Dignity Health Plan (HMO I-SNP), plan H8492-001-0, is a Medicare Advantage Special Needs Plan from Dignity Health Plan. Delivery of healthcare services and costs are significantly different than in Original Medicare, and the plan offers additional benefits that are not included with Medicare Part A and Part B.
GET NOTIFIED: 2024 Medicare Special Needs Plan Notification.
What You Need to Know
- Dignity Health Plan is a private HMO health plan for people who are institutionalized.
- This plan is for individuals living in a long-term care facility.
- If you qualify and enroll, this HMO plan replaces your Original Medicare coverage and offers the same benefits as Medicare Part A and Part B.
- To qualify, you must have Medicare Part A and Part B, live in the plan's service area, and live in an institution (like a nursing home) or require nursing care at home.
- This Dignity Health Plan plan includes Medicare Part D prescription drug coverage and other benefits not covered by Original Medicare.
- The annual Part D deductible is $505.00. You pay this amount before cost-sharing begins.
- If you qualify for the Social Security "Extra Help" program, you can get financial assistance to help pay your Medicare Part D monthly premium, annual deductible, and prescription copayments.
- If you don't qualify to join an SNP plan like this one, you can compare Washington Parish, Louisiana Medicare Advantage plans.
- 2024 costs and benefits for Dignity Health Plan will be available in early October. Get Notification.
|H8492-001-0 Plan Basics|
Plus your Part B premium.
|Health Plan Deductible:||$0.00|
|Out-of-Pocket Maximum:||$8,300 In-network|
|Drug Plan Benefit:||Basic |
|Rx Gap Coverage:||No|
|Supplemental Benefits:||Vision, Hearing|
|Availability:||Washington Parish, LA|
|Insured By:||Dignity Health Plan|
Health Plan Costs & Benefits
Dignity Health Plan is a Health Maintenance Organization (HMO) plan. HMO plan members usually receive health care services through the plan’s local network of providers. Referrals are almost always required to see a specialist and other providers. However, Dignity Health Plan does allow out-of-network care for emergencies and out-of-area dialysis.
Premiums, deductibles, and copays vary widely from plan to plan. It is very important to compare costs and apply them to your personal financial and healthcare needs.
Dignity Health Plan's total monthly premium in Washington Parish is $38.00. This includes your prescription coverage, as well. Plus, you must continue to pay your monthly Medicare Part B premium.
Dignity Health Plan's annual health plan deductible is $0.00. This does not include the deductible for the prescription drug plan (if any), which is detailed below.
Maximum Out-of-Pocket Limit
The Maximum Out-of-Pocket (MOOP) with this Dignity Health Plan plan is $8,300 in-network. Unlike Original Medicare, Medicare Advantage plans must set an annual Maximum Out-of-Pocket (MOOP) limit on inpatient and outpatient healthcare services. Once you reach this amount of spending on your copayments, all of your Medicare Part A and Part B services will be covered at no additional charge for the remainder of the year. MOOP does not include monthly premiums, prescriptions, or other extra benefits.
Health Plan Out-of-Pocket Costs
The following table is a summary of the most common out-of-pocket costs you will incur if you join this Dignity Health Plan plan:
|Healthcare Service||Member Cost|
|Health plan deductible||$226 per year for in-network services.|
|Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)||$8,300 In-network|
|Primary||0-20% coinsurance per visit|
|Wellness programs (e.g., fitness, nursing hotline)||Not covered|
|Preventive care||$0 copay|
|Mental Health Services|
|Inpatient hospital - psychiatric||In 2023 the amounts for each benefit period are:|
$1,600 deductible for days 1 through 60
$400 copay per
|Outpatient individual therapy visit with a psychiatrist||20% coinsurance|
|Outpatient individual therapy visit||20% coinsurance|
|Outpatient group therapy visit with a psychiatrist||20% coinsurance|
|Occupational therapy visit||20% coinsurance|
|Medical Equipment / Supplies|
|Prosthetics (e.g., braces, artificial limbs)||20% coinsurance per item|
|Diabetes supplies||20% coinsurance per item|
|Diagnostic Procedures / Lab Services / Imaging|
|Lab services||$0 copay|
|Outpatient x-rays||20% coinsurance|
(referral required, authorization required)
|Diagnostic tests and procedures||20% coinsurance|
|Medicare Part B Drugs|
|Foot Care (podiatry Services)|
|Routine foot care||Not covered|
|Hearing aids||$0 copay|
(limits may apply)
(limits may apply)
|Dental x-ray(s)||Not covered|
|Fluoride treatment||Not covered|
|Oral exam||Not covered|
|Prosthodontics, other oral/maxillofacial surgery, other services||Not covered|
|Diagnostic services||Not covered|
|Non-routine services||Not covered|
|Routine eye exam||$0 copay|
(limits may apply)
|Eyeglasses (frames and lenses)||$0 copay|
(limits may apply)
|Eyeglass frames||Not covered|
|Eyeglass lenses||Not covered|
|Emergency Care / Urgent Care|
|Urgent care||20% coinsurance per visit (always covered)|
|Ground ambulance||20% coinsurance|
|Inpatient hospital coverage||In 2023 the amounts for each benefit period are:|
$1,600 deductible for days 1 through 60
$400 copay per
|Outpatient hospital coverage||20% coinsurance per visit|
|Skilled Nursing Facility||In 2023 the amounts for each benefit period are:|
$0 copay for days 1 through 20
$200 copay per day for
|Optional supplemental benefits||No|
Feel free to download our Dignity Health Plan Summary of Benefits information.
