2027 Medicare Advantage plan

Verda Noble Care (HMO): 2027 benefits and costs

Verda Health Plan of Texas HMO

CMS plan ID: H5163-001-0 · Plan year: 2027

Verda Noble Care (HMO) is a 2027 Medicare Advantage plan offered by Verda Health Plan of Texas. It is listed in Texas.

2027 plan costs at a glance

Monthly plan premium$0.00

Drug deductible$300.00

In-network medical out-of-pocket maximum$1,599.00

Organization: Verda Health Plan of Texas
Plan organization: VERDA HEALTH PLAN OF TEXAS INC
Parent company: Verda Healthcare, Inc.
Plan type: HMO
Part C premium: $0.00
Part D premium: $0.00
Prescription drug coverage: Yes
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: None
In-network medical maximum: $1,599.00

2027 benefit summary

Doctor visits and medical care

Common medical services and member costs
Service	In-network	What to know
Primary care doctor	$0 Service-specific deductible No
Specialist visit	$0 Service-specific deductible No	Approval required Yes Referral required Yes
Telehealth	$0 Service-specific deductible No	Approval required Yes Referral required Yes
Emergency care	$90.00 copay
Urgent care	$0
Home health	$0 Service-specific deductible No	Approval required Yes Referral required Yes
Dialysis	20% coinsurance Service-specific deductible No	Approval required Yes Referral required Yes
Part B chemotherapy and radiation drugs	0% to 20% coinsurance Deductible applies No	Approval required Yes
Other Part B drugs	0% to 20% coinsurance Deductible applies No	Approval required Yes
Kidney disease education services	$0 Service-specific deductible No	Approval required Yes Referral required Yes
Medicare-covered chiropractic	$0 Service-specific deductible No	Approval required Yes Referral required Yes
Medicare-covered foot care	$0 Service-specific deductible No	Approval required Yes Referral required Yes
Other health professionals	$0 Service-specific deductible No	Approval required Yes Referral required Yes

Hospital, outpatient surgery and observation care

Inpatient stays and skilled nursing care

In-network stays. Charges can depend on the number of days and the benefit period.
Care	Your share of the cost	What to know
Inpatient mental health care	$0.00 copay per stay Days 1–5: $150.00 copay per day Days 6–90: $0.00 copay per day	Approval required Yes Referral required Yes Benefit period Original Medicare
Skilled nursing facility	Days 1–20: $0.00 copay per day Days 21–100: $221.00 copay per day	Approval required Yes Referral required Yes Benefit period Original Medicare

See plan documents for out-of-network hospital and skilled nursing costs.

Hospital, outpatient surgery and observation care and member costs
Service	In-network	What to know
Outpatient hospital care	$50.00 to $90.00 copay Service-specific deductible No
Hospital observation services	$90.00 copay Service-specific deductible No
Ambulatory surgical center	$0 Service-specific deductible No	Approval required Yes Referral required Yes
Outpatient blood	$0 Service-specific deductible No	Approval required Yes Referral required Yes

Tests, imaging and laboratory services

Tests, imaging and laboratory services and member costs
Service	In-network	What to know
Diagnostic procedures and tests	$0 Service-specific deductible No	Approval required Yes Referral required Yes
Laboratory services	$0 Service-specific deductible No	Approval required Yes Referral required Yes
Diagnostic radiology (CT, MRI)	$0.00 to $50.00 copay Service-specific deductible No	Approval required Yes Referral required Yes
Therapeutic radiology	20% coinsurance Service-specific deductible No	Approval required Yes Referral required Yes
X-rays	$0 Service-specific deductible No	Approval required Yes Referral required Yes

Mental health and substance use treatment

Mental health and substance use treatment and member costs
Service	In-network	What to know
Partial hospitalization	$25.00 copay Service-specific deductible No	Approval required Yes Referral required Yes
Intensive outpatient program	$25.00 copay Service-specific deductible No	Approval required No Referral required No
Substance use treatment, individual sessions	$40.00 copay Service-specific deductible No	Approval required Yes Referral required Yes
Substance use treatment, group sessions	$20.00 copay Service-specific deductible No	Approval required Yes Referral required Yes
Opioid treatment program	$25.00 copay Service-specific deductible No	Approval required Yes Referral required Yes
Mental health, individual sessions	$40.00 copay Service-specific deductible No	Approval required Yes Referral required Yes
Mental health, group sessions	$20.00 copay Service-specific deductible No	Approval required Yes Referral required Yes
Psychiatry, individual sessions	$40.00 copay Service-specific deductible No	Approval required Yes Referral required Yes
Psychiatry, group sessions	$20.00 copay Service-specific deductible No	Approval required Yes Referral required Yes

