Gold Dialysis Premier (HMO-POS C-SNP) H1526-011 • 2027 • Palm Beach 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
- Palm Beach County, FL
- Local Enrollment
- 0 beneficiaries in Palm Beach County
Introduction
Gold Dialysis Premier is a Medicare Advantage Chronic Condition Special Needs Plan (C-SNP) offered by Gold Kidney Health Plan. The plan uses a Health Maintenance Organization with a Point of Service (HMO-POS) provider network and includes Medicare Part D prescription drug coverage. For the 2027 plan year, it has a $0.00 monthly premium, $0.00 medical deductible, and $2400.00 in-network maximum out-of-pocket. CMS Plan ID H1526-011 identifies this plan. The 2027 Part D prescription drug deductible is $0.00.
This plan is available to eligible residents of Palm Beach County, Florida. CMS reports 0 beneficiaries enrolled in this plan in Palm Beach County. For assistance with this plan, new members can call (844)294-6535 (TTY 711).
Eligibility
Gold Dialysis Premier is a Medicare C-SNP plan for individuals with specific chronic or disabling 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 Palm Beach County
Compare this plan with the two most-enrolled HMO-POS C-SNP plans available in Palm Beach County, Florida. Enrollment is based on CMS local enrollment data.
| Plan Detail | Gold Dialysis Premier | CareComplete Platinum | Gold Heart & Diabetes |
|---|---|---|---|
| CMS Plan ID | H1526-011-0 |
H1019-130-0 |
H1526-001-0 |
| Local Enrollment | 0 | 385 | 131 |
| 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 | −$156.00 reduction | −$133.00 reduction |
| Primary Care | $0 copay | $0 copay | $0 copay |
| Specialist | $0-$35 copay | $20 copay | $0-$55 copay |
| Part D Deductible | $0.00 | $700.00 | $0.00 |
| CMS Star Rating | 2.5 | 4.0 | 2.5 |
| 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 H1526-011.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H1526-011-0 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)
CMS star ratings reflect how well a Medicare plan performs across key quality measures, such as managing chronic conditions, member satisfaction, and customer service. Ratings range from 1 to 5 stars and are updated each year by Medicare.
| 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 |
| CMS.gov | Medicare Advantage Plan Fact Sheet | April 28, 2026 |
| Medicare.gov | Joining a plan | April 28, 2026 |
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