VIVA Medicare Extra Value (HMO D-SNP)

by VIVA Medicare

2026 Medicare-Medicaid Dual Eligible D-SNP plan available in Alabama

Plan ID H0154-012-0

Additional coverage:

RxHearingVisionDental

Medicare-Medicaid Dual Eligible D-SNP HMO 4.0 Overall

Monthly plan premium $28 / mo

Annual deductible $0 / yr

Max out-of-pocket · in-network $6,750 / yr

Drug deductible $615 / yr

4.0 Overall Government Star Rating 2026 · out of 5 stars

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Plan Overview

VIVA Medicare Extra Value (HMO D-SNP) is a Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP), which is available in Alabama and offered by the health insurance company VIVA Medicare. This plan's network type is HMO, which determines the in-network doctors who accept the plan and whether a referral is needed.

Plan Name VIVA Medicare Extra Value (HMO D-SNP)

Insurance Carrier VIVA Medicare

Plan Type Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP)

Network Type HMO

Cost Summary

VIVA Medicare Extra Value (HMO D-SNP) has a monthly premium cost of $28 per month, with an annual deductible of $0 and a maximum out-of-pocket cost sharing of $6,750. The most common costs people evaluate when choosing a plan are listed here; a full list of benefit costs is defined below.

Monthly Premium $28 / mo

Health portion of premium $0

Drug portion of premium $28

Annual Deductible $0 / yr

Max Out-of-Pocket · in-network $6,750 / yr

Primary doctor visit $0 copay

Specialist visit $0-$18 copay

ER visit $130 copay

Ambulance $345 copay

Additional Benefits and Coverage

VIVA Medicare Extra Value (HMO D-SNP) is a Medicare Advantage plan which includes Medicare Part D prescription drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. VIVA Medicare Extra Value (HMO D-SNP) includes coverage for hearing, vision, dental.

Part D Prescription Drug Coverage Yes

Dental Yes

Vision Yes

Hearing Yes

Nationwide Coverage No

Other benefits

Fitness benefit Limited coverage

Over-the-counter drug benefits Limited coverage

In-home support services Not covered

Home & bathroom safety devices Not covered

Meals for short duration Not covered

Annual physical exams Limited coverage

Telehealth Limited coverage

Medical Benefits

Doctor Services

Primary doctor visit In-network: $0 copay
Out-of-network: $0 copay

Specialist visit In-network: $0-$18 copay
Out-of-network: $0-$18 copay

Tests, labs & imaging

Diagnostic tests & procedures In-network: $0-$50 copay
Out-of-network: $0-$50 copay

Lab services In-network: $0 copay
Out-of-network: $0 copay

Diagnostic radiology services (like MRI) In-network: $10-$100 copay
Out-of-network: $10-$100 copay

Outpatient x-rays In-network: $10 copay
Out-of-network: $10 copay

Emergency care $130 copay

Urgent care $0-$40 copay

Hospital Services

Inpatient hospital coverage Tier 1
$440 per day for days 1-6
$0 per day for days 7-90
$0 per stay

Outpatient hospital coverage In-network: $0-$400 copay
Out-of-network: $0-$400 copay

Skilled nursing facility

Skilled nursing facility Tier 1
$10 per day for days 1-20
$218 per day for days 21-51
$0 per day for days 52-100

Preventive services

Preventive services In-network: $0 copay
Out-of-network: $0 copay

Ambulance

Ground ambulance In-network: $345 copay
Out-of-network: $345 copay

Therapy services

Occupational therapy visit In-network: $18 copay
Out-of-network: $18 copay

Physical therapy & speech & language therapy visit In-network: $18 copay
Out-of-network: $18 copay

Mental health services

Outpatient group therapy with a psychiatrist In-network: $18 copay
Out-of-network: $18 copay

Outpatient individual therapy with a psychiatrist In-network: $18 copay
Out-of-network: $18 copay

