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Verda Noble Chronic Care (HMO C-SNP) H5163-002 • 2026 • Fort Bend County, TX

CMS Rating: ☆☆☆☆☆ (0.0 out of 5 stars*)

CMS Plan ID H5163-002 identifies the Medicare Chronic or Disabling Condition plan Verda Noble Chronic Care, offered by Verda Health Plan of Texas for the 2026 plan year. This Special Needs Plan (SNP) is designed for individuals who meet specific eligibility requirements.

Last update:

Verda Noble Chronic Care Overview

2026 Medicare Special Needs Plan Overview for H5163-002-0
Plan Overview for H5163-002-0
CMS Plan ID: H5163-002-0
Plan Type: HMO C-SNP
Plan Year: 2026
Monthly Premium: $0.00
Plus your Medicare Part B premium.
Medical Deductible: $0.00
Maximum Out-of-Pocket: $999.00 (In-Network)
Part B Give Back: Not offered
Prescription Drug Coverage: Enhanced, $300.00 deductible
Additional Benefits: Dental, Vision, Hearing
Service Area: Fort Bend County, TX
Enrollment (Nationwide): 2,648 beneficiaries
Enrollment (CMS – Local)400 beneficiaries in Fort Bend County
Provided By: Verda Health Plan of Texas

Plan Overview and Eligibility

  • Verda Noble Chronic Care is a Medicare C-SNP plan for individuals with specific chronic conditions.
  • This plan is for individuals with cardiovascular disorders, chronic heart failure, and/or diabetes.
Eligibility requirements for Verda Noble Chronic Care (H5163-002-0)
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.
Service Area Requirement: Must live in the plan's service area
Prescription Drug Coverage: Medicare Part D prescription drug coverage is included.

Verda Noble Chronic Care 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.

In-network cost sharing for primary and specialist office visits.
Covered Service In-Network Cost
Primary: In-network: $0 copay
Specialist: In-network: $0 copay

This section outlines in-network costs for preventive and wellness services included in the plan.

In-network cost sharing for preventive and wellness services.
Covered Service In-Network Cost
Annual wellness exam: Not covered
Telehealth benefit: In-network: $0 copay
Routine chiropractic: In-network: $0 copay
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.

In-network cost sharing for diagnostic, lab, and imaging services.
Covered Service In-Network Cost
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

This section outlines in-network costs for emergency services, urgent care, ambulance transportation, inpatient hospital stays, and skilled nursing facility care.

In-network cost sharing for emergency, urgent care, and inpatient hospital services.
Covered Service In-Network Cost
Emergency room care: $90 copay
Worldwide emergency care: $90 copay
Urgent care: $0 copay
Inpatient hospital care: Tier 1 | $0 per stay
Skilled Nursing Facility: Tier 1 | $0 per day for days 1-20 | $218 per day for days 21-100
Ground ambulance: In-network: $99 copay

This section outlines in-network costs for mental health services, including outpatient therapy and inpatient psychiatric care.

In-network cost sharing for mental health services.
Covered Service In-Network Cost
Outpatient individual therapy: In-network: $40 copay
Outpatient group therapy: In-network: $20 copay
Inpatient psychiatric hospital care: Tier 1 | $0 per stay

This section outlines in-network costs for rehabilitation services, including physical therapy, speech and language therapy, and occupational therapy.

In-network cost sharing for rehabilitation services.
Covered Service In-Network Cost
Physical therapy and speech and language therapy: In-network: $0 copay
Occupational therapy: In-network: $0 copay

This section outlines in-network costs for medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.

In-network cost sharing for medical equipment and supplies.
Covered Service In-Network Cost
Diabetes supplies: In-network: 0%-20% coinsurance
Durable medical equipment: In-network: 0%-20% coinsurance
Prosthetics: In-network: 20% coinsurance

This section outlines in-network cost sharing for chemotherapy and other Medicare Part B-covered drugs.

In-network cost sharing for Medicare Part B-covered drugs.
Covered Service In-Network Cost
Chemotherapy: In-network: 0%-20% coinsurance
Other Part B drugs (Medicare-covered): In-network: 0%-20% coinsurance

This section outlines in-network cost sharing for dental services, including preventive care, exams, x-rays, cleanings, and comprehensive dental procedures.

In-network cost sharing for dental services.
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-$435 copay
Endodontics: In-network: $22-$535 copay
Restorative services: In-network: $22-$530 copay
Implant services: In-network: $0-$58 copay
Orthodontics: Not covered
Oral/Maxillofacial surgery: In-network: $0-$1615 copay

This section outlines in-network cost sharing for vision services, including eye exams, eyeglasses, and contact lenses.

In-network cost sharing for vision services and eyewear.
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): In-network: $0 copay
Upgrades: In-network: $0 copay

This section outlines in-network cost sharing for hearing-related services, including exams, fittings, and hearing aids.

In-network cost sharing for hearing aids and related services.
Covered Service In-Network Cost
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

This section outlines in-network cost sharing for additional and special needs services that may be included in the plan.

In-network cost sharing for additional and special needs services.
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: In-network: $0 copay
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 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.

Verda Noble Chronic Care (H5163-002-0) Prescription Drug Plan Premium Details
Basic Part D Premium: $0.00
Supplemental Part D Premium: $0.00
Total Part D Premium: $0.00
Low-Income Premium Subsidy: $4.82
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.

Verda Noble Chronic Care (H5163-002-0) Pharmacy Out-of-Pocket Costs by Drug Tier
Drug Tier Retail Mail Order
Preferred Generic$0.00 copayComing soon
Generic$0.00 copayComing soon
Preferred Brand$30.00 copayComing soon
Non-Preferred Drug28% coinsuranceComing soon
Specialty Tier29% coinsuranceComing soon
Select Care Drugs$0.00 copayComing 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.

2026 Medicare Star Ratings for Contract H5163
CMS Measure Star Rating
2026 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

Verda Health Plan of Texas Plan Contact Details for Verda Noble Chronic Care (H5163-002-0)
Contact Type Details
Website: Verda Health Plan of Texas Plan Page
New Members: 1-877-933-6767
Existing Members: 1-888-256-5123
Plan Address: 7755 Center Ave., Suite 1200 | Huntington Beach, CA 92647

Enrollment status and eligibility information are available through the Social Security Administration . Additional information about Medicare Advantage is available at medicare.gov .

Primary CMS datasets used for this Medicare Advantage Special Needs Plan resource.
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.

Official plan information and secondary Medicare references.
Publisher Reference Last Accessed
Verda Health Plan of Texas (official source) https://verdahealthcare.com/ October 13, 2025
CMS.gov Chronic Condition Special Needs Plans (C-SNPs) April 28, 2026
CMS.gov Medicare Advantage Plan Fact Sheet April 28, 2026
AARP.org The Big Choice: Original Medicare vs. Medicare Advantage April 28, 2026

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Data provenance is documented in accordance with the U.S. Core Data for Interoperability (USCDI) Provenance standard.