2027 Medicare Advantage plan

Verda Noble Chronic Care (HMO C-SNP): 2027 benefits and costs

Verda Health Plan of Texas HMO C-SNP Special Needs Plan

CMS plan ID: H5163-002-0 · Plan year: 2027

Verda Noble Chronic Care (HMO C-SNP) 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$999.00

Organization: Verda Health Plan of Texas
Plan organization: VERDA HEALTH PLAN OF TEXAS INC
Parent company: Verda Healthcare, Inc.
Plan type: HMO C-SNP
Part C premium: $0.00
Part D premium: $0.00
Prescription drug coverage: Yes
Special Needs Plan type: Chronic or Disabling Condition
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: $999.00

Who can join this Special Needs Plan?

This plan is for people with qualifying chronic or disabling conditions. The plan must confirm that your condition meets its eligibility rules.

Plan eligibility type: Chronic or Disabling Condition
Qualifying conditions: Diabetes Mellitus, Chronic Heart Failure, and Cardiovascular Disorders

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: $100.00 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 $25.00 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	$99.00 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	$99.00 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; Tier 6 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	$30.00	$60.00	$90.00
Tier 4Non-Preferred Drug	28%	Not listed	Not listed
Tier 5Specialty Tier	30%	Not listed	Not listed
Tier 6Select Diabetic Drugs	$0.00	$0.00	$0.00

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	$60.00
Tier 4Non-Preferred Drug	28%	Not listed
Tier 5Specialty Tier	30%	Not listed
Tier 6Select Diabetic Drugs	Not listed	$0.00

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	$30.00
Tier 4Non-Preferred Drug	28%
Tier 5Specialty Tier	30%
Tier 6Select Diabetic Drugs	$0.00

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	$30.00
Tier 4Non-Preferred Drug	28%
Tier 5Specialty Tier	30%
Tier 6Select Diabetic Drugs	$0.00

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

Tier 6: Select Diabetic Drugs

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

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.