Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP)

Available to residents of Fulton County, AR for 2027. Contract H1587, plan 001, segment 0.

2027 drug-by-drug coverage is not published by CMS yet. The drug lookup covers 2026, whose formulary is live.

Renewed for 2027. CMS carries this plan forward from 2026. Every AR plan’s 2026–2027 changes →

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)	$29.50 a month?You must continue to pay your Medicare Part B premium.
In-network out-of-pocket maximum	$9,850.00?
Drug deductible	$635.00
Drug out-of-pocket threshold	$2,400.00
Plan type	HMO D-SNP?
Special needs plan	Dual-eligible SNP
D-SNP integration status	Coordination Only (CO)
Zero-dollar cost sharing D-SNP	Yes
Contract / plan	H1587-001-0
Offered by	Arkansas Superior Select Health Plans
Parent organization	Select Founders, LLC
Formulary tiers	1
Formulary exception tier	1?
Pharmacy search	www.AIPCares.com
Member services	(866)488-5457TTY 711

CMS star ratings

Overall: —
Health plan (Part C): —
Drug plan (Part D): 3.5 out of 5 stars for Drug plan (Part D)

Published per contract — every plan under contract H1587 shares this rating.

Plan health benefits

Service	In-network
Doctor visits
Primary care doctor	20% coinsurance
Specialist	20% coinsurance
Other health care professional	20% coinsurance
Additional telehealth services	20% coinsurance
Preventive care
Medicare-covered preventive services	$0 copay
Annual physical exam	Not covered
Kidney disease education	$0 copay
Glaucoma screening	20% coinsurance
Diabetes self-management training	20% coinsurance
Diagnostic tests, labs and imaging
Diagnostic tests and procedures	20% coinsurance
Lab services	20% coinsurance
Diagnostic radiology (e.g. MRI, CT)	20% coinsurance(authorization required)
Therapeutic radiology	20% coinsurance(authorization required)
Outpatient x-rays	20% coinsurance(authorization required)
Emergency and urgent care
Emergency room	20% coinsurance
Urgent care	20% coinsurance
Worldwide emergency coverage	Not covered
Worldwide urgent care	Not covered
Worldwide emergency transportation	Not covered
Hospital care
Inpatient hospital stay	Original Medicare cost-sharing(authorization required)
Outpatient hospital services	20% coinsurance(authorization required)
Outpatient observation	20% coinsurance
Ambulatory surgical center	20% coinsurance(authorization required)
Outpatient blood services	20% coinsurance
Skilled nursing and home health
Skilled nursing facility	Original Medicare cost-sharing(authorization required)
Home health care	0% coinsurance(authorization required)
Kidney dialysis	20% coinsurance
Rehabilitation
Occupational therapy	20% coinsurance(authorization required)
Physical therapy and speech-language therapy	20% coinsurance(authorization required)
Cardiac rehabilitation	20% coinsurance(authorization required)
Pulmonary rehabilitation	20% coinsurance(authorization required)
Mental health and substance use
Inpatient psychiatric hospital stay	Original Medicare cost-sharing(authorization required)
Outpatient mental health, individual session	20% coinsurance(authorization required)
Outpatient mental health, group session	20% coinsurance(authorization required)
Psychiatrist, individual session	20% coinsurance(authorization required)
Psychiatrist, group session	20% coinsurance(authorization required)
Partial hospitalization	20% coinsurance(authorization required)
Intensive outpatient program	20% coinsurance
Outpatient substance use, individual session	20% coinsurance(authorization required)
Outpatient substance use, group session	20% coinsurance(authorization required)
Opioid treatment program	20% coinsurance
Ambulance and transportation
Ground ambulance	20% coinsurance
Air ambulance	20% coinsurance
Transportation to plan-approved locations	Not covered
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 supplies	20% coinsurance(authorization required)
Diabetes supplies	20% coinsurance
Diabetic therapeutic shoes or inserts	20% coinsurance
Chiropractic, acupuncture and foot care
Chiropractic (Medicare-covered)	20% coinsurance
Routine chiropractic care	Not covered
Acupuncture	Not covered
Foot exams and treatment (Medicare-covered)	20% coinsurance
Routine foot care	Not covered
Dental?
Medicare-covered dental services	20% coinsurance
Preventive dental plan limit	$1,500 plan limit every year
Oral exams	$0 copay
Cleanings	$0 copay
Fluoride treatment	$0 copay
Dental x-rays	$0 copay
Other diagnostic dental services	$0 copay
Other preventive dental services	$0 copay
Restorative services (fillings, crowns)	$0 copay
Endodontics (root canals)	$0 copay
Periodontics (gum disease)	$0 copay
Dentures and other removable prosthodontics	$0 copay
Maxillofacial prosthetics	$0 copay
Implants	$0 copay
Bridges and other fixed prosthodontics	$0 copay
Oral and maxillofacial surgery	$0 copay
Orthodontics	$0 copay
Adjunctive general services	$0 copay
Vision?
Eye exam (Medicare-covered)	20% coinsurance(limits apply)
Routine eye exam	$0 copay(limits apply)
Eyewear after cataract surgery (Medicare-covered)	$0 copay(limits apply)
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)	$0 copay(limits apply)
Routine hearing exam	$0 copay(limits apply)
Hearing aid fitting and evaluation	$0 copay(limits apply)
Hearing aids (all types)	$0 copay(limits apply)
Hearing aids, inner ear	Not covered
Hearing aids, outer ear	Not covered
Hearing aids, over the ear	Not covered
Medicare Part B drugs
Part B insulin	0%–20% coinsurance(authorization required)
Chemotherapy and radiation drugs	0%–20% coinsurance(authorization required)
Other Part B drugs	0%–20% coinsurance(authorization required)
Other extra benefits?
Over-the-counter (OTC) allowance	$30 allowance every month
Meals after a hospital stay or for a chronic condition	$0 copay(referral required)
Fitness benefit	Not covered
Health education	Not covered
Nutritional / dietary benefit	Not covered
Extra smoking and tobacco cessation counseling	Not covered
Enhanced disease management	Not covered
Telemonitoring	Not covered
Remote access technologies (web/phone, nurse line)	Not covered
Home and bathroom safety devices	Not covered
Counseling services	Not covered
In-home safety assessment	Not covered
Personal emergency response system (PERS)	$0 copay(referral required)
Medical nutrition therapy	Not covered
Post-discharge in-home medication reconciliation	Not covered
Re-admission prevention	Not covered
Wigs for hair loss from chemotherapy	Not covered
Weight management programs	Not covered
Alternative therapies	Not covered
Therapeutic massage	Not covered
Adult day health services	Not covered
Home-based palliative care	Not covered
In-home support services	Not covered
Support for caregivers	Not covered

