Imperial Courage Plan (HMO)
Imperial Health Plan of California, Inc. · HMO · 2026 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
- Lower than most plans here
- Drug coverage
- Not included
- You would need a separate drug plan
- Lowers your Part B premium by
- $75 a month
- Medicare star rating
- 3.5 of 5
In plain English
Compared with the 25 other plans in Santa Clara County that the same person could join.
What stands out
- No monthly premium
- At most $2,999 a year for covered care, lower than most plans here
- Dental, vision and hearing extras included
Watch out for
- $5 for specialist visits, higher 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
- 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$5Higher than most plans hereReferral 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, scans, mental health, therapy, home health and more
- Outpatient surgery center$200Higher than most plans hereReferral 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$150Lower than most plans herePlan 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
- Mental health therapy visit20%Referral neededPlan approval may be needed
- Psychiatrist visit$0Tied for lowest hereReferral neededPlan approval may be needed
- Physical or speech therapy20%Referral neededPlan approval may be needed
- Occupational therapy$10Higher than most plans hereReferral neededPlan approval may be needed
- Home health care$10Highest of 26 plans hereReferral neededPlan approval may be needed
- Medical equipment, like a walker or oxygen20%Plan approval may be needed
- Kidney dialysis20%Referral neededPlan approval may be needed
- Chemotherapy and radiation drugs0% to 20%Depends on the servicePlan approval may be needed
- Other drugs given at a clinic0% to 20%Depends on the servicePlan approval may be needed
- Heart rehab20%Referral neededPlan approval may be needed
- Foot doctor (podiatrist)$5Higher than most plans hereReferral neededPlan approval may be needed
- Chiropractor$0Referral neededPlan approval may be needed
From the costs the plan filed with Medicare for 2026. A range like “$0 to $100” means the cost depends on the service or the place. “Lower than most” compares this plan with the 25 other plans in Santa Clara County that the same person could join. Read the plan’s 2026 booklet (PDF)
Is my doctor in this plan?
Look up your doctors, then confirm with their office.
Add your doctors once. We’ll check them against each plan you look at.
Before you choose, call each doctor’s office and ask:
“Do you take Imperial Courage Plan (HMO), plan number H5496-016, for 2026?”
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 $1,500 a year.
- Vision IncludedYearly eye exam: $0. Glasses or contacts covered.Eyewear: plan pays up to $250 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 $75 every three months for things like vitamins, pain relief and bandages.Unused money does not carry over.
- Fitness IncludedIncludes gym or fitness classes and an activity tracker.
- Rides to care Included100 one-way rides to medical visits a year.
- Meals IncludedMeals for a short time, right after surgery or a hospital stay.Plan pays up to $105 a year.
- Other extras IncludedIncludes acupuncture.
Help paying for this plan
Programs that can lower your Medicare costs if your income is limited.
Help with your Part B premium
A Medicare Savings Program can pay your Part B premium, and for some people more of their Medicare costs.
This plan also lowers the Part B premium by $75 a month. If Medi-Cal or a Medicare Savings Program already pays your Part B premium, you may not see that money.
See who can get a Medicare Savings ProgramContact the plan
- Call about joining(800) 838-5914 · TTY 711
- Plan websitewww.imperialhealthplan.com
- Full 2026 rulesRead the plan’s booklet (PDF)
From the details the plan filed with Medicare for 2026. To check whether a doctor takes this plan, call the doctor’s office, not the plan.