VillageHealth (HMO-POS C-SNP)
VillageHealth · HMO-POS C-SNP · 2026 coverage
The big numbers
The plan premium is on top of your Part B premium.
- Monthly premium
- $6.30
- Higher than most plans here
- Most you pay in a year for covered care in network
- $9,250
- Drug deductible
- $370
- Lower than most plans here
- 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 25 other plans in Riverside County that the same person could join.
What stands out
- $370 drug deductible, lower than most plans here
Watch out for
- $6.30 monthly premium, higher than most plans here
- Dental: plan pays up to $2,000 a year, less than most plans here
- No hearing extra, though most plans here have one
What a year could cost
Premiums plus the plan’s copays for three example years. Medicines are not included.
- A light year$75.60$75.60 in premiums + $0 for careHigher than most plans here2 checkups and 2 lab tests.
- A busier year$75.60$75.60 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: X-rays.
- A hard year$75.60$75.60 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: MRI, CT and other scans, Ground ambulance, Emergency room, 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$0
- Urgent care$0
- Emergency room20%
- Lab tests$0
More care: surgery, X-rays, scans, ambulance, nursing home
- Outpatient surgery center$0
- Outpatient hospital care20%
- X-rays20%
- MRI, CT and other scans20%
- Ground ambulance20%
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 Riverside County that the same person could join. Read the plan’s 2026 booklet (PDF)
What medicines cost
| Drug tier | Preferred pharmacy | Other network pharmacy |
|---|---|---|
| 1Preferred Generic | $0 | $5 |
| 2GenericAfter the deductible | $2 | $7 |
| 3Preferred BrandAfter the deductible | 25% of the price | 25% of the price |
| 4Non-Preferred DrugAfter the deductible | 25% of the price | 25% of the price |
| 5Specialty TierAfter the deductible | 25% of the price | 25% of the price |
For a 1-month supply. The $370 drug deductible applies only to the tiers marked. Covered insulin costs at most $35 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 2026, 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.Plan pays up to $2,000 a year.
- Vision IncludedRoutine eye exam covered. Glasses or contacts covered.Eyewear: plan pays up to $200 a year.
- Hearing Not included
- Over-the-counter items Not included
- Fitness IncludedIncludes gym or fitness classes.
- Rides to care Included50 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 VillageHealth (HMO-POS C-SNP), plan number H5943-003, for 2026?”