Valor Health Plan (HMO I-SNP)

Available to residents of Montgomery County, OH for 2027. Contract H1119, 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, service area expanded for 2027. CMS carries this plan forward from 2026. Every OH plan’s 2026–2027 changes →

Plan details

Monthly premium (Part C + D)	$21.10
— medical (Part C) part	$0.00
— drug (Part D) part	$21.10?
Monthly premium with full Extra Help (LIS)	$0.00?
Part B premium reduction (giveback)	None
In-network out-of-pocket maximum	$9,850.00?
Drug deductible	$700.00
Drug out-of-pocket threshold	$2,400.00
Plan type	HMO I-SNP?
Special needs plan	Institutional SNP
Contract / plan	H1119-001-0
Offered by	Valor Health Plan
Parent organization	The Schroer Group, Inc.
Pharmacy search	www.valorhealthplan.com
Member services	(800)485-3793TTY 711

CMS star ratings

Overall: 3.5 out of 5 stars for Overall
Health plan (Part C): 3.5 out of 5 stars for Health plan (Part C)
Drug plan (Part D): 3 out of 5 stars for Drug plan (Part D)

Published per contract — every plan under contract H1119 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	20% coinsurance
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	$0 per stay(authorization required)
Home health care	$0 copay(authorization required)
Kidney dialysis	20% coinsurance
Rehabilitation
Occupational therapy	20% coinsurance
Physical therapy and speech-language therapy	20% coinsurance
Cardiac rehabilitation	20% coinsurance
Pulmonary rehabilitation	20% coinsurance
Mental health and substance use
Inpatient psychiatric hospital stay	Original Medicare cost-sharing(authorization required)
Outpatient mental health, individual session	20% coinsurance
Outpatient mental health, group session	20% coinsurance
Psychiatrist, individual session	20% coinsurance
Psychiatrist, group session	20% coinsurance
Partial hospitalization	20% coinsurance
Intensive outpatient program	20% coinsurance
Outpatient substance use, individual session	20% coinsurance
Outpatient substance use, group session	20% coinsurance
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(authorization required)
Diabetic therapeutic shoes or inserts	20% coinsurance(authorization required)
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
Oral exams	Not covered
Cleanings	Not covered
Fluoride treatment	Not covered
Dental x-rays	Not covered
Other diagnostic dental services	Not covered
Other preventive dental services	Not covered
Restorative services (fillings, crowns)	Not covered
Endodontics (root canals)	Not covered
Periodontics (gum disease)	Not covered
Dentures and other removable prosthodontics	Not covered
Maxillofacial prosthetics	Not covered
Implants	Not covered
Bridges and other fixed prosthodontics	Not covered
Oral and maxillofacial surgery	Not covered
Orthodontics	Not covered
Adjunctive general services	Not covered
Vision?
Eye exam (Medicare-covered)	20% coinsurance
Routine eye exam	Not covered
Eyewear after cataract surgery (Medicare-covered)	20% coinsurance
Contact lenses	Not covered
Eyeglasses (frames and lenses)	Not covered
Eyeglass lenses	Not covered
Eyeglass frames	Not covered
Eyewear upgrades	Not covered
Hearing?
Hearing exam (Medicare-covered)	20% coinsurance
Routine hearing exam	Not covered
Hearing aid fitting and evaluation	Not covered
Hearing aids (all types)	Not covered
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	$214 allowance every three months
Meals after a hospital stay or for a chronic condition	Not covered
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)	Not covered
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.

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 H1119 shares it.

Benefits in plain text

Valor Health Plan (HMO I-SNP) (H1119-001-0) is a 2027 HMO I-SNP Medicare Advantage plan offered by Valor Health Plan, available to residents of Montgomery County, OH.

The monthly premium is $21.10.

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 $700.00.

It is a special needs plan (Institutional SNP).

CMS gives the plan's contract (H1119) an overall rating of 3.5 out of 5 stars.

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.