Brand New Day Embrace Care Plan (C-SNP) H0838 047 0 Plan Details
CMS rated this Brand New Day plan 2.5 (Below Average) out of 5 stars.
Brand New Day Embrace Care Plan (C-SNP HMO) is a Special Needs Plan (SNP). 2025 plan enrollment begins Oct 15. Get notified.
This Brand New Day HMO plan is required to provide all of the same benefits as Original Medicare, but out-of-pocket costs are different. This private health insurance option may include extra benefits not covered by Medicare Part A or Part B.
Eligible individuals must meet all qualification requirements to join this Brand New Day plan.
2025 Brand New Day Embrace Care Plan Cost and Coverage Notification
The 2025 cost and coverage information for Brand New Day Embrace Care Plan will not be available until early October. We'll notify you when it is available from CMS.
Sign-Up for 2025 Medicare Plan Notification. The 2025 enrollment period begins October 15.
Plan Basics | |
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Plan ID: | H0838-047-0 |
Plan Type: | HMO |
Plan Year: | 2024 |
Premium: | $55.00/mo Plus your Part B premium. |
Health Plan Deductible: | $0.00 |
Out-of-Pocket Maximum: | /yr |
Part B Reduction: | $0.00/mo |
Drug Plan Benefit: | Enhanced $0.00 deductible |
Supplemental Benefits: | Dental, Vision, Hearing |
Availability: | See List |
Insured By: | Brand New Day |
Summary of Benefits |
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Health Plan Cost Sharing & Benefits
Brand New Day Embrace Care Plan is a Health Maintenance Organization (HMO) plan. HMO C-SNP 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, Brand New Day Embrace Care Plan does allow out-of-network care for emergencies and out-of-area dialysis.
The following table is a summary of the most common out-of-pocket costs you will incur if you join this Brand New Day plan:
Healthcare Service | Member Cost |
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Doctor Visits (In-Network) | |
Primary: | $0 Copay |
Specialist: | $10 Copay Prior Authorization Required, Referral Required |
Wellness programs (e.g., fitness, nursing hotline): | |
Preventive care: | $0 Copay |
Foot Care (In-Network) | |
Foot exams and treatment (Medicare-covered): | $0 Copay Prior Authorization Required, Referral Required |
Routine foot care: | $0 |
Chiropractic Care (In-Network) | |
Medicare-covered chiropractic care: | $0 Copay Prior Authorization Required, Referral Required |
Routine chiropractic care: | $0 Copay Prior Authorization Required, Referral Required |
Emergency Care / Urgent Care | |
Emergency room care: | $100 Copay |
Urgent care: | $0 Copay |
Ground ambulance: | $200 Copay |
Inpatient hospital coverage: | $195.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
Outpatient hospital coverage: | $75 Copay Prior Authorization Required, Referral Required |
Skilled Nursing Facility: | Unknown |
Optional supplemental benefits: | Not Covered |
Mental Health Services (In-Network) | |
Outpatient individual therapy visit with a psychiatrist: | $25 Copay |
Outpatient group therapy visit with a psychiatrist: | $10 Copay |
Inpatient hospital - psychiatric: | $250.00 per stay |
Outpatient group therapy visit: | $10 Copay |
Outpatient individual therapy visit: | $0 |
Rehabilitation Services (In-Network) | |
Physical therapy and speech and language therapy visit: | $10 Copay Prior Authorization Required, Referral Required |
Occupational therapy visit: | $10 Copay Prior Authorization Required, Referral Required |
Medical Equipment / Supplies (In-Network) | |
Diabetes supplies: | $0 Copay Prior Authorization Required |
Durable medical equipment (e.g., wheelchairs, oxygen): | 20% Coinsurance Prior Authorization Required |
Prosthetics (e.g., braces, artificial limbs): | 20% Coinsurance |
Diagnostic Procedures / Lab Services / Imaging (In-Network) | |
Diagnostic radiology services (e.g., MRI): | $100 Copay Prior Authorization Required, Referral Required |
Lab services: | $0 Copay Prior Authorization Required, Referral Required |
Outpatient x-rays: | $0 Copay Prior Authorization Required, Referral Required |
Diagnostic tests and procedures: | $0 Copay Prior Authorization Required, Referral Required |
Medicare Part B Drugs (In-Network) | |
Chemotherapy: | 20% Coinsurance |
Other Part B drugs (Medicare-covered) | 20% Coinsurance |
Feel free to download our Brand New Day Embrace Care Plan Summary of Benefits information.
