Tribute Select (HMO-POS I-SNP) H1587-003 • 2027 • Hot Spring County, AR
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $9850.00In-network
- Part B Giveback
- −$199.00 reduction
- Prescription Coverage
- Basic, $700.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Hot Spring County, AR
- Local Enrollment
- 70 beneficiaries in Hot Spring County
Introduction
CMS Plan ID H1587-003 identifies Tribute Select, a Medicare Advantage Institutional Special Needs Plan (I-SNP) offered by Tribute Health Plans. Its provider network is a Health Maintenance Organization with a Point of Service (HMO-POS), and Medicare Part D prescription drug coverage is included. For 2027, the plan has a $0.00 monthly premium, $0.00 medical deductible, and $9850.00 in-network maximum out-of-pocket. The 2027 Part D prescription drug deductible is $700.00.
Enrollment in this plan requires you to live in Hot Spring County, Arkansas. CMS reports 70 beneficiaries enrolled in this plan in Hot Spring County. New members can call the plan directly at (877)372-1033 (TTY 711) for assistance.
Eligibility
Tribute Select is a Hybrid Institutional (HI-SNP) plan for individuals that require nursing care.
- Special Needs Plan Type
- Institutional Special Needs Plan (I-SNP)
- Medicare Requirement
- Must have Medicare Part A and Part B
- Special Needs Requirement
- This plan accommodates individuals in a long-term care facility. It is also available to people who need the level of care given in a long-term care facility who can remain at home or live in an assisted living facility.
- Service Area Requirement
- Must live in the plan's service area
- Prescription Drug Coverage
- Medicare Part D prescription drug coverage is included.
Compare Similar Plans in Hot Spring County
Although no other HMO-POS I-SNP plans meet the comparison criteria in Hot Spring County, you may have other Medicare Advantage options. Browse all Medicare Advantage SNP plans available in Hot Spring County, or explore our Arkansas Medicare Special Needs directory for statewide information on plan availability, premiums, out-of-pocket costs, CMS ratings, and enrollment.
Plan Benefits
Tribute Select has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The tables below detail the most common in-network out-of-pocket expenses for plan H1587-003.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H1587-003-0 Cost Compare.
Office Visits
- Primary care
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance - Specialist
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
- Telehealth benefit
- In-network: 20% coinsurance
- Routine chiropractic
- Not covered
- Fitness benefits
- Coming soon
- Health education
- Not covered
- Counseling services
- Not covered
- Over-the-counter drug benefits
- In-network: $0 copay
- Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance - Lab services
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance - Outpatient x-rays
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance - Diagnostic tests and procedures
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Emergency and Urgent Care Services
- Emergency room care
- 20% coinsurance
- Worldwide emergency care
- Coming soon
- Urgent care
- 20% coinsurance
- Inpatient hospital care
- In-network:
Tier 1
$0 per day for days 1-60
$434 per day for days 61-90
$868 per day for days 91-150
Out-of-network:
$0 per day for days 1-60
$434 per day for days 61-90
$868 per day for days 91-150 - Skilled Nursing Facility
- In-network:
Tier 1
$0 per day for days 1-20
$217 per day for days 21-100 - Ground ambulance
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Mental Health Services
- Outpatient individual therapy
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance - Outpatient group therapy
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance - Inpatient psychiatric hospital care
- In-network:
Tier 1
$0 per day for days 1-60
$434 per day for days 61-90
$868 per day for days 91-150
Out-of-network:
$0 per day for days 1-60
$434 per day for days 61-90
$868 per day for days 91-150
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance - Occupational therapy
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Medical Equipment and Supplies
- Diabetes supplies
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance - Durable medical equipment
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance - Prosthetics
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Medicare Part B Drugs
- Chemotherapy
- In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance - Other Part B drugs (Medicare-covered)
- In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance
Dental Services
- Oral exam
- Not covered
- Dental x-rays
- Not covered
- Cleaning
- Not covered
- Periodontics
- Not covered
- Endodontics
- Not covered
- Restorative services
- Not covered
- Implant services
- Not covered
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- Not covered
Vision Services
- Routine eye exam
- Not covered
- Contact lenses
- Not covered
- Eyeglass frames only
- Not covered
- Eyeglass lenses only
- Not covered
- Eyeglasses (frames & lenses)
- Not covered
- Upgrades
- Not covered
Hearing Services
- Hearing exam
- Not covered
- Fitting/evaluation
- Not covered
- Prescription hearing aids
- Not covered
- OTC hearing aids
- Not covered
Additional and Special Needs Services
- Adult day health services
- Not covered
- Home-based palliative care
- Not covered
- Personal emergency response system
- Coming soon
- Weight management programs
- Not covered
- Wigs for chemotherapy-related hair loss
- Coming soon
- Alternative therapies
- Not covered
- Massage therapy
- Not covered
- Home/bathroom safety devices
- Not covered
Certain preventive services are covered 100% by Tribute Select as a Part B benefit.
Prescription Drug Coverage
Tribute Select includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.
Prescription Drug Plan Premium
The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.
| Part D Premium Component | Amount |
|---|---|
| Basic Part D Premium: | $0.00 |
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $0.00 |
| Low-Income Premium Subsidy: | $6.28 |
| Low-Income Premium Subsidy Paid by CMS: | $0.00 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program .
Prescription Drug Plan Deductible
This plan has a $700.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Tribute Health Plans starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Tribute Select may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Brand-name drugs | 25% coinsurance | 25% coinsurance |
| Generic drugs | 25% coinsurance | 25% coinsurance |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H1587)
Medicare assigns star ratings to plans based on quality and performance across multiple measures, including customer service, member experience, and health outcomes. Ratings are updated annually by the Centers for Medicare & Medicaid Services (CMS) and are shown on a 1 to 5 star scale, with 5 stars representing the highest quality.
| CMS Measure | Star Rating |
|---|---|
| 2027 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | Not enough data available |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | Not enough data available |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | Not enough data available |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | Not enough data available |
| Drug Safety and Accuracy of Drug Pricing |
Contact Information for Tribute Health Plans
- Website
- Tribute Health Plans Plan Page
- Providers
- Tribute Health Plans Providers Page
- Formulary
- Tribute Health Plans Formulary Page
- Pharmacy
- Tribute Health Plans Pharmacy Page
- New Member Health Plan Help
- (877)372-1033
- New Member Health Plan TTY
- 711
- New Member Part D Help
- (877)372-1033
- New Member Part D TTY Users
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | October 5, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Tribute Health Plans (official source) | http://www.tributemedicare.com | October 4, 2026 |
| CMS.gov | Institutional Special Needs Plans (I-SNPs) | April 28, 2026 |
| Medicare.gov | Understanding Medicare Advantage Plans | April 28, 2026 |
| NCOA.org | 5 Steps to Choosing the Right Medicare Plan for You | April 28, 2026 |
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