Verda Noble Chronic Care (HMO C-SNP)
Available to residents of Collin County, TX for 2027. Contract H5163, plan 004, segment 0.
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- Plan health benefits
- Benefits in plain text
- Rx cost-sharing for all pharmacies and tiers
- Other plans in Collin County
- Plan website
- Browse the Verda Noble Chronic Care (HMO C-SNP) formulary
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 TX 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) | None |
| Health plan deductible (in-network) | None |
| In-network out-of-pocket maximum | $2,299.00? |
| Drug deductible | $300.00Tier 1, 2 and 6 exempt |
| Drug out-of-pocket threshold | $2,400.00 |
| Plan type | HMO C-SNP? |
| Special needs plan | Chronic-condition SNP |
| Qualifying condition | CardiovascularDisorders,ChronicHeartFailure,DiabetesMellitus |
| Contract / plan | H5163-004-0 |
| Offered by | Verda Health Plan of Texas |
| Parent organization | Verda Healthcare, Inc. |
| Formulary tiers | 6 |
| Formulary exception tier | 5? |
| Pharmacy search | verdahptx.com/ |
| Member services | (877)933-6767TTY 711 |
CMS star ratings
- Overall
- 2 out of 5 stars for Overall
- Health plan (Part C)
- 1.5 out of 5 stars for Health plan (Part C)
- Drug plan (Part D)
- 2 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H5163 shares this rating.
Plan health benefits
| Service | In-network |
|---|---|
| Doctor visits | |
| Primary care doctor | $0 copay |
| Specialist | $0 copay(authorization and referral required) |
| Other health care professional | $0 copay(authorization and referral required) |
| Additional telehealth services | $0 copay(authorization and referral required) |
| Preventive care | |
| Medicare-covered preventive services | $0 copay |
| Annual physical exam | Not covered |
| Kidney disease education | $0 copay(authorization and referral required) |
| Glaucoma screening | $0 copay(authorization and referral required) |
| Diabetes self-management training | $0 copay(authorization and referral required) |
| Diagnostic tests, labs and imaging | |
| Diagnostic tests and procedures | $0 copay(authorization and referral required) |
| Lab services | $0 copay(authorization and referral required) |
| Diagnostic radiology (e.g. MRI, CT) | $0–$25 copay(authorization and referral required) |
| Therapeutic radiology | 20% coinsurance(authorization and referral required) |
| Outpatient x-rays | $0 copay(authorization and referral required) |
| Emergency and urgent care | |
| Emergency room | $109 copay |
| Urgent care | $0 copay |
| Worldwide emergency coverage | $109 copay · $50,000 plan limit |
| Worldwide urgent care | $0 copay · $50,000 plan limit |
| Worldwide emergency transportation | Not covered |
| Hospital care | |
| Inpatient hospital stay | $0 per day for days 1–3; $125 per day for days 4–7; $0 per day for days 8–90(authorization and referral required) |
| Outpatient hospital services | $50–$90 copay(authorization and referral required) |
| Outpatient observation | $90 copay(authorization and referral required) |
| Ambulatory surgical center | $0 copay(authorization and referral required) |
| Outpatient blood services | $0 copay(authorization and referral required) |
| Skilled nursing and home health | |
| Skilled nursing facility | $0 per day for days 1–7; $20 per day for days 8–20; $221 per day for days 21–100(authorization and referral required) |
| Home health care | $0 copay(authorization and referral required) |
| Kidney dialysis | 20% coinsurance(authorization and referral required) |
| Rehabilitation | |
| Occupational therapy | $0 copay(authorization and referral required) |
| Physical therapy and speech-language therapy | $0 copay(authorization and referral required) |
| Cardiac rehabilitation | $25 copay(authorization and referral required) |
| Pulmonary rehabilitation | $20 copay(authorization and referral required) |
| Mental health and substance use | |
| Inpatient psychiatric hospital stay | $150 per day for days 1–5; $0 per day for days 6–90(authorization and referral required) |
| Outpatient mental health, individual session | $40 copay(authorization and referral required) |
| Outpatient mental health, group session | $20 copay(authorization and referral required) |
| Psychiatrist, individual session | $40 copay(authorization and referral required) |
| Psychiatrist, group session | $20 copay(authorization and referral required) |
| Partial hospitalization | $25 copay(authorization and referral required) |
| Intensive outpatient program | $25 copay |
| Outpatient substance use, individual session | $40 copay(authorization and referral required) |
| Outpatient substance use, group session | $20 copay(authorization and referral required) |
