Verda Noble Chronic Care (HMO C-SNP) H5163-004 • 2027 • Dallas County, TX
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $2299.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Enhanced, $300.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Dallas County, TX
- Local Enrollment
- 14 beneficiaries in Dallas County
Introduction
Verda Noble Chronic Care is a Medicare Advantage Chronic Condition Special Needs Plan (C-SNP) offered by Verda Health Plan of Texas. The plan uses a Health Maintenance Organization (HMO) 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 $2299.00 in-network maximum out-of-pocket. CMS Plan ID H5163-004 identifies this plan. The 2027 Part D prescription drug deductible is $300.00.
You must live in Dallas County, Texas to enroll in this plan. CMS reports 14 beneficiaries enrolled in this plan in Dallas County. For assistance with this plan, new members can call (877)933-6767 (TTY 711).
Eligibility
Verda Noble Chronic Care 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 cardiovascular disorders, chronic heart failure, and/or diabetes mellitus.
- 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 Dallas County
Compare this plan with the two most-enrolled HMO C-SNP plans available in Dallas County, Texas. Enrollment is based on CMS local enrollment data.
| Plan Detail | Verda Noble Chronic Care | Humana Gold Plus - Diabetes and Heart | Humana Gold Plus - Diabetes and Heart |
|---|---|---|---|
| CMS Plan ID | H5163-004-0 |
H4461-067-0 |
H0028-060-0 |
| Local Enrollment | 14 | 4,042 | 2,520 |
| Monthly Premium | $0.00 | $0.00 | $0.00 |
| Medical Deductible | $0.00 | $0.00 | $0.00 |
| Maximum Out-of-Pocket | $2,299.00 | $3,950.00 | $3,950.00 |
| Part B Giveback | Not offered | Not offered | Not offered |
| Primary Care | $0 copay | $0 copay | $0 copay |
| Specialist | $0 copay | $15 copay | $15 copay |
| Part D Deductible | $300.00 | $700.00 | $700.00 |
| CMS Star Rating | 2.0 | 4.5 | 4.5 |
| Dental | $0 copay | $0 copay | $0 copay |
| Vision | $0 copay | $0 copay | $0 copay |
| Hearing | $0 copay | $0 copay | $0 copay |
Want to explore more options? Browse all Medicare Special Needs plans in Dallas County, or compare Medicare Advantage SNP plans across Texas, including premiums, out-of-pocket costs, CMS ratings, and enrollment.
Plan Benefits
Verda Noble Chronic Care 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 H5163-004.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H5163-004-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
- Specialist
- In-network: $0 copay
Preventive and Wellness Services
- Annual wellness exam
- Not covered
- Telehealth benefit
- In-network: $0 copay
- 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: $0-$25 copay
- Lab services
- In-network: $0 copay
- Outpatient x-rays
- In-network: $0 copay
- Diagnostic tests and procedures
- In-network: $0 copay
Emergency and Urgent Care Services
- Emergency room care
- $109 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $0 copay
- Inpatient hospital care
- Tier 1
$0 per day for days 1-3
$125 per day for days 4-7
$0 per day for days 8-90
$0 per stay - Skilled Nursing Facility
- Tier 1
$0 per day for days 1-7
$20 per day for days 8-20
$221 per day for days 21-100 - Ground ambulance
- In-network: $189 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $40 copay
- Outpatient group therapy
- In-network: $20 copay
- Inpatient psychiatric hospital care
- Tier 1
$0 per day for days 1-3
$125 per day for days 4-7
$0 per day for days 8-90
$0 per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $0 copay
- Occupational therapy
- In-network: $0 copay
Medical Equipment and Supplies
- Diabetes supplies
- In-network: 0%-20% coinsurance
- Durable medical equipment
- In-network: 0%-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
- In-network: $0 copay
- Dental x-rays
- In-network: $0 copay
- Cleaning
- In-network: $0 copay
- Periodontics
- In-network: $0-$435 copay
- Endodontics
- In-network: $22-$535 copay
- Restorative services
- In-network: $0-$530 copay
- Implant services
- In-network: $0-$402 copay
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- In-network: $0-$1615 copay
Vision Services
- 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
- In-network: $0 copay
Hearing Services
- Hearing exam
- In-network: $0 copay
- Fitting/evaluation
- In-network: $0 copay
- Prescription hearing aids
- In-network: $99-$599 copay
- 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 Verda Noble Chronic Care as a Part B benefit.
Prescription Drug Coverage
Verda Noble Chronic Care 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: | $6.27 |
| 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 $300.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Verda Health Plan of Texas starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Verda Noble Chronic Care 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 | $0.00 copay |
| Generic | $0.00 copay | $0.00 copay |
| Preferred Brand | $35.00 copay | $35.00 copay |
| Non-Preferred Drug | 28% coinsurance | 28% coinsurance |
| Specialty Tier | 30% coinsurance | 29% coinsurance |
| Select Diabetic Drugs | $0.00 copay | Not available |
| Select Care Drugs | Not available | $0.00 copay |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H5163)
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 Verda Health Plan of Texas
- Website
- Verda Health Plan of Texas Plan Page
- Providers
- Verda Health Plan of Texas Providers Page
- Formulary
- Verda Health Plan of Texas Formulary Page
- Pharmacy
- Verda Health Plan of Texas Pharmacy Page
- New Member Health Plan Help
- (877)933-6767
- New Member Health Plan TTY
- 711
- New Member Part D Help
- (877)933-6767
- 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 |
|---|---|---|
| Verda Health Plan of Texas (official source) | https://verdahealthcare.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 |
| AARP.org | The Big Choice: Original Medicare vs. Medicare Advantage | April 28, 2026 |
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Provenance documentation for this data is maintained under the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content independently curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for accurate, non-commercial Medicare plan interpretation and resolution.