Find Plan Options in Your Area
Sign Up Help
 
Mon-Fri: 8am-9pm, Sat: 8am-8pm ET
Medicare65quote.com
TTY 711

Gold Heart & Diabetes (HMO-POS C-SNP)

Florida Chronic Condition Special Needs C-SNP Plan (2025 Plan)

Monthly Premium

Your Cost
$0
by Gold Kidney Health Plan

Additional Coverage

HearingVisionDental

Overall Government Star Rating

(coming soon)

Ready to Enroll Online?

Plan Overview

Plan Name
Gold Heart & Diabetes (HMO-POS C-SNP)
Insurance Carrier
Gold Kidney Health Plan
Plan Type
Chronic Condition Special Needs Plan (C-SNP)
Network Type
HMO

Gold Heart & Diabetes (HMO-POS C-SNP) is a Chronic Condition Special Needs Plan (C-SNP), which is available in Florida and offered by the health insurance company Gold Kidney Health Plan. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.

Cost Summary

Monthly Premium
$0
Annual Deductible
$0
Max Out-of-Pocket
$2,700
Primary doctor visit
$0 copay
Specialist visit
$0-10 copay per visit
ER visit
$90 copay per visit (always covered)
Ambulance
$225 copay

Gold Heart & Diabetes (HMO-POS C-SNP) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $2,700 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for Gold Heart & Diabetes (HMO-POS C-SNP) are defined below.

Additional Benefits and Coverage

Yes
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing

Gold Heart & Diabetes (HMO-POS C-SNP) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Gold Heart & Diabetes (HMO-POS C-SNP) includes coverage for hearing, vision, dental.

Medicare Advantage health plans can offer even more additional benefits. Gold Heart & Diabetes (HMO-POS C-SNP) includes coverage for the following additional benefits:

Other benefits

Fitness benefit
Limited coverage
Over the counter drug benefits
Limited coverage
In-home support services
Limited coverage
Home and bathroom safety devices
Limited coverage
Meals for short duration
Limited coverage
Annual physical exams
Limited coverage
Telehealth
Limited coverage

Plan Benefits and Coverage Details

Monthly Premium
$0
Health Portion of Premium
$0
Drug Portion of Premium
$0
Health Plan Deductible
$0
Health Plan Max Out-of-Pocket
$2,700 In-network
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
Yes
Dental Coverage included
Yes
Doctor Lookup Link
https://goldkidney.com/find-a-doctor/
Plan Link
http://goldkidney.com

Medical Benefits

Doctor Services

Primary doctor visit
In-network: $0 copay
Out-of-network: $0 copay
Specialist visit
In-network: $0-10 copay per visit
Out-of-network: $0-10 copay per visit

Tests, labs, & imaging

Diagnostic tests & procedures
In-network: $0 copay
Out-of-network: $0 copay
Lab services
In-network: $0 copay
Out-of-network: $0 copay
Diagnostic radiology services (like MRI)
In-network: $50 copay
Out-of-network: $50 copay
Outpatient x-rays
In-network: $0 copay
Out-of-network: $0 copay
Emergency care
$90 copay per visit (always covered)
Urgent care
$10 copay per visit (always covered)

Hospital Services

Inpatient hospital coverage
In-network: $150 per day for days 1 through 5
$0 per day for days 6 through 90
Out-of-network: $150 per day for days 1 through 5
$0 per day for days 6 through 90
Outpatient hospital coverage
In-network: $0-150 copay per visit
Out-of-network: $0-150 copay per visit

Skilled nursing facility

Skilled nursing facility
In-network: $0 per day for days 1 through 20
$214 per day for days 21 through 100
Out-of-network: $0 per day for days 1 through 20
$214 per day for days 21 through 100

Preventive services

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

Ambulance

Ground ambulance
In-network: $225 copay
Out-of-network: $225 copay

Therapy services

Occupational therapy visit
In-network: $10 copay
Out-of-network: $10 copay
Physical therapy & speech & language therapy visit
In-network: $10 copay
Out-of-network: $10 copay

Mental health services

Outpatient group therapy with a psychiatrist
In-network: $10 copay
Out-of-network: $10 copay
Outpatient individual therapy with a psychiatrist
In-network: $25 copay
Out-of-network: $25 copay
Outpatient group therapy visit
In-network: $10 copay
Out-of-network: $10 copay
Outpatient individual therapy visit
In-network: $25 copay
Out-of-network: $25 copay

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
In-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item
Prosthetics (like braces, artificial limbs)
In-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item
Diabetes supplies
In-network: $0 copay
Out-of-network: $0 copay

Prescription Drug Benefits

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

TiersInitial coverage phaseCatastrophic coverage phase
Preferred Generic$0.00 copay$0 copay
Generic$0.00 copay$0 copay
Preferred Brand$40.00 copay$0 copay
Non-Preferred Drug
Specialty Tier33% coinsurance$0 copay

Part B Drugs

Chemotherapy drugs
In-network: 0-20% coinsurance
Out-of-network: $35 copay or 0-20% coinsurance
Other Part B drugs
In-network: 0-20% coinsurance
Out-of-network: $35 copay or 0-20% coinsurance

Extra Benefits

Hearing

Hearing exam
In-network: $0 copay
Out-of-network: $0 copay
Fitting/evaluation
In-network: $0 copay
Out-of-network: $0 copay
Hearing aids - All types
In-network: $0 copay
Out-of-network: $0 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
In-network: $0 copay
Out-of-network: $0 copay
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

When Can I Sign Up for Medicare?

Enter your birthday month and year to learn when you can sign up for different Medicare plan options.

 

 

Ready to Enroll Online?

Please Support Our Sponsor

Advertisement

Medicare Health Plans

Get Advice & Sign Up Help

TTY 711

Speak with a Licensed Insurance Agent

Mon-Fri: 8am - 9pm ET
Sat: 8am - 8pm ET

Medicare65quote

  • Medicare Advantage Plans
  • Medicare Prescription Drug Plans
  • Medicare Supplement Insurance Plans

No obligation to enroll. Find your plan online or speak with a licensed insurance agent to get help signing up for the right plan for you! See www.medicare65quote.com for our Third-Party Marketing Organization disclaimer.
Insurance Ad -No Government Affiliation

Related Articles
Best Florida Medicare Advantage Health Insurance Companies for 2025
Health Plan Radar Health Plan Radar

In this article we rank Florida Medicare Advantage plans based on our evaluation of government 5-star quality scores. Each year the government rates the quality of Medicare Advantage health insurance plans with a 5-star quality score. An overall quality score is assigned to each plan which is based on the scores of various quality metrics.

Read more →