| Opioid treatment program | $25 copay(authorization and referral required) |
| Ambulance and transportation | |
| Ground ambulance | $189 copay(authorization required) |
| Air ambulance | 20% coinsurance(authorization required) |
| Transportation to plan-approved locations | $0 copay(limits apply) |
| Medical equipment and supplies | |
| Durable medical equipment (e.g. wheelchairs, oxygen) | 0%–20% coinsurance(authorization required) |
| Prosthetics (e.g. braces, artificial limbs) | 20% coinsurance(authorization required) |
| Medical supplies | 20% coinsurance(authorization required) |
| Diabetes supplies | 0%–20% coinsurance(authorization required) |
| Diabetic therapeutic shoes or inserts | 0%–20% coinsurance(authorization required) |
| Chiropractic, acupuncture and foot care | |
| Chiropractic (Medicare-covered) | $0 copay(authorization and referral required) |
| Routine chiropractic care | Not covered |
| Acupuncture | Not covered |
| Foot exams and treatment (Medicare-covered) | $0 copay(authorization and referral required) |
| Routine foot care | Not covered |
| Dental? | |
| Medicare-covered dental services | $0 copay |
| Oral exams | $0 copay(limits apply) |
| Cleanings | $0 copay(limits apply) |
| Fluoride treatment | $0 copay(limits apply) |
| Dental x-rays | $0 copay(limits apply) |
| Other diagnostic dental services | $0 copay(limits apply) |
| Other preventive dental services | $0 copay(limits apply) |
| Maxillofacial prosthetics | Not covered |
| Orthodontics | Not covered |
| Vision? | |
| Eye exam (Medicare-covered) | $0 copay |
| Routine eye exam | $0 copay(limits apply) |
| Eyewear after cataract surgery (Medicare-covered) | $0 copay(limits apply) |
| Eyewear plan limit | $250 plan limit every year |
| 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 |
| Routine hearing exam | $0 copay(limits apply) |
| Hearing aid fitting and evaluation | $0 copay(limits apply) |
| Hearing aids (all types) | $99–$599 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 | $35 copay(authorization required, step therapy may apply) |
| Chemotherapy and radiation drugs | 0%–20% coinsurance(authorization required, step therapy may apply) |
| Other Part B drugs | 0%–20% coinsurance(authorization required, step therapy may apply) |
| Other extra benefits? | |
| Over-the-counter (OTC) allowance | $55 allowance every month |
| Meals after a hospital stay or for a chronic condition | $0 copay(authorization and referral required) |
| Fitness benefit | $0 copay(limits apply) |
| 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(limits apply) |
| 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 | $0 copay(limits apply) |
| 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 · Preferred Generic | $0.00 |
| Tier 2 · Generic | $0.00 |
| Tier 3 · Preferred Brand | $35.00 |
| Tier 4 · Non-Preferred Drug | 28% |
| Tier 5 · Specialty Tier | 30% |
| Tier 6 · Select Diabetic Drugs | $0.00 |
Rx cost-sharing by coverage phase
| Tier | 30-day supply | 90-day supply | ||||
|---|---|---|---|---|---|---|
| Preferred | Standard | Mail Order | Preferred | Standard | Mail Order | |
| Initial coverage phase | ||||||
| Tier 1: Preferred Generic | $0.00 | $0.00 | n/a | $0.00 | $0.00 | $0.00 |
| Tier 2: Generic | $0.00 | $0.00 | n/a | $0.00 | $0.00 | $0.00 |
| Tier 3: Preferred Brand | $35.00 | $35.00 | n/a | $105.00 | $105.00 | $70.00 |
| Tier 4: Non-Preferred Drug | 28% | 28% | 28% | n/a | n/a | n/a |
| Tier 5: Specialty Tier | 30% | 30% | 30% | n/a | n/a | n/a |
| Tier 6: Select Diabetic Drugs | $0.00 | $0.00 | n/a | $0.00 | $0.00 | $0.00 |
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
| Measure | 2027 | 2026 |
|---|---|---|
| Staying Healthy: Screenings, Tests and Vaccines | ||
| Colorectal Cancer Screening · C02 | 1 out of 5 stars for Colorectal Cancer Screening | Plan too small to be measured |
| Annual Flu Vaccine · C03 | 3 out of 5 stars for Annual Flu Vaccine | Plan too small to be measured |
| Monitoring Physical Activity · C06 | 4 out of 5 stars for Monitoring Physical Activity | too new |
| Managing Chronic (Long Term) Conditions | ||
| Special Needs Plan (SNP) Care Management · C07 | 1 out of 5 stars for Special Needs Plan (SNP) Care Management | 1 out of 5 stars for Special Needs Plan (SNP) Care Management |
| Care for Older Adults – Medication Review · C08 | 1 out of 5 stars for Care for Older Adults – Medication Review | 2 out of 5 stars for Care for Older Adults – Medication Review |
| Care for Older Adults - Functional Status Assessment · C09 | 3 out of 5 stars for Care for Older Adults - Functional Status Assessment | new measure |
| Diabetes Care – Eye Exam · C11 | 1 out of 5 stars for Diabetes Care – Eye Exam | Plan too small to be measured |