Supplemental Health Plan Benefits (H0838-047-0)
The following is a summary of the supplemental benefits Brand New Day includes with this plan:
Supplemental Healthcare Service | Member Cost |
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Preventive Dental | Maximum dental benefit: | Non Specified |
Oral exam (In-Network) | Covered |
Fluoride treatment (In-Network) | Covered |
Dental x-ray(s) (In-Network) | Covered |
Cleaning (In-Network) | Covered |
Comprehensive Dental | |
Periodontics (In-Network) | Covered |
Non-routine services (In-Network) | Covered |
Diagnostic services (In-Network) | Covered |
Extractions (In-Network) | Covered |
Endodontics (In-Network) | Covered |
Restorative services (In-Network) | Covered |
Prosthodontics, other oral/maxillofacial surgery, other services (In-Network) | Covered |
Hearing | |
Fitting/evaluation (In-Network) | $0 Copay |
Hearing aids (In-Network) | Covered Limits may apply |
Hearing exam (In-Network) | $0 Copay |
Vision | Maximum vision benefit: | $300.00 Every year |
Eyeglasses (frames and lenses) (In-Network) | Covered Limits may apply |
Routine eye exam (In-Network) | $0 Copay Prior Authorization Required, Referral Required |
Contact lenses (In-Network) | Covered Limits may apply |
Additional Supplemental Benefits
None specified.
Prescription Drug Plan Costs & Benefits
Brand New Day Embrace Care Plan includes an enhanced benefit Medicare Part D plan (PDP). Enhanced plans have a higher actuarial value than basic plans. Actuarial value simply refers to the percentage of cost that's covered by the plan.
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 details of this plan's prescription drug plan premium.
Basic Part D Premium: | $48.00 |
Supplemental Part D Premium: | $0.00 |
Total Part D Premium: | $48.00 |
Part D Premium with Full LIS Assistance: | $7.00 |
The Social Security Extra Help page has more information about the low-income subsidy (LIS) and how to enroll in the program.
Prescription Drug Plan Deductible
The Medicare Part D annual deductible with this plan is $0.00. This is the amount you must pay at the pharmacy before Brand New Day begins paying its share.
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Brand New Day Embrace Care Plan has out-of-pocket costs that you must pay when you pick up your prescriptions. The following table shows you those costs.
Drug Tier | Preferred | Standard |
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1 (Preferred Generic) | N/A | $0.00 copay |
2 (Generic) | N/A | $12.00 copay |
3 (Preferred Brand) | N/A | $47.00 copay |
4 (Non-Preferred Drug) | N/A | $100.00 copay |
5 (Specialty Tier) | N/A | 33% |
6 (Select Care Drugs) | N/A | $0.00 copay |
CMS Rating Marks
Each year Medicare rates C-SNP plans, using a 5-star rating system, 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 Brand New Day Embrace Care Plan.
CMS Measure | Star Rating |
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2024 Overall Rating | |
Staying Healthy: Screenings, Tests, Vaccines | |
Managing Chronic (Long Term) Conditions | |
Member Experience with Health Plan | |
Complaints and Changes in Plans Performance | |
Health Plan Customer Service | |
Drug Plan Customer Service | |
Complaints and Changes in the Drug Plan | |
Member Experience with the Drug Plan | |
Drug Safety and Accuracy of Drug Pricing |
How to Qualify to Enroll in
Brand New Day Embrace Care Plan
To be eligible to enroll in Brand New Day Embrace Care Plan, you must meet these requirements:
- You are eligible for Medicare;
- You live in County (the plan’s service area); and
- You have been diagnosed with one or more severe or disabling chronic conditions.
A disabiling chronic condition (disease) is one that lasts one or more years and requires ongoing medical attention and/or limits activities of daily living. They include:
- Autoimmune disorders
- End-stage renal disease
- Cancer
- Cardiovascular disorders
- Hematologic disorders
- HIV/AIDS
- Chronic heart failure
- Chronic lung disorders
- Neurologic disorders
- Dementia
- Diabetes
- End-stage liver disease
- Neurologic disorders
- Stroke
- Mental health conditions
This plan is for individuals with cardiovascular disorders, chronic heart failure, and/or diabetes.
Plan Availability
Brand New Day Embrace Care Plan (H0838-047-0) is available in the following locations (click to open):
Additional C-SNP Plan Options
Here are some additional Medicare SNP plans that might be worth reviewing:
- None.
Contact Brand New Day
Plan Website: | http://www.bndhmo.com |
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Formulay Information: | http://www.bndhmo.com |
Pharmacy Information: | Brand New Day Pharmacy Page |
Prospective Members: | (888)683-1882 |
TTY Users: | 711 |
If you qualify for Medicare benefits 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.
Health Plan Compatibility
Medicare Advantage Special Needs Plans (SNPs) are generally incompatible with most other health insurance options. Enrolling in an SNP plan while having Medicare Part A and/or Medicare Part B will result in disenrollment from Original Medicare. Additionally, it is not possible to simultaneously hold a Medicare Supplement Insurance policy and be part of an SNP plan.
With a D-SNP, members keep the same Medicaid plan and Medicaid benefits. If you are a Veteran and have VA Health Benefits, you may be able to care from your local VA hospital.
Citations & References
- Brand New Day, http://www.bndhmo.com, Last Accessed October 13, 2023
- Medicaid.gov, "Medicaid & CHIP in ", Last Accessed January 4, 2024
- CMS.gov, "Chronic Condition Special Needs Plans (C-SNPs)", Last Accessed January 20, 2023
- CMS.gov, Landscape Source Files, Last Accessed January 2, 2024
- CMS.gov, Medicare Part C & D Performance, Last Accessed January 2, 2024
- CMS.gov, Plan Benefits Package, Last Accessed January 3, 2024
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.