2027 Medicare Advantage plan
Nebraska Health Advantage (HMO I-SNP): 2027 benefits and costs
Iowa Health Advantage HMO I-SNP Special Needs Plan
CMS plan ID: H6765-003-0 · Plan year: 2027
Nebraska Health Advantage (HMO I-SNP) is a 2027 Medicare Advantage plan offered by Iowa Health Advantage. It is listed in Nebraska.
2027 plan costs at a glance
- Organization
- Iowa Health Advantage
- Plan organization
- AMERICAN HEALTH PLAN OF IOWA INC
- Parent company
- Mitchell Family Office
- Plan type
- HMO I-SNP
- Part C premium
- $0.00
- Part D premium
- $24.60
- Prescription drug coverage
- Yes
- Special Needs Plan type
- Institutional
- 2027 CMS Star Rating
- Standard monthly Medicare Part B premium
- $209.50 (estimated)
You must continue to pay your Medicare Part B premium.
- In-network medical deductible
- Same as Medicare's Part B deductible
Applies to certain in-network Medicare-covered services.
- In-network medical maximum
- $9,850.00
Who can join this Special Needs Plan?
This plan has institutional care eligibility requirements. The plan must confirm your qualifying care needs or living situation before you enroll.
- Plan eligibility type
- Institutional
- Institutional plan type
- Hybrid Institutional special needs plan (HI-SNP)
2027 benefit summary
Doctor visits and medical care
Plan-level deductibles may still apply when a service-specific deductible is listed as No.
| Service | In-network | What to know |
|---|---|---|
| Primary care doctor | $0.00 copay
| |
| Specialist visit | 20% coinsurance
|
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| Telehealth | $0.00 copay
|
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| Emergency care | 20% coinsurance | |
| Urgent care | 20% coinsurance | |
| Home health | $0.00 copay
|
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| Dialysis | 20% coinsurance
|
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| Part B chemotherapy and radiation drugs | 0% to 20% coinsurance
|
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| Other Part B drugs | 0% to 20% coinsurance
|
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| Kidney disease education services | $0.00 copay
|
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| Medicare-covered chiropractic | 20% coinsurance
|
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| Medicare-covered foot care | 20% coinsurance
|
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| Other health professionals | 20% coinsurance
|
|
Hospital, outpatient surgery and observation care
Inpatient stays and skilled nursing care
| Care | Your share of the cost | What to know |
|---|---|---|
| Inpatient hospital stay | Original Medicare cost-sharing rules apply. |
|
| Inpatient mental health care | Original Medicare cost-sharing rules apply. |
|
| Skilled nursing facility | Days 1–20: $0.00 copay per day Days 21–100: $0.00 copay per day |
|
See plan documents for out-of-network hospital and skilled nursing costs.
| Service | In-network | What to know |
|---|---|---|
| Outpatient hospital care | 20% coinsurance
| |
| Hospital observation services | 20% coinsurance
| |
| Ambulatory surgical center | 20% coinsurance
|
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| Outpatient blood | 20% coinsurance
|
|
Tests, imaging and laboratory services
| Service | In-network | What to know |
|---|---|---|
| Diagnostic procedures and tests | 20% coinsurance
|
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| Laboratory services | $0.00 copay
|
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| Diagnostic radiology (CT, MRI) | 20% coinsurance
|
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| Therapeutic radiology | 20% coinsurance
|
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| X-rays | 20% coinsurance
|
|
Mental health and substance use treatment
| Service | In-network | What to know |
|---|---|---|
| Partial hospitalization | 20% coinsurance
|
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| Intensive outpatient program | 20% coinsurance
|
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| Substance use treatment, individual sessions | 20% coinsurance
|
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| Substance use treatment, group sessions | 20% coinsurance
|
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| Opioid treatment program | $0.00 copay
|
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| Mental health, individual sessions | 20% coinsurance
|
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| Mental health, group sessions | 20% coinsurance
|
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| Psychiatry, individual sessions | 20% coinsurance
|
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| Psychiatry, group sessions | 20% coinsurance
|
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Therapy and rehabilitation
| Service | In-network | What to know |
|---|---|---|
| Occupational therapy | 0% to 20% coinsurance
|
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| Physical and speech therapy | 0% to 20% coinsurance
|
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| Cardiac rehabilitation | 20% coinsurance
|
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| Intensive cardiac rehabilitation | 20% coinsurance
|
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| Pulmonary rehabilitation | 20% coinsurance
|
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| Supervised exercise for peripheral artery disease | 20% coinsurance
|
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Ambulance, medical equipment and supplies
| Service | In-network | What to know |
|---|---|---|
| Ground ambulance | 20% coinsurance
|
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| Air ambulance | 20% coinsurance
|
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| Durable medical equipment | 20% coinsurance
|
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| Prosthetic devices | 20% coinsurance
|
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| Medical supplies | 20% coinsurance
|
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| Diabetic supplies | $0.00 copay
|
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| Diabetic shoes and inserts | $0.00 copay
|
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| Diabetic monitors | $0.00 copay
|
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Dental benefits
| Service | In-network | What to know |
|---|---|---|
| Medicare-covered dental | 20% coinsurance |
Vision benefits
| Service | In-network | What to know |
|---|---|---|
| Medicare-covered eye exams | 20% coinsurance
|
|
| Routine eye examsAdditional plan benefit | $0.00 copay |
|
| Medicare-covered eyewear | 20% coinsurance
|
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| Contact lensesAdditional plan benefit | $0.00 copay |
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| Eyeglasses, lenses and framesAdditional plan benefit | $0.00 copay |
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| Eyeglass lensesAdditional plan benefit | $0.00 copay |
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| Eyeglass framesAdditional plan benefit | $0.00 copay |
|
Hearing benefits
| Service | In-network | What to know |
|---|---|---|
| Medicare-covered hearing exams | 20% coinsurance
|
|
| Routine hearing examsAdditional plan benefit | $0.00 copay |
|
| Hearing aid fitting and evaluationAdditional plan benefit | $0.00 copay |
|
| Prescription hearing aids (all types)Additional plan benefit | $0.00 copay
|
|
Extra benefits
These benefit details are not listed.
Prescription drug coverage
Costs shown are for initial coverage.
This plan uses a non-tiered standard drug benefit; individual drug prices are not listed here.
| Pharmacy | Supply |
|---|---|
| Standard retail | 30 days |
| Standard retail | 60 days |
| Standard retail | 90 days |
| Standard mail order | 30 days |
| Standard mail order | 60 days |
| Standard mail order | 90 days |
| Out-of-network pharmacy | 30 days |
| Long-term care pharmacy | 31 days |
Where this plan is offered
CMS lists this plan in 1 state or territory. Availability can vary by county and ZIP code.