Therapy and rehabilitation

Therapy and rehabilitation and member costs
Service	In-network	What to know
Occupational therapy	$0 Service-specific deductible No	Approval required Yes Referral required Yes
Physical and speech therapy	$0 Service-specific deductible No	Approval required Yes Referral required Yes
Cardiac rehabilitation	$25.00 copay Service-specific deductible No	Approval required Yes Referral required Yes
Intensive cardiac rehabilitation	$25.00 copay Service-specific deductible No	Approval required Yes Referral required Yes
Pulmonary rehabilitation	$20.00 copay Service-specific deductible No	Approval required Yes Referral required Yes
Supervised exercise for peripheral artery disease	$20.00 copay Service-specific deductible No	Approval required Yes Referral required Yes

Ambulance, medical equipment and supplies

Ambulance, medical equipment and supplies and member costs
Service	In-network	What to know
Ground ambulance	$119.00 copay Service-specific deductible No	Approval required Yes
Air ambulance	20% coinsurance Service-specific deductible No	Approval required Yes
Durable medical equipment	0% to 20% coinsurance Service-specific deductible No	Approval required Yes
Prosthetic devices	20% coinsurance Service-specific deductible No	Approval required Yes
Medical supplies	20% coinsurance Service-specific deductible No	Approval required Yes
Diabetic supplies	0% to 20% coinsurance Service-specific deductible No	Approval required Yes
Diabetic shoes and inserts	0% to 20% coinsurance Service-specific deductible No	Approval required Yes
Diabetic monitors	0% to 20% coinsurance Service-specific deductible No	Approval required Yes

Dental benefits

Dental benefits and member costs
Service	In-network	What to know
Medicare-covered dental	$0
Oral examsAdditional plan benefit	$0
Dental X-raysAdditional plan benefit	$0
Other diagnostic dentalAdditional plan benefit	$0
Dental cleaningAdditional plan benefit	$0
FluorideAdditional plan benefit	$0
Other preventive dentalAdditional plan benefit	$0
Restorative dental careAdditional plan benefit	$0.00 to $530.00 copay
Root canal treatment (endodontics)Additional plan benefit	$22.00 to $535.00 copay
Gum treatment (periodontics)Additional plan benefit	$0.00 to $435.00 copay
Removable dentures (prosthodontics)Additional plan benefit	$25.00 to $1,102.00 copay
Dental implantsAdditional plan benefit	$0.00 to $402.00 copay
Fixed dental restorations (prosthodontics)Additional plan benefit	$50.00 to $1,196.00 copay
Oral surgeryAdditional plan benefit	$0.00 to $1,615.00 copay
Other dental servicesAdditional plan benefit	$0.00 to $165.00 copay

Vision benefits

Vision benefits and member costs
Service	In-network	What to know
Medicare-covered eye exams	$0 Service-specific deductible No	Approval required No Referral required No
Routine eye examsAdditional plan benefit	$0	Approval required No Referral required No
Medicare-covered eyewear	$0 Service-specific deductible No	Approval required No Referral required No
Contact lensesAdditional plan benefit	$0	Approval required No Referral required No
Eyeglasses, lenses and framesAdditional plan benefit	$0	Approval required No Referral required No
Eyeglass lensesAdditional plan benefit	$0	Approval required No Referral required No
Eyeglass framesAdditional plan benefit	$0	Approval required No Referral required No

Hearing benefits

Hearing benefits and member costs
Service	In-network	What to know
Medicare-covered hearing exams	$0 Service-specific deductible No	Approval required No Referral required No
Routine hearing examsAdditional plan benefit	$0	Approval required No Referral required No
Hearing aid fitting and evaluationAdditional plan benefit	$0	Approval required No Referral required No
Prescription hearing aids (all types)Additional plan benefit	$299.00 to $599.00 copay Service-specific deductible No	Approval required No Referral required No

Extra benefits

Extra benefits and member costs
Service	In-network	What to know
Supplemental acupunctureAdditional plan benefit	$0 Service-specific deductible No	Approval required No Referral required No
Over-the-counter health itemsAdditional plan benefit	$0 Service-specific deductible No
Limited-duration mealsAdditional plan benefit	$0 Service-specific deductible No	Approval required Yes Referral required Yes
Fitness benefitAdditional plan benefit	$0 Service-specific deductible No	Approval required No Referral required No

Allowances and optional benefits

American Specialty Health (ASH) Benefits

One shared limit covers the listed services, not a separate allowance for each service.

