Special Needs Plan (Medicare Advantage) · HMO D-SNP · Plan ID H5734-001
HPSJ/MVHP Advantage D-SNP (HMO D-SNP)
Offered by Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO) (SAN JOAQUIN COUNTY HEALTH COMMISSION) · available in 4 counties in CA
Only for people who have both Medicare and Medicaid.
Monthly premium$7.30health + drug coverage
Yearly out-of-pocket max$9,850in network
Drug deductible$700Actuarially Equivalent Standard
Star RatingPlan Too New To Be Measured2027 CMS rating
Extra benefits listed in the CMS file
| Vision | routine eye exam; eyewear |
|---|---|
| Hearing | routine hearing exam; hearing aids, plan pays up to $1,200 per year |
| Over-the-counter items | $145 per quarter allowance |
Allowances and limits come from the plan's filing with CMS and are simplified here. Some benefits are only for members with certain chronic conditions. The plan's Evidence of Coverage is the final word.
Check the details that matter most
- Is my doctor in the network? (plan's provider directory)
- Are my prescriptions covered? (plan's drug list)
- Is my pharmacy in the network?
- Plan website
- See this plan on Medicare.gov, where you can add your prescriptions and compare estimated yearly costs.
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