Provider Partners Texas Advantage Plan (HMO I-SNP)
Available to residents of Goliad County, TX for 2026. Contract H4054, plan 001, segment 0.
Plan details
| Monthly drug premium | $4.80 |
|---|---|
| Drug deductible | $615.00 |
| Plan type | Institutional SNP |
| Special needs plan | Institutional SNP |
| Contract / plan | H4054-001-0 |
| Offered by | Provider Partners Health Plans |
| Parent organization | Rifkin Managed Care Holding, LLC |
| Formulary drugs | 3,321 |
CMS star ratings
- Overall
- 5 out of 5 stars for Overall
- Health plan (Part C)
- 4.5 out of 5 stars for Health plan (Part C)
- Drug plan (Part D)
- 4 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H4054 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | 25% |
Also available in 84 other TX counties
- Anderson
- Angelina
- Bandera
- Bexar
- Brazos
- Brown
- Burleson
- Burnet
- Caldwell
- Cass
- Chambers
- Cherokee
- Collin
- Comanche
- Concho
- Cooke
- Crane
- Dallas
- Delta
- Denton
- Ector
- El Paso
- Falls
- Fannin
- Fort Bend
- Freestone
- Garza
- Gregg
- Grimes
- Guadalupe
- Hamilton
- Hardin
- Harris
- Harrison
- Henderson
- Hood
- Hopkins
- Howard
- Hutchinson
- Jasper
- Jefferson
- Jim Wells
- Karnes
- Kaufman
- Lavaca
- Limestone
- Lubbock
- McLennan
- Madison
- Maverick
- Medina
- Midland
- Milam
- Moore
- Nacogdoches
- Navarro
- Orange
- Palo Pinto
- Parker
- Potter
Plan facts come from the CMS quarterly prescription drug plan public use files.