Imperial Courage 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
- $2,999
- Drug coverage
- Not included
- You would need a separate drug plan
- Medicare star rating
- No rating yet
In plain English
Compared with the 1 other plans in Humboldt County that the same person could join.
What stands out
- No monthly premium
Watch out for
- 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
- Does not include drug coverage
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$20$0 in premiums + $20 for care4 checkups, 4 specialist visits, 4 lab tests, 1 X-ray and 1 urgent care visit.
- A hard year$1,085$0 in premiums + $1,085 for care6 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$5Referral neededPlan approval may be needed
- Urgent care$0
- Emergency room$125Not charged if you stay in the hospital within 48 hours
- Hospital stay$150 a day for days 1 to 5, then $0 for days 6 to 90Referral 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$200Referral neededPlan approval may be needed
- Outpatient hospital care$200
- X-rays$0Referral neededPlan approval may be needed
- MRI, CT and other scans$0Referral neededPlan approval may be needed
- Ground ambulance$150Plan approval may be needed
- Skilled nursing facility$0 for days 1 to 20, then $200 a day for days 21 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 1 other plans in Humboldt County that the same person could join. Read the plan’s 2027 booklet (PDF)
Extras
Help Original Medicare doesn’t give you.
- Dental Not included
- Vision Not included
- Hearing Not included
- Over-the-counter items Not included
- Fitness Not included
- Rides to care Not included
What changed from 2026
- Dental2026Cleanings and exams: $0. Fillings, crowns and dentures: you pay $0. Cleanings and exams: plan pays up to $500 a year. Plan pays up to $1,500 a year2027Not covered
- Vision2026Yearly eye exam: $0. Glasses or contacts covered. Eyewear: plan pays up to $250 a year2027Not covered
- Hearing2026Hearing test: $0. Hearing aids covered. Hearing tests: plan pays up to $250 a year. Hearing aids: plan pays up to $500 a year, both ears2027Not covered
- Over-the-counter items2026Up to $75 every three months for things like vitamins, pain relief and bandages. Unused money does not carry over2027Not covered
- Fitness2026Includes gym or fitness classes and an activity tracker2027Not covered
- Rides to care2026100 one-way rides to medical visits a year2027Not covered
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 Courage Plan (HMO), plan number H5496-016, for 2027?”