All of our Medicare Advantage Dual plans feature a $0 copay for primary care visits and most plans have a $0 copay for urgent care visits.
Plans include the same medical benefits as Original Medicare Parts A and B (medical and hospital insurance), plus additional coverage for other health needs. For example:
- Inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care (Part A)
- Certain doctors’ services, outpatient care, medical supplies, and preventive services (Part B)
Medical Services
- Hospital care and medical care (Medicare Part A and B)
- Primary care
- Specialist care
- Lab services
- Urgent care and emergency care
- Ambulance services
- Diabetic supplies
- Physical therapy
- Podiatry
- Chiropractic
Doctor Visits:
- Primary and preventive care visits
- Urgent Care visits
- CHPW Virtual Care
- Specialist appointments
Diagnostic Services:
- Radiology
- Tests and procedures outside of preventive tests
- Lab services
- Outpatient X-ray
- Therapeutic radiology services (such as radiation treatment for cancer)
Medical Benefits by Medicare Advantage (HMO D-SNP) Plan
2027 Medical Benefits
| Dual Complete (HMO D-SNP)* | Primary Care (per visit): $0 copay
Specialist Care (per visit) $0 copay Medicare-covered Lab Services: $0 copay Urgent Care (per visit): $0 Emergency Care (per visit): $0 Diabetic Supplies: $0 Chiropractic (per Medicare-covered visit): $0 copay Out-of-pocket Maximum: $9,850 per calendar year |
| Dual Select (HMO D-SNP)* | Primary Care (per visit): $0 copay or 20% coinsurance*
Specialist Care (per visit) $0 copay or 20% coinsurance* Medicare-covered Lab Services: $0 copay or 20% coinsurance* Urgent Care (per visit): $0 or 20% coinsurance*; $40 limit Emergency Care (per visit): $0 or 20% coinsurance*; $115 limit Diabetic Supplies: $0 or 20% coinsurance* Chiropractic (per Medicare-covered visit): $0 copay or 20% coinsurance* Out-of-pocket Maximum: $9,850 per calendar year |
2026 Medical Benefits
| Dual Complete (HMO D-SNP)* | Primary Care (per visit): $0 copay
Specialist Care (per visit) $0 copay Medicare-covered Lab Services: $0 copay Urgent Care (per visit): $0 Emergency Care (per visit): $0 Worldwide Emergency/Urgent Care: $0 copay Diabetic Supplies: $0 Chiropractic (per Medicare-covered visit): $0 copay Out-of-pocket Maximum: $9,250 per calendar year |
| Dual Select (HMO D-SNP)* | Primary Care (per visit): $0 copay or 20% coinsurance*
Specialist Care (per visit) $0 copay or 20% coinsurance* Medicare-covered Lab Services: $0 copay or 20% coinsurance* Urgent Care (per visit): $0 or 20% coinsurance*; $40 limit Emergency Care (per visit): $0 or 20% coinsurance*; $115 limit Worldwide Emergency/Urgent Care: 20% coinsurance Diabetic Supplies: $0 or 20% coinsurance* Chiropractic (per Medicare-covered visit): $0 copay or 20% coinsurance* Out-of-pocket Maximum: $9,250 per calendar year |
Download documents
Summary of Benefits
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Evidence of Coverage
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Dual Complete (HMO D-SNP)
Dual Select (HMO D-SNP) |
*For most services, Dual Complete and Dual Select members pay a $0 copay or 20%. The amount you pay depends on the level of state Apple Health (Medicaid) assistance you receive. CHPW Medicare Representatives can tell you what your share (if any) of the service costs will be: 1-800-944-1247 (TTY: 711).
We’re here to help.
To ask questions, request print copies of materials, and more, contact Customer Service at 1-800-942-0247 (TTY: 711), 8:00 a.m. to 8:00 p.m., 7 days a week.
Did you know that certain prescription medicines are available as a 90-day supply? Medicine that you take on a long-term basis to manage your health is called a “maintenance drug.” A 90-day supply makes it easier to keep taking the medicine you need to feel your best. You may also be eligible to receive your long-term medications through free home delivery.