Services sharing this allowance: Routine Chiropractic Care; Acupuncture Treatments; Therapeutic Massage
How benefits are provided: Claims Processing
Advance choice of benefits required: No
Shared limit on visits or trips: Yes
Indicate number of shared visits/trips: 20
How often this limit applies: Every year

Benefits for qualifying members

Additional benefits for qualifying members with chronic conditions

The plan must confirm eligibility, including any qualifying condition.

Qualifying conditions: Chronic alcohol use disorder and other substance use disorders (SUDs); Autoimmune disorders; Cancer; Cardiovascular disorders; Chronic heart failure; Dementia; Diabetes mellitus; Overweight, obesity, and metabolic syndrome; Chronic gastrointestinal disease; Chronic kidney disease (CKD); Severe hematologic disorders; Chronic lung disorders; Chronic and disabling mental health conditions; Neurologic disorders; Stroke; Post-organ transplantation; Immunodeficiency and Immunosuppressive disorders; Conditions associated with cognitive impairment; Chronic conditions that impair vision, hearing (deafness), taste, touch, and smell; Conditions that require continued therapy services in order for individuals to maintain or retain functioning; Other 1
Qualifying conditions: Chronic Hypertension
Included services: Food and produce; Support for daily living
Some package benefits are exempt from the deductible: No

Prescription drug coverage

Costs shown are for initial coverage.

Drug deductible exceptions: Tier 1; Tier 2 are exempt from the deductible.

Standard retail costs

On a small screen, scroll the table sideways to compare all fill lengths.

Standard retail: initial-coverage cost per prescription fill
Drug tier	30 days	60 days	90 days
Tier 1Preferred Generic	$0.00	$0.00	$0.00
Tier 2Generic	$0.00	$0.00	$0.00
Tier 3Preferred Brand	$35.00	$70.00	$105.00
Tier 4Non-Preferred Drug	30%	Not listed	Not listed
Tier 5Specialty Tier	30%	Not listed	Not listed

Mail-order and other pharmacies

Out-of-network pricing: The standard retail copay or coinsurance applies, without an added difference between the billed charge and the plan’s allowed amount. The plan’s out-of-network coverage rules still apply.

Standard mail order costs

Standard mail order: initial-coverage cost per prescription fill
Drug tier	30 days	90 days
Tier 1Preferred Generic	Not listed	$0.00
Tier 2Generic	Not listed	$0.00
Tier 3Preferred Brand	Not listed	$70.00
Tier 4Non-Preferred Drug	30%	Not listed
Tier 5Specialty Tier	30%	Not listed

Long-term care pharmacy costs

Long-term care pharmacy: initial-coverage cost per prescription fill
Drug tier	31 days
Tier 1Preferred Generic	$0.00
Tier 2Generic	$0.00
Tier 3Preferred Brand	$35.00
Tier 4Non-Preferred Drug	30%
Tier 5Specialty Tier	30%

Out-of-network pharmacy costs

Out-of-network pharmacy: initial-coverage cost per prescription fill
Drug tier	30 days
Tier 1Preferred Generic	$0.00
Tier 2Generic	$0.00
Tier 3Preferred Brand	$35.00
Tier 4Non-Preferred Drug	30%
Tier 5Specialty Tier	30%

Drug coverage rules and exceptions

Tier 1: Preferred Generic

Drugs included in this tier: Part D Drugs Only
Longer fills available for every covered drug: No
Some longer-fill prescriptions require a one-month first fill: Yes

Tier 2: Generic

Drugs included in this tier: Both Part D and Excluded Drugs
Longer fills available for every covered drug: No
Some longer-fill prescriptions require a one-month first fill: Yes

Tier 3: Preferred Brand

Drugs included in this tier: Part D Drugs Only
Longer fills available for every covered drug: No
Some longer-fill prescriptions require a one-month first fill: Yes

Tier 4: Non-Preferred Drug

Drugs included in this tier: Part D Drugs Only

Tier 5: Specialty Tier

Drugs included in this tier: Part D Drugs Only

Initial-coverage prices also apply to drugs exempt from the deductible: Yes

Special cost protections apply to covered insulin and recommended adult vaccines.

Where this plan is offered

CMS lists this plan in 1 state or territory. Availability can vary by county and ZIP code.