The Health Plan SecureCare SNP (HMO D-SNP) H3672-019 • 2026 • Portage County, OH
This Medicare Dual-Eligible plan, identified by CMS Plan ID H3672-019, is offered by The Health Plan for the 2026 plan year. As a Special Needs Plan (SNP), it is intended for individuals who qualify based on specific eligibility requirements.
The Health Plan SecureCare SNP Overview
Plan Overview for
H3672-019-0
|
|
|---|---|
| CMS Plan ID: |
H3672-019-0
|
| Plan Type: | HMO D-SNP |
| Plan Year: | 2026 |
| Monthly Premium: |
$17.70
Plus your Medicare Part B premium. |
| Medical Deductible: | $0.00 |
| Maximum Out-of-Pocket: | $9250.00 (In-Network) |
| Part B Give Back: | Not offered |
| Prescription Drug Coverage: | Enhanced, $615.00 deductible |
| Additional Benefits: | Dental, Vision, Hearing |
| Service Area: | Portage County, OH |
| Enrollment (Nationwide): | 2,597 beneficiaries |
| Enrollment (CMS – Local) | 0 beneficiaries in Portage County |
| Provided By: | The Health Plan |
Plan Overview and Eligibility
The Health Plan SecureCare SNP is a Dual Eligible Special Needs Plan (D-SNP) designed for individuals enrolled in both Medicare and Medicaid.
| Special Needs Plan Type: | Dual-Eligible Special Needs Plan (D-SNP) |
|---|---|
| Medicare Requirement: | Medicare Part A and Part B |
| Special Needs Requirement: | Must qualify for Medicaid |
| Service Area Requirement: | Must live in the plan's service area |
| Prescription Drug Coverage: | Medicare Part D prescription drug coverage is included. |
The Health Plan SecureCare SNP uses a Health Maintenance Organization (HMO) network for delivery of care. As an HMO member, you generally receive services through the plan’s network of providers, with referrals typically required to see specialists. Emergency care and out-of-area dialysis are covered even outside the network.
Covered Services & Costs
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% or 20% coinsurance |
| Specialist: | In-network: 0% or 20% 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: | Not covered |
| Fitness benefits: | In-network: $0 copay |
| Health education: | In-network: $0 copay |
| 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: 0% or 20% coinsurance |
| Lab services: | In-network: $0 copay |
| Outpatient x-rays: | In-network: 0% or 20% coinsurance |
| Diagnostic tests and procedures: | In-network: 0% or 20% 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: | 0% or 20% coinsurance |
| Worldwide emergency care: | Not covered |
| Urgent care: | 0% or 20% coinsurance |
| Inpatient hospital care: | Tier 1 | $0 per day for days 1-60 | $0 or $419 per day for days 61-90 | $0 or $838 per day for days 91-150 |
| Skilled Nursing Facility: | Tier 1 | $0 per day for days 1-20 | $0 or $209.5 per day for days 21-100 |
| Ground ambulance: | In-network: 0% or 20% 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: 0% or 20% coinsurance |
| Outpatient group therapy: | In-network: 0% or 20% coinsurance |
| Inpatient psychiatric hospital care: | Tier 1 | $0 per day for days 1-60 | $0 or $419 per day for days 61-90 | $0 or $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: 0% or 20% coinsurance |
| Occupational therapy: | In-network: 0% or 20% 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: 0% or 20% coinsurance |
| Durable medical equipment: | In-network: 0% or 20% coinsurance |
| Prosthetics: | In-network: 0% or 20% 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% or 0%-20% coinsurance |
| Other Part B drugs (Medicare-covered): | In-network: 0% or 0%-20% 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: | Not covered |
| 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): | Not covered |
| 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: $0 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: | In-network: $0 copay |
| 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 The Health Plan SecureCare SNP as a Part B benefit.
Prescription Drug Coverage
The Health Plan SecureCare SNP 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 Special Needs 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.
| Basic Part D Premium: | $17.70 |
|---|---|
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $17.70 |
| Low-Income Premium Subsidy: | $31.38 |
| Low-Income Premium Subsidy Paid by CMS: | $17.70 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program .
Prescription Drug Plan Deductible
This plan has a $615.00 annual Part D deductible. You'll pay this deductible at the pharmacy before The Health Plan starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, The Health Plan SecureCare SNP 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 | Coming soon |
| Generic | 25% coinsurance | Coming soon |
| Preferred Brand | 25% coinsurance | Coming soon |
| Non-Preferred Drug | 25% coinsurance | Coming soon |
| Specialty Tier | 25% coinsurance | Coming soon |
| *Deductible does not apply. | ||
CMS Star Ratings
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 |
|---|---|
| 2026 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
Contact Information for The Health Plan
| Contact Type | Details |
|---|---|
| Website: | The Health Plan Plan Page |
| New Members: | 1-877-847-7915 |
| Existing Members: | 1-877-847-7907 |
| Plan Address: | The Health Plan | 1110 Main Street | Wheeling, WV 26003 |
Enrollment status and eligibility information are available through the Social Security Administration . Additional information about Medicare Advantage is available at medicare.gov .
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | September 8, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | September 8, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | September 8, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | September 8, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| The Health Plan (official source) | http://www.healthplan.org/medicare | October 13, 2025 |
| CMS.gov | Dual Eligible Special Needs Plans (D-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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