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Oct 15th - Dec 7th
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Tribute Select (HMO-POS I-SNP)

Medicare Advantage Health Plan Details

Institutional Special Needs Plans (I-SNP)

Health insurance company offering plan: Arkansas Superior Select Health Plans

Arkansas Superior Select Health Plans
$9 /mo
monthly premium
Tribute Select (HMO-POS I-SNP)
Additional Coverage
Overall Star Rating (2026)
  • Rx
(coming soon)

General Plan Details

Medical Deductible
$0
Out-of-Pocket Maximum
$9250
Rx Drug Coverage
Yes
Rx Deductible
$615
Primary Doctor Office Visit
20% coinsurance
Specialist Office Visit
20% coinsurance

Additional Benefits

Dental Coverage
No
Vision Coverage
No
Mental Health Coverage
Yes
Transportation for non-emergency
No
Fitness Benefits
No
Worldwide emergency
No
Telehealth
Yes
Part B Premium Reduction
Yes $58 annually

Doctor & Hospital Coverage

Primary Doctor Office Visit
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Specialist Office Visit
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Periodic Exam Coverage
In-network: $0 copay
Out-of-network: 20% coinsurance

Emergency Room

20% coinsurance

Ambulance Coverage

In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Lab, X-Ray, Radiology Coverage

Diagnostic tests & procedures:
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Lab services:
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Diagnostic radiology services (e.g., CT, MRI, etc):
In-network: $0 copay
Out-of-network: 20% coinsurance
Outpatient x-rays:
In-network: $0 copay
Out-of-network: 20% coinsurance

Hospital Services

Inpatient hospital coverage:
In-network:
  Tier 1
  $0 per day for days 1-60
  $434 per day for days 61-90
  $868 per day for days 91-150
Out-of-network:
  $0 per day for days 1-60
  $434 per day for days 61-90
  $868 per day for days 91-150
Outpatient hospital coverage:
In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Rehabilitation Coverage

Occupational therapy services:
In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Urgent Care Coverage

20% coinsurance

Skilled Nursing Facility (SNF)

In-network:
  Tier 1
  $0 per day for days 1-20
  $217 per day for days 21-100
Out-of-network:
  $ per stay

Mental Health Coverage

Outpatient group therapy with a psychiatrist:
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Outpatient individual therapy with a psychiatrist:
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Outpatient group therapy visits:
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Outpatient individual therapy visit:
In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Dental, Vision, Hearing Benefits

Additional Added Benefits

Annual physical exams
Yes
Chiropractic Coverage
No
Acupuncture
No
Massage Therapy
No
Health Education
Yes
Counseling Services
No
Support for Caregivers of Enrollees
No
Personal Emergency Response System (PERS)
No
In-home support services
No
Home and bathroom safety devices
No
Meals for short duration
No

Plan Links

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Where This Plan is Available

Additional Plan Info

Plan Year:
2026
Insurance Company Website:
Arkansas Superior Select Health Plans

Health Insurance Companies Offering Plans

Medicare Advantage and Part D plans and benefits offered by the following insurance companies:

  • Aetna Medicare
  • Anthem Blue Cross Blue Shield
  • Anthem Blue Cross
  • Anthem Blue Cross and Blue Shield
  • Aspire Health Plan
  • Baylor Scott & White Health Plan
  • Capital Blue Cross
  • Cigna Healthcare
  • Dean Health Plan
  • Devoted Health
  • Florida Blue Medicare
  • Freedom Health
  • GlobalHealth
  • Health Care Service Corporation
  • Healthy Blue
  • HealthSun
  • Humana
  • Molina Healthcare
  • Mutual of Omaha
  • Medica Central Health Plan
  • Optimum HealthCare
  • Premera Blue Cross
  • SCAN Health Plan
  • Simply
  • UnitedHealthcareⓇ
  • Wellcare
  • WellPoint