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Premier Care (HMO-POS I-SNP)

Available to residents of Gratiot County, MI for 2026. Contract H6832, plan 004, segment 0.

Renewed, service area expanded for 2026. CMS carries this plan forward from 2025.

Plan details

Monthly premium (Part C + D)$0.00
— medical (Part C) part$0.00
— drug (Part D) part$0.00?
Monthly premium with full Extra Help (LIS)$0.00?
Part B premium reduction (giveback)None
Health plan deductible (in-network)None
In-network out-of-pocket maximum$4,700.00?
In- and out-of-network out-of-pocket maximum$4,700.00
Drug deductible$615.00Tier 1 and 2 exempt
Drug out-of-pocket threshold$2,100.00
Plan typeHMO-POS I-SNP?
Special needs planInstitutional SNP
Contract / planH6832-004-0
Offered byAlign Senior Care
Parent organizationCurana Health Holdings, LLC
Formulary drugs3,347
Formulary exception tier4?
Pharmacy searchwww.PLACEHOLDER.com
Member services(855)855-0336TTY 711

CMS star ratings

Overall
2.5 out of 5 stars for Overall
Health plan (Part C)
3 out of 5 stars for Health plan (Part C)
Drug plan (Part D)
2.5 out of 5 stars for Drug plan (Part D)

Published per contract — every plan under contract H6832 shares this rating.

Plan health benefits

ServiceIn-network
Doctor visits
Primary care doctor$0 copay
Specialist$10 copay
Other health care professional20% coinsurance
Additional telehealth services$0–$20 copay
Preventive care
Medicare-covered preventive services$0 copay
Annual physical examNot covered
Kidney disease education$0 copay
Glaucoma screening$0 copay
Diabetes self-management training$0 copay
Diagnostic tests, labs and imaging
Diagnostic tests and procedures20% coinsurance(authorization required)
Lab services$0 copay(authorization required)
Diagnostic radiology (e.g. MRI, CT)20% coinsurance(authorization required)
Therapeutic radiology20% coinsurance(authorization required)
Outpatient x-rays$0 copay(authorization required)
Emergency and urgent care
Emergency room$90 copay
Urgent care$40 copay
Worldwide emergency coverageNot covered
Worldwide urgent careNot covered
Worldwide emergency transportationNot covered
Hospital care
Inpatient hospital stay$230 per day for days 1–6; $0 per day for days 7–90(authorization required)
Outpatient hospital services$0–$225 copay(authorization required)
Outpatient observation$100 copay(authorization required)
Ambulatory surgical center20% coinsurance(authorization required)
Outpatient blood services20% coinsurance
Skilled nursing and home health
Skilled nursing facilityOriginal Medicare cost-sharing(authorization required)
Home health care$0 copay(authorization required)
Kidney dialysis20% coinsurance
Rehabilitation
Occupational therapy$0 copay(authorization required)
Physical therapy and speech-language therapy$0 copay(authorization required)
Cardiac rehabilitation20% coinsurance(authorization required)
Pulmonary rehabilitation20% coinsurance(authorization required)
Mental health and substance use
Inpatient psychiatric hospital stay$230 per day for days 1–6; $0 per day for days 7–90(authorization required)
Outpatient mental health, individual session$20 copay
Outpatient mental health, group session$10 copay
Psychiatrist, individual session20% coinsurance
Psychiatrist, group session20% coinsurance
Partial hospitalization20% coinsurance(authorization required)
Intensive outpatient program20% coinsurance
Outpatient substance use, individual session20% coinsurance(authorization required)
Outpatient substance use, group session20% coinsurance(authorization required)
Opioid treatment program$0 copay(authorization required)
Ambulance and transportation
Ground ambulance$250 copay(authorization required)
Air ambulance20% coinsurance(authorization required)
Transportation to plan-approved locations$0 copay
Medical equipment and supplies
Durable medical equipment (e.g. wheelchairs, oxygen)20% coinsurance(authorization required)
Prosthetics (e.g. braces, artificial limbs)20% coinsurance(authorization required)
Medical supplies20% coinsurance(authorization required)
Diabetes supplies$0 copay
Diabetic therapeutic shoes or inserts20% coinsurance
Chiropractic, acupuncture and foot care
Chiropractic (Medicare-covered)20% coinsurance(authorization required)
Routine chiropractic care$30 copay(authorization required, limits apply)
AcupunctureNot covered
Foot exams and treatment (Medicare-covered)20% coinsurance
Routine foot care$0 copay(limits apply)
Dental?
Medicare-covered dental services20% coinsurance(authorization required)
Oral exams$0 copay(limits apply)
Cleanings$0 copay(limits apply)
Fluoride treatment$0 copay(limits apply)
Dental x-rays$0 copay(limits apply)
Other diagnostic dental services$0 copay
Other preventive dental servicesNot covered
Comprehensive dental plan limit$3,500 plan limit every year
Restorative services (fillings, crowns)$0 copay(limits apply)
Endodontics (root canals)$0 copay(limits apply)
Periodontics (gum disease)$0 copay(limits apply)
Dentures and other removable prosthodontics$0 copay(limits apply)
Maxillofacial prostheticsNot covered
Implants$0 copay
Bridges and other fixed prosthodontics$0 copay(limits apply)
Oral and maxillofacial surgery$0 copay(limits apply)
OrthodonticsNot covered
Adjunctive general services$0 copay(limits apply)
Vision?
Eye exam (Medicare-covered)20% coinsurance
Routine eye exam$0 copay(limits apply)
Eyewear after cataract surgery (Medicare-covered)20% coinsurance(limits apply)
Eyewear plan limit$200 plan limit every year
Contact lenses$0 copay(limits apply)
Eyeglasses (frames and lenses)$0 copay(limits apply)
Eyeglass lenses$0 copay(limits apply)
Eyeglass frames$0 copay(limits apply)
Eyewear upgrades$0 copay(limits apply)
Hearing?
Hearing exam (Medicare-covered)20% coinsurance
Routine hearing exam$0 copay(limits apply)
Hearing aid fitting and evaluation$0 copay(limits apply)
Hearing aid plan limit$1,560 plan limit every two years
Hearing aids (all types)$0 copay(limits apply)
Hearing aids, inner earNot covered
Hearing aids, outer earNot covered
Hearing aids, over the earNot covered
Medicare Part B drugs
Part B insulin0%–20% coinsurance(authorization required, step therapy may apply)
Chemotherapy and radiation drugs0%–20% coinsurance(authorization required, step therapy may apply)
Other Part B drugs0%–20% coinsurance(authorization required, step therapy may apply)
Other extra benefits?
Over-the-counter (OTC) allowanceCovered (allowance not stated)
Meals after a hospital stay or for a chronic conditionNot covered
Fitness benefitNot covered
Health educationNot covered
Nutritional / dietary benefitNot covered
Extra smoking and tobacco cessation counselingNot covered
Enhanced disease managementNot covered
TelemonitoringNot covered
Remote access technologies (web/phone, nurse line)Not covered
Home and bathroom safety devicesNot covered
Counseling servicesNot covered
In-home safety assessmentNot covered
Personal emergency response system (PERS)$0 copay
Medical nutrition therapyNot covered
Post-discharge in-home medication reconciliationNot covered
Re-admission preventionNot covered
Wigs for hair loss from chemotherapyNot covered
Weight management programsNot covered
Alternative therapiesNot covered
Therapeutic massageNot covered
Adult day health servicesNot covered
Home-based palliative careNot covered
In-home support services$0 copay
Support for caregiversNot covered

