Medicare Advantage · HMOPOS
Perennial Advantage
Plan year 2026

Perennial Advantage Premier (HMO-POS I-SNP) H8797-004

Monthly premium
$0
+ your Part B premium
Max out-of-pocket
$3,900
in-network annual cap
Primary care
$0
per visit copay
Specialist
$10
per visit
Eligibility required for this I-SNP
The plan must verify that, for 90 days or longer, you have needed or are expected to need the level of care provided in a qualifying institution. Some plans also serve people who need an equivalent institutional level of care while living in the community. Review the official plan documents for the residence, care-level, and enrollment requirements.
Medical coverage is different from long-term room and board

An I-SNP coordinates Medicare-covered care for members who meet its institutional eligibility rules. That eligibility does not mean Medicare pays for long-term custodial care or an ongoing nursing-home stay. Medicare may cover short-term skilled nursing care when its coverage requirements are met; Medicaid, long-term-care insurance, or personal funds may cover other long-term-care costs.

Research nearby nursing homes
The nursing-home finder shows CMS facility information. It does not confirm that a facility participates in this plan. Confirm participation with both the facility and the plan before enrolling.
Extra benefits for members who qualify
  • Food and produce benefit
  • Non-medical transportation benefit
  • $75/month general supports for living
These benefits are not available to every member. Even if you have a listed chronic condition, the plan must confirm that you meet its coverage criteria. See the Evidence of Coverage for complete rules.

Your costs at a glanceIn-network, for the 2026 plan year

Rx deductible
$0
Inpatient hospital
Days 1-5: $275/day, Days 6-90: $0/day
no limit on covered hospital days
Inpatient mental health
Days 1-5: $280/day, Days 6-90: $0/day
no limit on covered hospital days
Outpatient surgery
$250
Emergency room
$90
Urgent care
20% (max $60/visit)

What's included, and what it's actually worth4 benefits included. Tap any card for the detail

Hearing

$2,200/yr hearing aid allowance
Hearing aid allowance$2,200/yr hearing aid allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.

Vision

$300/yr eyewear allowance
Eyewear allowance$300/yr eyewear allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.
See more details about this plan
Doctor Visits: PCP$0 copay
In-network$0 copay per visit
Doctor Visits: Specialist$10 copay
In-network$10 copay per visit
Inpatient Hospital$275/day, days 1–5
In-networkDays 1-5: $275/day, Days 6-90: $0/day
Benefit limitNone — additional covered days are unlimited
Outpatient Surgery$250 copay
In-network$250 copay per procedure
Mental HealthDays 1-5: $280/day, Days 6-90: $0/day
Inpatient psychiatricDays 1-5: $280/day, Days 6-90: $0/day
TransportationNon-emergency transportation benefit
DetailsNon-emergency transportation benefit
MealsMeal benefit

Your coverageCheck your coverageFrom the doctors and prescriptions you added

Your plan's drug tiers30-day retail · after any applicable deductible

Tier 1
$0
Preferred Generic
Tier 2
$10
Generic
Tier 3
$45
Preferred Brand
Tier 4
$95
Non-Pref Brand
Tier 5
33%
Specialty

Our take

Where this plan shines

This plan has a $0 monthly premium.
This plan’s out-of-pocket maximum ($3,900) is among the lowest available.
See your primary doctor for $0.
The specialist copay ($10) is among the more affordable options.
No separate drug deductible.

Things to know before you enroll

Limited coverage while traveling outside the plan’s service area.
Questions? Talk to a licensed agent at1-866-764-3312 (TTY: 711)

Plan documents

Plan questions

Common questions about Perennial Advantage Premier (HMO-POS I-SNP) (HMOPOS)

What does Perennial Advantage Premier (HMO-POS I-SNP) (HMOPOS) cover?

Perennial Advantage Premier (HMO-POS I-SNP) (HMOPOS) is an Institutional Special Needs Plan, a Medicare Advantage plan for people whose qualifying institutional level of care the plan verifies. The plan record also identifies Part D prescription drug coverage. Its published drug benefit lists 5 formulary tiers. Published supplemental benefits include vision ($300/yr eyewear allowance), hearing ($2,200/yr hearing aid allowance), transportation (Non-emergency transportation benefit), and meals (Meal benefit). Review the plan documents for covered services, limits, and rules. Coverage can change each plan year.

Learn about Medicare Advantage

How much does Perennial Advantage Premier (HMO-POS I-SNP) (HMOPOS) cost in 2026?

The published 2026 monthly plan premium for Perennial Advantage Premier (HMO-POS I-SNP) (HMOPOS) is $0. The standard Part B premium is $202.90/month in 2026 for most people; assistance may pay it for some members. The listed Part D deductible is $0. The in-network medical out-of-pocket maximum is $3,900; it does not include Part D drug spending. Published visit costs include primary care $0 and specialist visits $10. These figures are plan data, not a personal yearly-cost estimate.

Understand Medicare drug-cost limits

Can I use my current doctors with Perennial Advantage Premier (HMO-POS I-SNP) (HMOPOS)?

CMS lists Perennial Advantage Premier (HMO-POS I-SNP) (HMOPOS) as a HMOPOS plan. The record also identifies point-of-service flexibility, but exact out-of-network rules can vary. A network label alone does not confirm that a specific doctor participates. Use the doctor lookup tool, then confirm with the doctor's office and the plan before receiving care. Provider networks and member costs can change. Emergency care and travel coverage can follow different network rules.

Check your doctors

Who is eligible for Perennial Advantage Premier (HMO-POS I-SNP) (HMOPOS)?

Perennial Advantage Premier (HMO-POS I-SNP) (HMOPOS) is listed in the current plan record as a I-SNP. The plan must verify that, for 90 days or longer, you have needed or are expected to need the level of care provided in a qualifying institution. Some plans also serve people who need an equivalent institutional level of care while living in the community. Review the official plan documents for the residence, care-level, and enrollment requirements.

Learn about Special Needs Plans

What does Perennial Advantage Premier (HMO-POS I-SNP) (HMOPOS) cover for people who need institutional care?

Perennial Advantage Premier (HMO-POS I-SNP) (HMOPOS) is identified in the current plan record as an Institutional Special Needs Plan. The record identifies Part D prescription drug coverage. It also lists vision ($300/yr eyewear allowance), hearing ($2,200/yr hearing aid allowance), transportation (Non-emergency transportation benefit), and meals (Meal benefit). The page data does not describe facility-specific therapy, nursing, or care-coordination arrangements. Confirm covered services, participating facilities, benefit limits, and coordination responsibilities in the official plan documents before enrolling.

When can I enroll in Perennial Advantage Premier (HMO-POS I-SNP) (HMOPOS)?

Perennial Advantage Premier (HMO-POS I-SNP) (HMOPOS) is a 2026 Medicare Advantage plan. The Annual Enrollment Period runs from October 15 through December 7, with changes taking effect January 1. The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 for people already enrolled in Medicare Advantage. Because this is a I-SNP, the plan must also verify its eligibility requirements. A qualifying circumstance may create a Special Enrollment Period, but eligibility alone does not guarantee a year-round right to enroll. Confirm the enrollment window and effective date that apply to you before changing coverage.

Review Medicare enrollment periods

More plan options

Browse the full 2026 Institutional Special Needs Plan directory. This plan is offered in Ohio. Plan availability can vary by county.

Helpful next steps

Perennial Advantage Premier H8797-004 (HMO-POS I-SNP) — 2026