IEHP DualChoice (HMO D-SNP)
IEHP DualChoice · HMO D-SNP · 2026 coverage
The big numbers
The plan premium is on top of your Part B premium.
- Monthly premium
- $12
- Tied for highest here
- Most you pay in a year for covered care in network
- $9,250
- Drug deductible
- $615
- Tied for highest here
- Medicare star rating
- 3 of 5
This is a special needs plan. Only some people can join: Dual-Eligible.
In plain English
Compared with the 6 other plans in Riverside County that the same person could join.
Watch out for
- $12 monthly premium, tied for highest here
- $615 drug deductible, tied for highest here
- No dental extra, though most plans here have one
- 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$144$144 in premiums + $0 for careTied for highest here2 checkups and 2 lab tests.Not counted, because the plan charges a percentage: Primary care visit, Lab tests.
- A busier year$144$144 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$144$144 in premiums + $0 for care6 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, 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 visit20%
- Specialist visit20%Referral neededPlan approval may be needed
- Urgent care20%
- Emergency room20%
- Lab tests0%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%
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 6 other plans in Riverside County that the same person could join. Ask the plan for its 2026 Evidence of Coverage booklet for the full rules.
What medicines cost
| Drug tier | Network pharmacy |
|---|---|
| 1Preferred Generic | $0 |
| 2GenericAfter the deductible | 25% of the price |
| 3Preferred BrandAfter the deductible | 25% of the price |
| 4Non-Preferred DrugAfter the deductible | 30% of the price |
| 5Specialty TierAfter the deductible | 25% of the price |
| 6Select Care Drugs | $0 |
For a 1-month supply. The $615 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 Not included
- Vision IncludedRoutine eye exam covered. Glasses or contacts covered.Eyewear has a limit; ask the plan.
- Hearing Not included
- Over-the-counter items IncludedUp to $60 every three months for things like vitamins, pain relief and bandages.Unused money does not carry over.
- Fitness Not included
- Rides to care Not included
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 IEHP DualChoice (HMO D-SNP), plan number H8894-001, for 2026?”