EternalHealth Valor Give Back (HMO-POS)
Medicare Advantage Plan H3551-003 • 2026
EternalHealth Valor Give Back (HMO-POS) Medicare Advantage Plan H3551-003 • 2026
The Medicare Advantage plan identified by CMS Plan ID H3551-003 (EternalHealth Valor Give Back) is a HMO-POS Part C plan offered by eternalHealth for the 2026 plan year. It uses a Health Maintenance Organization with a Point of Service (HMO-POS) provider network and comes without drug coverage (Part D prescriptions).
EternalHealth Valor Give Back Overview
Plan Overview for H3551-003-0 |
|
|---|---|
| CMS Plan ID: | H3551-003-0 |
| Plan Type: | HMO-POS |
| Plan Year: | 2026 |
| Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
| Medical Deductible: | $0.00 |
| Maximum Out-of-Pocket: | $5500.00 (In-Network) |
| Part B Give Back: | −$100.00 reduction |
| Prescription Drug Coverage: | Not Included |
| Additional Benefits: | Dental, Vision, Hearing |
| Service Area: | See List |
| Enrollment (Nationwide) | 202 beneficiaries |
| Provided By: | eternalHealth |
Plan Availability
EternalHealth Valor Give Back (H3551-003-0) is available in the following locations (click to open):
Plan Overview for EternalHealth Valor Give Back
This Medicare Advantage HMO-POS plan provides Medicare Part A and Part B coverage through a network of participating providers, with limited coverage available for out-of-network services in certain situations. The monthly premium is $0.00, and costs are generally lower when services are received from in-network providers.
Primary care visits have a $0 copay | Out-of-network: $0 copay, 0% coinsurance, specialist visits come with a $0 copay | Out-of-network: $0 copay, 0% coinsurance, urgent care services carry a 20% coinsurance, and ambulance transportation is 20% coinsurance | Out-of-network: 50% coinsurance. These costs apply toward the annual maximum out-of-pocket (MOOP) limit of $5500.00. After this limit is reached, in-network services are fully covered for the remainder of the year.
This plan is registered with CMS under Plan ID {title_plan_id}. Cost-sharing details for key services are provided below.
Cost-Sharing Overview
EternalHealth Valor Give Back has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The table below details the most common in-network out-of-pocket expenses for plan H3551-003.
This section outlines in-network costs for primary care and specialist office visits, along with related preventive services.
| Covered Service | In-Network Cost |
|---|---|
| Primary: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Specialist: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
This section outlines in-network costs for preventive and wellness services included in the plan.
| Covered Service | In-Network Cost |
|---|---|
| Annual wellness exam: | In-network: $0 copay |
| Telehealth benefit: | In-network: $0 copay |
| Routine chiropractic: | In-network: $25 copay |
| Fitness benefits: | In-network: $0 copay |
| Health education: | Not covered |
| Counseling services: | Not covered |
| Over-the-counter drug benefits: | In-network: $0 copay |
| Health transportation (non-emergency): | In-network: $0 copay |
This section outlines in-network costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Covered Service | In-Network Cost |
|---|---|
| Diagnostic radiology services: | In-network: 20% coinsurance | Out-of-network: 50% coinsurance |
| Lab services: | In-network: $0 copay | Out-of-network: 50% coinsurance |
| Outpatient x-rays: | In-network: 20% coinsurance | Out-of-network: 50% coinsurance |
| Diagnostic tests and procedures: | In-network: 20% coinsurance | Out-of-network: 50% coinsurance |
This section outlines in-network costs for emergency services, urgent care, ambulance transportation, inpatient hospital stays, and skilled nursing facility care.
| Covered Service | In-Network Cost |
|---|---|
| Emergency room care: | 20% coinsurance |
| Worldwide emergency care: | 20% coinsurance |
| Urgent care: | 20% coinsurance |
| Inpatient hospital care: | In-network: | Tier 1 | $0 per day for days 1-60 | $419 per day for days 61-90 | $838 per day for days 91-150 | Out-of-network: | $0 per day for days 1-60 | $419 per day for days 61-90 | $838 per day for days 91-150 |
| Skilled Nursing Facility: | In-network: | Tier 1 | $0 per day for days 1-20 | $209.5 per day for days 21-100 | Out-of-network: | $0 per day for days 1-20 | $209.5 per day for days 21-100 |
| Ground ambulance: | In-network: 20% coinsurance | Out-of-network: 50% coinsurance |
This section outlines in-network costs for mental health services, including outpatient therapy and inpatient psychiatric care.
| Covered Service | In-Network Cost |
|---|---|
| Outpatient individual therapy: | In-network: 20% coinsurance | Out-of-network: 50% coinsurance |
| Outpatient group therapy: | In-network: 20% coinsurance | Out-of-network: 50% coinsurance |
| Inpatient psychiatric hospital care: | In-network: | Tier 1 | $0 per day for days 1-60 | $419 per day for days 61-90 | $838 per day for days 91-150 | Out-of-network: | $0 per day for days 1-60 | $419 per day for days 61-90 | $838 per day for days 91-150 |
This section outlines in-network costs for rehabilitation services, including physical therapy, speech and language therapy, and occupational therapy.
