. We’ll show if this plan covers it, what a month costs, and any rules.
Extras
Help Original Medicare doesn’t give you.
- Dental IncludedCleanings and exams: $0. Fillings, crowns and dentures: you pay $0.Cleanings and exams: plan pays up to $500 a year. Plan pays up to $4,000 a year.
- Vision IncludedYearly eye exam: $0. Glasses or contacts covered.Eyewear: plan pays up to $500 a year.
- Hearing IncludedHearing test: $0. Hearing aids covered.Hearing tests: plan pays up to $250 a year. Hearing aids: plan pays up to $500 a year, both ears.
- Over-the-counter items IncludedUp to $40 a month for things like vitamins, pain relief and bandages.Unused money does not carry over.
- Fitness IncludedIncludes gym or fitness classes, a home fitness kit and an activity tracker.
- Rides to care Included45 one-way rides to medical visits a year.
What changed from 2026
- Most you pay in a year2026$2962027$295
- Over-the-counter items2026Up to $140 every three months for things like vitamins, pain relief and bandages. Unused money does not carry over2027Up to $40 a month for things like vitamins, pain relief and bandages. Unused money does not carry over
- Fitness2026Includes gym or fitness classes and an activity tracker2027Includes gym or fitness classes, a home fitness kit and an activity tracker
- Rides to care2026100 one-way rides to medical visits a year202745 one-way rides to medical visits a year
Is my doctor in this plan?
Look up your doctors, then confirm with their office.
Call each doctor’s office and ask:
“Do you take Imperial Dynamic Plan (HMO), plan number H5496-012, for 2027?”