Gold Dialysis Premier (HMO-POS C-SNP) H1526-010 • 2027 • Manatee County, FL
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $2400.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Enhanced, $0.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Manatee County, FL
- Local Enrollment
- 0 beneficiaries in Manatee County
Introduction
CMS Plan ID H1526-010 identifies Gold Dialysis Premier, a Medicare Advantage Chronic Condition Special Needs Plan (C-SNP) offered by Gold Kidney Health Plan. 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 $2400.00 in-network maximum out-of-pocket. The 2027 Part D prescription drug deductible is $0.00.
Qualifying residents of Manatee County, Florida may enroll in this plan. CMS reports 0 beneficiaries enrolled in this plan in Manatee County. New members can call the plan directly at (844)294-6535 (TTY 711) for assistance.
Eligibility
Gold Dialysis Premier is a Chronic Condition Special Needs Plan (C-SNP) designed for people with qualifying health conditions.
- Special Needs Plan Type
- Chronic Condition Special Needs Plan (C-SNP)
- Medicare Requirement
- Must have Medicare Part A and Part B
- Special Needs Requirement
- This plan is for individuals with chronic kidney disease.
- 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 Manatee County
Compare this plan with the two most-enrolled HMO-POS C-SNP plans available in Manatee County, Florida. Enrollment is based on CMS local enrollment data.
| Plan Detail | Gold Dialysis Premier | UHC Complete Care FL-14 | Gold Heart & Diabetes |
|---|---|---|---|
| CMS Plan ID | H1526-010-0 |
H1045-048-2 |
H1526-001-0 |
| Local Enrollment | 0 | 903 | 57 |
| Monthly Premium | $0.00 | $0.00 | $0.00 |
| Medical Deductible | $0.00 | $0.00 | $0.00 |
| Maximum Out-of-Pocket | $2,400.00 | $3,400.00 | $2,700.00 |
| Part B Giveback | Not offered | −$30.00 reduction | −$133.00 reduction |
| Primary Care | $0 copay | $0 copay | $0 copay |
| Specialist | $0-$35 copay | $0-$30 copay | $0-$55 copay |
| Part D Deductible | $0.00 | $405.00 | $0.00 |
| CMS Star Rating | Not yet rated | Not yet rated | Not yet rated |
| Dental | Not covered | $0 copay | $0 copay |
| Vision | Not covered | $0 copay | $0 copay |
| Hearing | Not covered | $0 copay | $0 copay |
Plan Benefits
Gold Dialysis Premier 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 H1526-010.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H1526-010-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
- Specialist
- In-network: $0-$35 copay
Out-of-network: $0-$35 copay
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
- Telehealth benefit
- In-network: $0 copay
- Routine chiropractic
- In-network: $20 copay
- Fitness benefits
- Coming soon
- Health education
- In-network: $0 copay
- Counseling services
- Not covered
- Over-the-counter drug benefits
- Not covered
- Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: $0-$75 copay
- Lab services
- In-network: $25 copay
- Outpatient x-rays
- In-network: $0 copay
- Diagnostic tests and procedures
- In-network: $25 copay
Emergency and Urgent Care Services
- Emergency room care
- $120 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $40 copay
- Inpatient hospital care
- In-network:
Tier 1
$150 per day for days 1-7
$0 per day for days 8-90
$0 per stay
Out-of-network:
30% per stay - 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: $200 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $25 copay
- Outpatient group therapy
- In-network: $10 copay
- Inpatient psychiatric hospital care
- In-network:
Tier 1
$150 per day for days 1-7
$0 per day for days 8-90
$0 per stay
Out-of-network:
30% per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $15 copay
- Occupational therapy
- In-network: $15 copay
Medical Equipment and Supplies
- Diabetes supplies
- In-network: $0 copay
- Durable medical equipment
- In-network: 20% coinsurance
- Prosthetics
- In-network: 20% coinsurance
Medicare Part B Drugs
- Chemotherapy
- In-network: 0%-20% coinsurance
- Other Part B drugs (Medicare-covered)
- In-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 Gold Dialysis Premier as a Part B benefit.
Prescription Drug Coverage
Gold Dialysis Premier 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: | $7.28 |
| 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 $0.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Gold Kidney Health Plan starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Gold Dialysis Premier may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | Not available |
| Generic | $5.00 copay | Not available |
| Preferred Brand | $45.00 copay | Not available |
| Non-Preferred Brand | 30% coinsurance | Not available |
| Specialty Tier | 33% coinsurance | Not available |
| Select Diabetic Drugs | $0.00 copay | Not available |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H1526)
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 | 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 |
Contact Information for Gold Kidney Health Plan
- Website
- Gold Kidney Health Plan Plan Page
- Providers
- Gold Kidney Health Plan Providers Page
- Formulary
- Gold Kidney Health Plan Formulary Page
- Pharmacy
- Gold Kidney Health Plan Pharmacy Page
- New Member Health Plan Help
- (844)294-6535
- New Member Health Plan TTY
- 711
- New Member Part D Help
- (844)294-6535
- 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 | CMS Version |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | CY2027 Landscape (202609.1) |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | 2027 Star Ratings Data Tables |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | PBP Benefits-2027 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | 2026-09 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Gold Kidney Health Plan (official source) | http://goldkidney.com | October 4, 2026 |
| CMS.gov | Chronic Condition Special Needs Plans (C-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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