Outpatient group therapy visit In-network: $18 copay
Out-of-network: $18 copay

Outpatient individual therapy visit In-network: $18 copay
Out-of-network: $18 copay

Opioid treatment services

Opioid treatment services Covered

Other services

Durable medical equipment (like wheelchairs & oxygen) In-network: 25% coinsurance
Out-of-network: 25% coinsurance

Prosthetics (like braces, artificial limbs) In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Diabetes supplies In-network: $0 copay
Out-of-network: $0 copay

Prescription drugs (Part D benefits)

Drug tier standard retail · 1-month supply Initial coverage Catastrophic

Generic Drugs 25% coinsurance 0% coinsurance

Brand Name Drugs 25% coinsurance 0% coinsurance

Part B drugs

Chemotherapy drugs In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance

Other Part B drugs In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance

Medicare star rating

Each year the federal government rates Medicare Advantage and Part D plans on a 5-star system covering quality of care, chronic-condition management, member experience, and customer service. For 2026, VIVA Medicare Extra Value (HMO D-SNP) earned an overall rating of 4.0 stars — better than Alabama's state average of 3.7 stars.

Rating category This plan State average

Overall star rating ★ 4.0 3.7

Health plan quality

Summary rating of health plan quality ★ 4.5 3.8

Staying healthy: screenings, tests & vaccines ★ 3.0 3.2

Managing chronic (long-term) conditions ★ 4.0 3.5

Member experience with health plan ★ 5.0 4.4

Member complaints & changes in performance ★ 4.0 3.3

Health plan customer service ★ 3.0 4.2

Drug plan quality

Summary rating of drug plan quality ★ 3.0 3.4

Drug plan customer service ★ 3.0 4.8

Member complaints & changes in performance ★ 4.0 3.1

Member experience with the drug plan ★ 5.0 4.3

Drug safety & accuracy of drug pricing ★ 3.0 3.5

Extra Benefits

Hearing

Hearing exam In-network: $0-$18 copay
Out-of-network: $0-$18 copay

Fitting/evaluation In-network: $0 copay
Out-of-network: $0 copay

Hearing aids - prescription In-network: $300-$1775 copay
Out-of-network: $300-$1775 copay

Hearing aids - over the counter In-network: $500-$2700 copay
Out-of-network: $500-$2700 copay

Preventive dental

Oral exam In-network: $0 copay
Out-of-network: $0 copay

Cleaning In-network: $0 copay
Out-of-network: $0 copay

Fluoride treatment In-network: $0 copay
Out-of-network: $0 copay

Dental x-rays In-network: $0 copay
Out-of-network: $0 copay

Comprehensive dental

Restorative services In-network: $0 copay
Out-of-network: $0 copay

Endodontics In-network: $0 copay
Out-of-network: $0 copay

Periodontics In-network: $0 copay
Out-of-network: $0 copay

Prosthodontics, removable In-network: $0 copay
Out-of-network: $0 copay

Prosthodontics, fixed In-network: $0 copay
Out-of-network: $0 copay

Maxillofacial prosthetics In-network: $0 copay
Out-of-network: $0 copay

Implant services In-network: $0 copay
Out-of-network: $0 copay

Oral and maxillofacial surgery In-network: $0 copay
Out-of-network: $0 copay

Orthodontics Not covered

Adjunctive general services In-network: $0 copay
Out-of-network: $0 copay

Vision

Routine eye exam In-network: $0 copay
Out-of-network: $0 copay

Contact lenses In-network: $0 copay
Out-of-network: $0 copay

Eyeglasses (frames & lenses) In-network: $0 copay
Out-of-network: $0 copay

Eyeglass frames (only) In-network: $0 copay
Out-of-network: $0 copay

Eyeglass lenses (only) In-network: $0 copay
Out-of-network: $0 copay

Upgrades In-network: $0 copay
Out-of-network: $0 copay

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