Medicare Blue Dual (HMO D-SNP)
Available to residents of Broome County, NY for 2026. Contract H7524, plan 003, segment 0.
Plan details
| Monthly drug premium | $0.00 |
|---|---|
| Drug deductible | $615.00 |
| Plan type | Dual-eligible SNP |
| Special needs plan | Dual-eligible SNP |
| Contract / plan | H7524-003-0 |
| Offered by | Excellus Health Plan Community Care LLC |
| Parent organization | Lifetime Healthcare, Inc. |
| Formulary drugs | 4,032 |
CMS star ratings
- Overall
- —
- Health plan (Part C)
- —
- Drug plan (Part D)
- —
Published per contract — every plan under contract H7524 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $0.00 |
| Tier 2 | $20.00 |
| Tier 3 | $47.00 |
| Tier 4 | 25% |
| Tier 5 | 25% |
Also available in 10 other NY counties
Plan facts come from the CMS quarterly prescription drug plan public use files.