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Neighborhood Dual CONNECT (HMO D-SNP)

Available to residents of Bristol County, RI for 2027. Contract H2126, 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 RI plan’s 2026–2027 changes →

Plan details

Monthly premium (Part C + D)$21.60
— medical (Part C) part$0.00
— drug (Part D) part$21.60?
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 typeHMO D-SNP?
Special needs planDual-eligible SNP
D-SNP integration statusCoordination Only (CO)
Zero-dollar cost sharing D-SNPNo
Contract / planH2126-001-0
Offered byNeighborhood Health Plan of Rhode Island
Parent organizationNEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND
Pharmacy searchwww.nhpri.org/medicare-medicaid/pharmacy-benefits/2025-pharmacy-benefits/
Member services(866)696-4774TTY 711

CMS star ratings

Overall
—
Health plan (Part C)
—
Drug plan (Part D)
—

Published per contract — every plan under contract H2126 shares this rating.

Plan health benefits

ServiceIn-network
Doctor visits
Primary care doctor20% coinsurance
Specialist20% coinsurance
Other health care professional20% coinsurance
Additional telehealth services20% coinsurance(authorization required)
Preventive care
Medicare-covered preventive services$0 copay
Annual physical exam$0 copay
Kidney disease education20% coinsurance
Glaucoma screening20% coinsurance
Diabetes self-management training20% coinsurance
Diagnostic tests, labs and imaging
Diagnostic tests and procedures20% coinsurance(authorization required)
Lab services20% coinsurance(authorization required)
Diagnostic radiology (e.g. MRI, CT)20% coinsurance(authorization required)
Therapeutic radiology20% coinsurance(authorization required)
Outpatient x-rays20% coinsurance(authorization required)
Emergency and urgent care
Emergency room20% coinsurance
Urgent care20% coinsurance
Worldwide emergency coverage$0 copay
Worldwide urgent care$0 copay
Worldwide emergency transportationNot covered
Hospital care
Inpatient hospital stayOriginal Medicare cost-sharing(authorization required)
Outpatient hospital services20% coinsurance(authorization required)
Outpatient observation20% coinsurance
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(authorization required)
Rehabilitation
Occupational therapy20% coinsurance(authorization required)
Physical therapy and speech-language therapy20% coinsurance(authorization required)
Cardiac rehabilitation20% coinsurance
Pulmonary rehabilitation20% coinsurance
Mental health and substance use
Inpatient psychiatric hospital stayOriginal Medicare cost-sharing
Outpatient mental health, individual session20% coinsurance
Outpatient mental health, group session20% coinsurance
Psychiatrist, individual session20% coinsurance
Psychiatrist, group session20% coinsurance
Partial hospitalization20% coinsurance
Intensive outpatient program20% coinsurance
Outpatient substance use, individual session20% coinsurance
Outpatient substance use, group session20% coinsurance
Opioid treatment program0%–20% coinsurance
Ambulance and transportation
Ground ambulance20% coinsurance(authorization required)
Air ambulance20% coinsurance(authorization required)
Transportation to plan-approved locationsNot 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 supplies20% coinsurance(authorization required)
Diabetes supplies20% coinsurance(authorization required)
Diabetic therapeutic shoes or inserts20% coinsurance(authorization required)
Chiropractic, acupuncture and foot care
Chiropractic (Medicare-covered)20% coinsurance(authorization required)
Routine chiropractic careNot covered
AcupunctureNot covered
Foot exams and treatment (Medicare-covered)20% coinsurance
Routine foot careNot covered
Dental?
Medicare-covered dental services20% coinsurance(authorization required)
Oral examsNot covered
CleaningsNot covered
Fluoride treatmentNot covered
Dental x-raysNot covered
Other diagnostic dental servicesNot covered
Other preventive dental servicesNot covered
Restorative services (fillings, crowns)Not covered
Endodontics (root canals)Not covered
Periodontics (gum disease)Not covered
Dentures and other removable prosthodonticsNot covered
Maxillofacial prostheticsNot covered
ImplantsNot covered
Bridges and other fixed prosthodonticsNot covered
Oral and maxillofacial surgeryNot covered
OrthodonticsNot covered
Adjunctive general servicesNot covered
Vision?
Eye exam (Medicare-covered)20% coinsurance
Routine eye examNot covered
Eyewear after cataract surgery (Medicare-covered)20% coinsurance
Contact lensesNot covered
Eyeglasses (frames and lenses)Not covered
Eyeglass lensesNot covered
Eyeglass framesNot covered
Eyewear upgradesNot covered
Hearing?
Hearing exam (Medicare-covered)20% coinsurance
Routine hearing examNot covered
Hearing aid fitting and evaluationNot covered
Hearing aids (all types)Not covered
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) allowance$25 allowance every month
Meals after a hospital stay or for a chronic condition$0 copay
Fitness benefit$0 copay
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)Not covered
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 servicesNot covered
Support for caregiversNot 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

Each CMS star measure for contract H2126, 2027 against 2026
Measure20272026
Health Plan Customer Service
Call Center – Foreign Language Interpreter and TTY Availability · C325 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availabilitytoo new
DD1: Drug Plan Customer Service
Call Center – Foreign Language Interpreter and TTY Availability · D014 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availabilitytoo new

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 H2126 shares it.

Also available in 4 other RI counties

Benefits in plain text

Neighborhood Dual CONNECT (HMO D-SNP) (H2126-001-0) is a 2027 HMO D-SNP Medicare Advantage plan offered by Neighborhood Health Plan of Rhode Island, available to residents of Bristol County, RI.

The monthly premium is $21.60.

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 (Dual-eligible SNP).

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