| Covered Service | In-Network Cost |
|---|---|
| Physical therapy and speech and language therapy: | In-network: $30 copay | Out-of-network: 50% coinsurance |
| Occupational therapy: | In-network: $30 copay | Out-of-network: 50% coinsurance |
This section outlines in-network costs for medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Covered Service | In-Network Cost |
|---|---|
| Diabetes supplies: | In-network: 20% coinsurance | Out-of-network: 50% coinsurance |
| Durable medical equipment: | In-network: 20% coinsurance | Out-of-network: 50% coinsurance |
| Prosthetics: | In-network: 20% coinsurance | Out-of-network: 50% coinsurance |
This section outlines in-network cost sharing for chemotherapy and other Medicare Part B-covered drugs.
| Covered Service | In-Network Cost |
|---|---|
| Chemotherapy: | In-network: 0%-20% coinsurance | Out-of-network: 50% coinsurance |
| Other Part B drugs (Medicare-covered): | In-network: 0%-20% coinsurance | Out-of-network: 50% coinsurance |
This section outlines in-network cost sharing for dental services, including preventive care, exams, x-rays, cleanings, and comprehensive dental procedures.
| Covered Service | In-Network Cost |
|---|---|
| Oral exam: | In-network: $0 copay |
| Dental x-rays: | In-network: $0 copay |
| Cleaning: | In-network: $0 copay |
| Periodontics: | In-network: $0 copay |
| Endodontics: | In-network: $0 copay |
| Restorative services: | In-network: $0 copay |
| Implant services: | In-network: $0 copay |
| Orthodontics: | Not covered |
| Oral/Maxillofacial surgery: | In-network: $0 copay |
This section outlines in-network cost sharing for vision services, including eye exams, eyeglasses, and contact lenses.
| Covered Service | In-Network Cost |
|---|---|
| Routine eye exam: | In-network: $0 copay |
| Contact lenses: | In-network: $0 copay |
| Eyeglass frames only: | In-network: $0 copay |
| Eyeglass lenses only: | In-network: $0 copay |
| Eyeglasses (frames & lenses): | In-network: $0 copay |
| Upgrades: | Not covered |
This section outlines in-network cost sharing for hearing-related services, including exams, fittings, and hearing aids.
| Covered Service | In-Network Cost |
|---|---|
| Hearing exam: | In-network: $0 copay |
| Fitting/evaluation: | In-network: $0 copay |
| Prescription hearing aids: | In-network: $595-$895 copay |
| OTC hearing aids: | Not covered |
This section outlines in-network cost sharing for additional and special needs services that may be included in the plan.
| Covered Service | In-Network Cost |
|---|---|
| Adult day health services: | Not covered |
| Home-based palliative care: | Not covered |
| Personal emergency response system: | Not covered |
| Weight management programs: | Not covered |
| Wigs for chemotherapy-related hair loss: | Not covered |
| Alternative therapies: | Not covered |
| Massage therapy: | Not covered |
| Home/bathroom safety devices: | Not covered |
Certain preventive services are covered 100% by EternalHealth Valor Give Back as a Part B benefit.
Prescription Drug Coverage
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Ratings
The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage (Part C) and Part D prescription drug plans each year using a 5-star system. These ratings measure plan performance in areas such as preventive care, management of chronic conditions, and member experience.
| CMS Measure | Star Rating |
|---|---|
| 2026 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | Plan too new to be measured |
| Managing Chronic (Long Term) Conditions | Plan too new to be measured |
| Member Experience with Health Plan | Plan too new to be measured |
| Complaints and Changes in Plans Performance | Plan too new to be measured |
| Health Plan Customer Service | Plan too new to be measured |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | Plan too new to be measured |
| Member Experience with the Drug Plan | Plan too new to be measured |
| Drug Safety and Accuracy of Drug Pricing |
How much does plan H3551-003 cost per month?
The plan’s monthly premium is $0.00 for 2026. The Part B premium is not included.
What is the in-network MOOP for plan H3551-003?
The annual in-network MOOP is $5500.00 for 2026. After this limit is reached, covered in-network services are fully paid.
What is the current enrollment for EternalHealth Valor Give Back?
The plan has 202 enrolled beneficiaries according to CMS.
What is the prescription drug deductible for 2026?
For 2026, the prescription drug deductible is $0.00.
Contact Information for eternalHealth
| Contact Type | Details |
|---|---|
| Website: | eternalHealth Plan Page |
| New Members: | 1-833-870-3443 |
| Existing Members: | 1-800-680-4568 |
| Plan Address: | 31 St. James Ave | Suite 950 | Boston, MA 02116 |
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at medicare.gov.
- CMS.gov, Landscape Source Files — Last accessed May 2, 2026
- CMS.gov, Medicare Part C & D Performance — Last accessed May 2, 2026
- CMS.gov, Plan Benefits Package — Last accessed May 2, 2026
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County — Last accessed May 2, 2026
Data sources and methodology documentation..
- eternalHealth (official source), https://www.eternalhealth.com/ — Last accessed October 13, 2025
- Medicare.gov, "Understanding Medicare Advantage Plans" — Last accessed 25 May, 2025
- AARP.org, "The Big Choice: Original Medicare vs. Medicare Advantage" — Last accessed 25 May, 2025
- Medicare.gov, "Your coverage options" — Last accessed 25 May, 2025
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