| Diabetes Care – Blood Sugar Controlled · C12 | 2 out of 5 stars for Diabetes Care – Blood Sugar Controlled | Plan too small to be measured |
| Kidney Health Evaluation for Patients with Diabetes · C13 | 2 out of 5 stars for Kidney Health Evaluation for Patients with Diabetes | Plan too small to be measured |
| Controlling High Blood Pressure · C14 | 2 out of 5 stars for Controlling High Blood Pressure | Plan too small to be measured |
| Transitions of Care · C19 | 2 out of 5 stars for Transitions of Care | Plan too small to be measured |
| Member Experience with Health Plan | ||
| Getting Needed Care · C21 | 1 out of 5 stars for Getting Needed Care | Plan too small to be measured |
| Getting Appointments and Care Quickly · C22 | 3 out of 5 stars for Getting Appointments and Care Quickly | Plan too small to be measured |
| Customer Service · C23 | 1 out of 5 stars for Customer Service | Plan too small to be measured |
| Rating of Health Care Quality · C24 | 1 out of 5 stars for Rating of Health Care Quality | Plan too small to be measured |
| Rating of Health Plan · C25 | 2 out of 5 stars for Rating of Health Plan | Plan too small to be measured |
| Member Complaints and Changes in the Health Plan's Performance | ||
| Complaints about the Health Plan · C27 | 1 out of 5 stars for Complaints about the Health Plan | not enough data |
| Members Choosing to Leave the Plan · C28 | 2 out of 5 stars for Members Choosing to Leave the Plan | not enough data |
| Health Plan Customer Service | ||
| Call Center – Foreign Language Interpreter and TTY Availability · C32 | 1 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability | 3 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability |
| DD1: Drug Plan Customer Service | ||
| Call Center – Foreign Language Interpreter and TTY Availability · D01 | 1 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability | 3 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability |
| DD2: Member Complaints and Changes in the Drug Plan’s Performance | ||
| Complaints about the Drug Plan · D02 | 1 out of 5 stars for Complaints about the Drug Plan | not enough data |
| Members Choosing to Leave the Plan · D03 | 2 out of 5 stars for Members Choosing to Leave the Plan | not enough data |
| Drug Plan Quality Improvement · D04 | 1 out of 5 stars for Drug Plan Quality Improvement | not enough data |
| DD3: Member Experience with the Drug Plan | ||
| Rating of Drug Plan · D05 | 4 out of 5 stars for Rating of Drug Plan | Plan too small to be measured |
| DD4: Drug Safety and Accuracy of Drug Pricing | ||
| MPF Price Accuracy · D07 | 5 out of 5 stars for MPF Price Accuracy | 4 out of 5 stars for MPF Price Accuracy |
| Medication Adherence for Diabetes Medications · D08 | 1 out of 5 stars for Medication Adherence for Diabetes Medications | 4 out of 5 stars for Medication Adherence for Diabetes Medications |
| Medication Adherence for Hypertension (RAS antagonists) · D09 | 2 out of 5 stars for Medication Adherence for Hypertension (RAS antagonists) | 3 out of 5 stars for Medication Adherence for Hypertension (RAS antagonists) |
| Medication Adherence for Cholesterol (Statins) · D10 | 1 out of 5 stars for Medication Adherence for Cholesterol (Statins) | 2 out of 5 stars for Medication Adherence for Cholesterol (Statins) |
| Statin Use in Persons with Diabetes (SUPD) · D11 | 5 out of 5 stars for Statin Use in Persons with Diabetes (SUPD) | not enough data |
| Concurrent Use of Opioids and Benzodiazepines (COB) · D12 | 5 out of 5 stars for Concurrent Use of Opioids and Benzodiazepines (COB) | new measure |
| Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH) · D13 | 4 out of 5 stars for Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH) | new measure |
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 H5163 shares it.
Also available in 3 other TX counties
Benefits in plain text
Verda Noble Chronic Care (HMO C-SNP) (H5163-004-0) is a 2027 HMO C-SNP Medicare Advantage plan offered by Verda Health Plan of Texas, available to residents of Collin County, TX.
The monthly premium is $0.00.
With full Extra Help (the Low-Income Subsidy), the total monthly premium is $0.00.
There is no in-network deductible for health services.
Its in-network out-of-pocket maximum is $2,299.00.
The drug deductible is $300.00. Tier 1, 2 and 6 exempt.
It is a special needs plan (Chronic-condition SNP).
At a preferred pharmacy in the initial coverage phase, a 30-day supply costs tier 1 (Preferred Generic): $0.00; tier 2 (Generic): $0.00; tier 3 (Preferred Brand): $35.00; tier 4 (Non-Preferred Drug): 28%; tier 5 (Specialty Tier): 30%; tier 6 (Select Diabetic Drugs): $0.00.
CMS gives the plan's contract (H5163) an overall rating of 2 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.