Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) H9706-002 • 2026 • Dimmit County, TX
This Medicare Dual-Eligible plan, identified by CMS Plan ID H9706-002, is offered by Blue Cross and Blue Shield of Texas for the 2026 plan year. As a Special Needs Plan (SNP), it is intended for individuals who qualify based on specific eligibility requirements.
Blue Cross Medicare Advantage Dual Care Plus Overview
Plan Overview for
H9706-002-0
|
|
|---|---|
| CMS Plan ID: |
H9706-002-0
|
| Plan Type: | HMO D-SNP |
| Plan Year: | 2026 |
| Monthly Premium: |
$4.80
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: | Basic, $615.00 deductible |
| Additional Benefits: | Dental, Vision, Hearing |
| Service Area: | Dimmit County, TX |
| Enrollment (Nationwide): | 128 beneficiaries |
| Enrollment (CMS – Local) | 0 beneficiaries in Dimmit County |
| Provided By: | Blue Cross and Blue Shield of Texas |
Plan Overview and Eligibility
Blue Cross Medicare Advantage Dual Care Plus is a Medicare D-SNP plan for dual-eligible beneficiaries (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. |
This plan uses a Health Maintenance Organization (HMO) network, meaning covered services are primarily provided by in-network doctors and facilities. Referrals are typically required for specialist care. Emergency services and out-of-area dialysis are covered 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: | Not covered |
| Telehealth benefit: | In-network: $0 copay |
| Routine chiropractic: | Not covered |
| Fitness benefits: | In-network: $0 copay |
| Health education: | Not covered |
| 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% coinsurance |
| Outpatient x-rays: | In-network: 0% or 20% coinsurance |
| Diagnostic tests and procedures: | In-network: 0% 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: | Not covered |
| 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 Blue Cross Medicare Advantage Dual Care Plus as a Part B benefit.
Prescription Drug Coverage
Blue Cross Medicare Advantage Dual Care Plus 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: | $4.80 |
|---|---|
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $4.80 |
| Low-Income Premium Subsidy: | $4.82 |
| Low-Income Premium Subsidy Paid by CMS: | $4.80 |
| 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 Blue Cross and Blue Shield of Texas starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Blue Cross Medicare Advantage Dual Care Plus 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 | Coming soon |
| Generic drugs | 25% coinsurance | Coming soon |
| *Deductible does not apply. | ||
Quality Ratings (CMS)
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 |
|---|---|
| 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 Blue Cross and Blue Shield of Texas
| Contact Type | Details |
|---|---|
| Website: | Blue Cross and Blue Shield of Texas Plan Page |
| New Members: | 1-877-583-8129 |
| Existing Members: | 1-877-895-6437 |
| Plan Address: | PO Box 4555 | Scranton, PA 18505 |
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 |
|---|---|---|
| Blue Cross and Blue Shield of Texas (official source) | http://getbluetx.com/mapd | October 13, 2025 |
| CMS.gov | Dual Eligible Special Needs Plans (D-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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