In-network cost-sharing as the plan filed it with CMS (CMS plan benefit package (PBP) files, CY2027). 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

Tier	Cost-sharing
Tier 1 · Single Tier	25%

Rx cost-sharing by coverage phase

Tier	30-day supply			90-day supply
Tier	Preferred	Standard	Mail Order	Preferred	Standard	Mail Order
Initial coverage phase
Tier 1: Single Tier	25%	25%	25%	25%	25%	25%

These are the initial coverage phase amounts, as the plan filed them in its benefit package. The deductible and post-threshold phases are not stated per tier in that filing, so they are not shown here rather than being inferred; the plan's annual out-of-pocket threshold is $2,400.00.

Star rating measures

Measures are paired between the two years by name, not by the C/D number: CMS reuses those numbers, and in 2027 nineteen of them refer to a different measure than they did in 2026. A measure introduced for 2027 has no 2026 score to show. Published per contract — every plan under H1587 shares it.

Benefits in plain text

Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) (H1587-001-0) is a 2027 HMO D-SNP Medicare Advantage plan offered by Arkansas Superior Select Health Plans, available to residents of Fulton County, AR.

The monthly premium is $0.00.

The plan reduces the member's Medicare Part B premium by $29.50 a month (a "giveback"); the Part B premium itself must still be paid.

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

Its in-network out-of-pocket maximum is $9,850.00.

The drug deductible is $635.00.

It is a special needs plan (Dual-eligible SNP).

At a preferred pharmacy in the initial coverage phase, a 30-day supply costs tier 1 (Single Tier): 25%.

Email a copy of the plan benefit details

Plan facts come from the CMS plan Landscape file and the CMS plan benefit package (PBP) files.