Texas Independence Health Plan, Inc. (HMO I-SNP)

Available to residents of Refugio County, TX for 2027. Contract H5015, 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 TX plan’s 2026–2027 changes →

Plan details

Monthly premium (Part C + D)	$3.90
— medical (Part C) part	$0.00
— drug (Part D) part	$3.90?
Monthly premium with full Extra Help (LIS)	$0.00?
Part B premium reduction (giveback)	None
In-network out-of-pocket maximum	$9,250.00?
Drug deductible	$700.00
Drug out-of-pocket threshold	$2,400.00
Plan type	HMO I-SNP?
Special needs plan	Institutional SNP
Contract / plan	H5015-001-0
Offered by	Texas Independence Health Plan
Parent organization	Regency ISNP Holdings LLC
Pharmacy search	www.txindependencehealthplan.com/participating-pharmacies/
Member services	(833)471-8447TTY 711

CMS star ratings

Overall: 4.5 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 H5015 shares this rating.

Plan health benefits

Service	In-network
Doctor visits
Primary care doctor	20% coinsurance
Specialist	20% coinsurance
Other health care professional	0%–20% coinsurance
Additional telehealth services	20% coinsurance
Preventive care
Medicare-covered preventive services	$0 copay
Annual physical exam	20% coinsurance
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(authorization required)
Lab services	20% coinsurance(authorization required)
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	$0 copay
Physical therapy and speech-language therapy	$0 copay(authorization required)
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(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(authorization required)
Ambulance and transportation
Ground ambulance	20% coinsurance(authorization required)
Air ambulance	20% coinsurance(authorization required)
Transportation to plan-approved locations	$0 copay
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	$0 copay(limits apply)
Dental?
Medicare-covered dental services	20% coinsurance
Preventive dental plan limit	$2,000 plan limit every year
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)
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
Routine eye exam	$0 copay(limits apply)
Eyewear after cataract surgery (Medicare-covered)	20% coinsurance(limits apply)
Eyewear plan limit	$100 plan limit every year
Contact lenses	$0 copay(limits apply)
Eyeglasses (frames and lenses)	Not covered
Eyeglass lenses	$0 copay(limits apply)
Eyeglass frames	$0 copay(limits apply)
Eyewear upgrades	Not covered
Hearing?
Hearing exam (Medicare-covered)	20% coinsurance
Routine hearing exam	$0 copay(limits apply)
Hearing aid fitting and evaluation	$0 copay(limits apply)
Hearing aid plan limit	$1,000 plan limit every two years
Hearing aids (all types)	Not covered
Hearing aids, inner ear	$0 copay(limits apply)
Hearing aids, outer ear	$0 copay(limits apply)
Hearing aids, over the ear	$0 copay(limits apply)
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	$60 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 H5015 shares it.

Benefits in plain text

Texas Independence Health Plan, Inc. (HMO I-SNP) (H5015-001-0) is a 2027 HMO I-SNP Medicare Advantage plan offered by Texas Independence Health Plan, available to residents of Refugio County, TX.

The monthly premium is $3.90.

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

Its in-network out-of-pocket maximum is $9,250.00.

The drug deductible is $700.00.

It is a special needs plan (Institutional SNP).

CMS gives the plan's contract (H5015) an overall rating of 4.5 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.