In-network cost-sharing as the plan filed it with CMS (CMS plan benefit package (PBP) files, CY2026). A range means the cost depends on the service or setting. Rows the filing does not state are left out rather than guessed. Contact the plan for the full Evidence of Coverage.

Drug tiers — preferred pharmacy, initial coverage

TierCost-sharing
Tier 1$2.00
Tier 2$15.00
Tier 3$45.00
Tier 4$95.00
Tier 525%

Rx cost-sharing by coverage phase

Tier30-day supply90-day supply
PreferredStandardMail OrderPreferredStandardMail Order
Initial deductible phase
Tier 1: Preferred Generic$2.00$2.00$2.00$6.00$6.00$6.00
Tier 2: Generic$15.00$15.00$15.00$45.00$45.00$45.00
Initial coverage phase
Tier 1: Preferred Generic$2.00$2.00$2.00$6.00$6.00$6.00
Tier 2: Generic$15.00$15.00$15.00$45.00$45.00$45.00
Tier 3: Preferred Brand$45.00$45.00$45.00$135.00$135.00$135.00
Tier 4: Non-Preferred Drug$95.00$95.00$95.00$285.00$285.00$285.00
Tier 5: Specialty Tier25%25%25%n/an/an/a
Catastrophic coverage phase
Tier 1: Preferred Generic$0.00$0.00$0.00$0.00$0.00$0.00
Tier 2: Generic$0.00$0.00$0.00$0.00$0.00$0.00
Tier 3: Preferred Brand$0.00$0.00$0.00$0.00$0.00$0.00
Tier 4: Non-Preferred Drug$0.00$0.00$0.00$0.00$0.00$0.00
Tier 5: Specialty Tier$0.00$0.00$0.00$0.00$0.00$0.00

Also available in 20 other MI counties

Benefits in plain text

Premier Care (HMO-POS I-SNP) (H6832-004-0) is a 2026 HMO-POS I-SNP Medicare Advantage plan offered by Align Senior Care, available to residents of Gratiot County, MI.

The monthly premium is $0.00 (Part C and Part D together).

With full Extra Help (the Low-Income Subsidy), the total monthly premium is $0.00.

There is no in-network deductible for health services.

Its in-network out-of-pocket maximum is $4,700.00.

The combined in- and out-of-network out-of-pocket maximum is $4,700.00.

The drug deductible is $615.00. Tier 1 and 2 exempt.

It is a special needs plan (Institutional SNP).

The plan's formulary lists 3,347 drugs.

At a preferred pharmacy in the initial coverage phase, a 30-day supply costs tier 1: $2.00; tier 2: $15.00; tier 3: $45.00; tier 4: $95.00; tier 5: 25%.

CMS gives the plan's contract (H6832) an overall rating of 2.5 out of 5 stars.

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Plan facts come from the CMS quarterly prescription drug plan public use files; the premium split, Extra Help premium, MOOP and plan type from the CMS Landscape file; the Part B giveback and health benefits from the CMS plan benefit package (PBP) files.