Prescription Drug Plan Costs & Benefits
Dignity Health Plan includes an basic benefit Medicare Part D plan (PDP). This simply means that the plan covers the minimum amount required by the Centers for Medicare & Medicaid Services, whereas enhanced benefit plans cover more.
Basic plans typically have less cost-sharing by the plan than plans with an enhanced benefit. But, close to a third of all enhanced plans charge more than the average for preferred brand name drugs, and over 50% charge more for non-preferred brand drugs. For most people, a basic plan is their best bet, due to lower premiums and lower cost-sharing, even if the plan has a deductible.
Prescription Drug Plan Premium
Although the prescription drug plan (Part D) premium is bundled with the total plan cost, some plans have supplemental costs and/or offer low-income subsidy (LIS) assistance. The following table outlines the prescription drug plan premium details of this plan.
|Basic Part D Premium:||$38.00|
|Supplemental Part D Premium:||$0.00|
|Total Part D Premium:||$38.00|
|Part D Premium with Full LIS Assistance:||$0.00|
|Part D Premium with 75% LIS Assistance:||$9.50|
|Part D Premium with 50% LIS Assistance:||$19.00|
|Part D Premium with 25% LIS Assistance:||$28.50|
For more information about the Low-Income Subsidy (aka, "Extra Help") program, refer to the Social Security Extra Help page.
Prescription Drug Plan Deductible
The Medicare Part D annual deductible with this plan is $505.00. This is the amount you must pay at the pharmacy before Dignity Health Plan begins paying its share.
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Dignity Health Plan has copayments (a fixed dollar amount) and/or coinsurances (a percentage amount) that you must pay when you pick up your prescriptions. The following table shows you those costs.
|$0 copay on all covered generic and brand-name prescriptions.|
CMS Rating Marks and Our Review
Each year Medicare rates I-SNP plans, like this one, in nine major categories. These ratings are designed to help you understand the quality of care and service you can expect if you qualify and choose to join Dignity Health Plan.
Although Dignity Health Plan is too new to have a Medicare star rating, we can offer some input on its value.At this time, we do not have enough information to rate how well Dignity Health Plan does at keeping its members healthy. We do not have enough information to rate how well this plan manages long-term (chronic) health conditions. We do not have enough information from this plan to rate member experience. We do not have enough information from this plan to rate complaints and plan performance changes.
|CMS Measure||Star Rating|
|2023 Overall Rating|
|Staying Healthy: Screenings, Tests, Vaccines||Not enough data available|
|Managing Chronic (Long Term) Conditions||Not enough data available|
|Member Experience with Health Plan||Not enough data available|
|Complaints and Changes in Plans Performance||Not enough data available|
|Health Plan Customer Service||Not enough data available|
|Drug Plan Customer Service|
|Complaints and Changes in the Drug Plan||Not enough data available|
|Member Experience with the Drug Plan||Not enough data available|
|Drug Safety and Accuracy of Drug Pricing||Not enough data available|
How to Qualify to Enroll in
Dignity Health Plan
To be eligible to enroll in Dignity Health Plan, you must meet three requirements:
- You are eligible for Medicare;
- You live in Washington Parish (the plan’s service area); and
- You require the level of care provided in an institutionalized setting, such as a long-term care nursing facility, for 90 days or more.
If you live at home and require an equivalent level of skilled care, you may be eligible for an Institutional Equivalent Special Needs Plan (IE-SNP).
Before joining Dignity Health Plan, consider these questions:
- Does the plan's provider network include my nursing home or home care provider?
- What costs should I expect with my coverage (premiums, deductibles, copayments)?
- Is there an annual limit on my out-of-pocket costs?
- Will I be able to use my doctors? Are they in the plan's network?
- Are the plan's in-network providers and facilities in convenient locations?
- Does the plan provide coverage for services I receive from out-of-network providers?
- Do I need a referral to see a specialist?
- Are my medications on the Part D plan's formulary?
- What special accommodations does the plan make for persons with disabilities?
- What special language and cultural accommodations does the plan make?
Additional I-SNP Plan Options
Here are some additional Medicare SNP plans that might be worth reviewing:
Contact Dignity Health Plan
Call 1-855-728-0510 (TTY 711) to speak with a licensed insurance agent (Mon-Fri, 8am-9pm , Sat 8am-8pm EST) and learn more about this Special Needs Plan and other plans on this site. You may also Enroll Online using our safe and secure online enrollment website or take advantage of the following plan resources:
|Pharmacy Information:||Dignity Health Plan Pharmacy Page|
If you qualify for Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program on www.medicare.gov.
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Centene Corporation, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna-HealthSpring, Humana, Molina Healthcare, Mutual of Omaha, Oscar Health Insurance, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, and UnitedHealthcare.
Citations & References
- Dignity Health Plan, http://www.dignityhealthplan.com, Last Accessed October 13, 2022
- Medicaid.gov, "Medicaid & CHIP in Louisiana", Last Accessed January 20, 2023
- CMS.gov, "Institutional Special Needs Plans (I-SNPs)", Last Accessed January 20, 2023
- CMS.gov, Landscape Source Files, Last Accessed January 21, 2023
- CMS.gov, Medicare Part C & D Performance, Last Accessed January 21, 2023
- CMS.gov, Plan Benefits Package, Last Accessed January 21, 2023