Sonder Dual Complete (D-SNP) H1748 005 0 Plan Details
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*This plan is new and has not yet been rated by CMS.
Sonder Dual Complete (D-SNP) is a Dual-Eligible Special Needs Plan. The 2025 Annual Enrollment period starts October 15. Plan benefits begin January 1.
This 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 Dual-Eligible SNP qualification requirements to join this Sonder Health Plans, Inc. D-SNP plan.
Plan Basics | |
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Plan ID: | H1748-005-0 |
Plan Type: | HMO D-SNP |
Plan Year: | 2025 |
Premium: | $40.00/mo Plus your Part B premium. |
Health Plan Deductible: | $0.00 |
Out-of-Pocket Maximum: | 9,350.00 /yr |
Part B Reduction: | $0.00/mo |
Drug Plan Benefit: | $590.00 deductible |
Supplemental Benefits: | Vision, Hearing |
Availability: | See List |
Insured By: | Sonder Health Plans, Inc. |
Summary of Benefits |
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Health Plan Cost Sharing & Benefits
The following table is a summary of the most common out-of-pocket costs you will incur if you join this Sonder Health Plans, Inc. plan:
Healthcare Service | Member Cost |
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Doctor Visits (In-Network) | |
Primary: | 20% Coinsurance |
Specialist: | 20% Coinsurance |
Preventive care: | 20% Coinsurance |
Foot Care (In-Network) | |
Foot exams and treatment (Medicare-covered): | 20% Coinsurance Referral Required |
Routine foot care: | $0 |
Chiropractic Care (In-Network) | |
Medicare-covered chiropractic care: | 20% Coinsurance Prior Authorization Required |
Routine chiropractic care: | $0 |
Emergency Care / Urgent Care | |
Emergency room care: | 20% Coinsurance |
Urgent care: | 20% Coinsurance |
Ground ambulance: | 20% Coinsurance |
Inpatient hospital coverage: | Coming Soon |
Outpatient hospital coverage: | 20% Coinsurance Prior Authorization Required |
Skilled Nursing Facility: | Unknown |
Optional supplemental benefits: | Not Covered |
Mental Health Services (In-Network) | |
Outpatient individual therapy visit with a psychiatrist: | 20% Coinsurance |
Outpatient group therapy visit with a psychiatrist: | 20% Coinsurance |
Inpatient hospital - psychiatric: | Coming Soon |
Outpatient group therapy visit: | 20% Coinsurance |
Outpatient individual therapy visit: | 20% Coinsurance |
Rehabilitation Services (In-Network) | |
Physical therapy and speech and language therapy visit: | 20% Coinsurance Prior Authorization Required, Referral Required |
Occupational therapy visit: | 20% Coinsurance Prior Authorization Required, Referral Required |
Medical Equipment / Supplies (In-Network) | |
Diabetes supplies: | 20% Coinsurance 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): | 20% Coinsurance Referral Required |
Lab services: | 20% Coinsurance Referral Required |
Outpatient x-rays: | 20% Coinsurance Referral Required |
Diagnostic tests and procedures: | 20% Coinsurance Referral Required |
Medicare Part B Drugs (In-Network) | |
Chemotherapy: | 20% Coinsurance |
Other Part B drugs (Medicare-covered) | 20% Coinsurance |
Feel free to download our Sonder Dual Complete Summary of Benefits information.
Supplemental Health Plan Benefits (H1748-005-0)
The following is a summary of the supplemental benefits Sonder Health Plans, Inc. includes with this plan:
Supplemental Healthcare Service | Member Cost |
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Preventive Dental | |
Oral exam (In-Network) | Not Covered |
Fluoride treatment (In-Network) | Not Covered |
Dental x-ray(s) (In-Network) | Not Covered |
Cleaning (In-Network) | Not Covered |
Comprehensive Dental | |
Periodontics (In-Network) | Not Covered |
Non-routine services (In-Network) | Not Covered |
Diagnostic services (In-Network) | Not Covered |
Extractions (In-Network) | Not Covered |
Endodontics (In-Network) | Not Covered |
Restorative services (In-Network) | Not Covered |
Prosthodontics, other oral/maxillofacial surgery, other services (In-Network) | Not Covered |
Hearing | |
Fitting/evaluation (In-Network) | Covered Limits may apply |
Hearing aids (In-Network) | Not Covered |
Hearing exam (In-Network) | Not Covered |
Vision | Maximum vision benefit: | $2.00 Every three years |
Eyeglasses (frames and lenses) (In-Network) | Not Covered |
Routine eye exam (In-Network) | Covered Limits may apply |
Contact lenses (In-Network) | Not Covered |
Prescription Drug Plan Costs & Benefits
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: | |
Supplemental Part D Premium: | |
Total Part D Premium: | |
Part D Premium with Full LIS Assistance: |
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 $590.00. This is the amount you must pay at the pharmacy before Sonder Health Plans, Inc. begins paying its share.
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Sonder Dual Complete 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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$0 copay on all covered generic and brand-name prescriptions. |
CMS Rating Marks
Each year Medicare rates D-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 Sonder Dual Complete .
CMS Measure | Star Rating |
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2025 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 |
Plan Availability
Sonder Dual Complete (H1748-005-0) is available in the following locations (click to open):
Additional D-SNP Plan Options
Here are some additional Medicare SNP plans that might be worth reviewing:
- H1748-004-0: Sonder Heart Healthy ()
- H1748-003-0: Sonder Diabetes Wellness ()
- H1748-005-0: Sonder Dual Complete ()
- H1748-013-0: Sonder Breathe Well ()
- H1748-011-0: Sonder Mind Matters ()
Contact Sonder Health Plans, Inc.
Plan Website: | http://www.sonderhealthplans.com |
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Formulay Information: | http://www.sonderhealthplans.com |
Pharmacy Information: | Sonder Health Plans, Inc. Pharmacy Page |
Prospective Members: | (888)428-4440 |
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
- Sonder Health Plans, Inc., http://www.sonderhealthplans.com, Last Accessed October 13, 2023
- Medicaid.gov, "Medicaid & CHIP in Georgia", Last Accessed October 1, 2024
- CMS.gov, Landscape Source Files, Last Accessed October 2, 2024
- CMS.gov, Medicare Part C & D Performance, Last Accessed October 2, 2024
- CMS.gov, Plan Benefits Package, Last Accessed October 5, 2024
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, 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.