Imperial Flex (HMO C-SNP)
Imperial Health Plan of California, Inc. · HMO C-SNP · 2027 coverage
The big numbers
The plan premium is on top of your Part B premium.
- Monthly premium
- $2.70
- Higher than most plans here
- Most you pay in a year for covered care in network
- $9,850
- Drug deductible
- $450
- Medicare star rating
- No rating yet
This is a special needs plan. Only some people can join: Chronic or Disabling Condition.
In plain English
Compared with the 18 other plans in Fresno County that the same person could join.
What stands out
- $0 for a 5-day hospital stay, tied for lowest here
- Dental, vision and hearing extras included
Watch out for
- $2.70 monthly premium, higher than most plans here
- Dental: plan pays up to $500 a year, tied for least here
- You need a referral to see a specialist
What a year could cost
Premiums plus the plan’s copays for three example years. Medicines are not included.
- A light year$32.40$32.40 in premiums + $0 for careHigher than most plans here2 checkups and 2 lab tests.Not counted, because the plan charges a percentage: Primary care visit, Lab tests.
- A busier year$32.40$32.40 in premiums + $0 for careHigher than most plans here4 checkups, 4 specialist visits, 4 lab tests, 1 X-ray and 1 urgent care visit.Not counted, because the plan charges a percentage: Primary care visit, Specialist visit, Lab tests, X-rays, Urgent care.
- A hard year$32.40$32.40 in premiums + $0 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.Not counted, because the plan charges a percentage: Primary care visit, Specialist visit, Lab tests, MRI, CT and other scans, Ground ambulance, Emergency room.
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 visit20%
- Specialist visit20%Referral neededPlan approval may be needed
- Urgent care20%
- Emergency room20%
- Hospital stay$0Tied for lowest hereReferral neededPlan approval may be needed
- Lab tests20%Referral neededPlan approval may be needed
More care: surgery, X-rays, scans, ambulance, nursing home
- Outpatient surgery center20%Referral neededPlan approval may be needed
- Outpatient hospital care20%
- X-rays20%Referral neededPlan approval may be needed
- MRI, CT and other scans20%Referral neededPlan approval may be needed
- Ground ambulance20%Plan 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 |
| 2GenericAfter the deductible | 10% of the price |
| 3Preferred BrandAfter the deductible | 25% of the price |
| 4Non-Preferred DrugAfter the deductible | 25% of the price |
| 5Specialty TierAfter the deductible | 25% of the price |
| 6Select Care Drugs | $0 |
For a 1-month supply. The $450 drug deductible applies only to the tiers marked. 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 IncludedRoutine hearing test covered. Hearing aids covered.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 Included20 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 Flex (HMO C-SNP), plan number H5496-017, for 2027?”