Medicare Plan Lookup Official CMS data · Contract Year 2026
CMS 2026 data

2026 Medicare plan code

H9153-001

Medicare Plan

WV Senior Advantage (HMO I-SNP) · West Virginia Senior Advantage · HMO · West Virginia (partial)

Full CMS plan ID: H9153-001-000

H9153-001-000 is the full CMS identifier for the H9153-001 Medicare plan. Common searches include H9153 001 and H9153001.

Historical 2026 record. Benefits and service areas shown apply to that year.

2026

Spaces or dashes work: H5216-435-002 · S2135 802

● CMS 2026 plan record

WV Senior Advantage (HMO I-SNP)

H9153-001-000 West Virginia (partial) HMO Institutional

At-a-glance

Quick view

01

In-network

Inpatient hospital

inpatient coinsurance is selected but its percentage is missing

02

Emergency transport

Ambulance

Ground · in-network20% coinsurance
Air · in-network20% coinsurance
03

Emergency services

Emergency room

$100 copay

Waived if admitted

04

Medical maximum

Maximum out-of-pocket

In-network$9,250
Combined in + outNot reported
05

Skilled care at home

Home health

In-networkCost share not reported
Out-of-networkNot separately reported
06

Monthly cost

Premium & giveback

Part C premium$0 / month
Consolidated C + D$32.70 / month

Plan details

All plan benefits

Medical care3 benefits

Primary care physician

In-network20% coinsurance
Out-of-networkNot separately reported

Specialist

In-network20% coinsurance
Out-of-networkNot separately reported

Preventive care

In-network20% coinsurance
Out-of-networkNot separately reported
Diagnostics & imaging4 benefits

Diagnostic procedures & tests

In-network20% coinsurance
Out-of-networkNot separately reported

Laboratory services

In-networkCost share not reported
Out-of-networkNot separately reported

X-rays & standard imaging

In-network20% coinsurance
Out-of-networkNot separately reported

MRI, CT & PET imaging

In-network20% coinsurance
Out-of-networkNot separately reported
Urgent & hospital care6 benefits

Urgent care

In-networkCost share not reported
Out-of-networkNot separately reported

Emergency room

In-network$100 copay
Out-of-networkNot separately reported

Ground ambulance

In-network20% coinsurance
Out-of-networkNot separately reported

Air ambulance

In-network20% coinsurance
Out-of-networkNot separately reported

Outpatient hospital

In-network20% coinsurance
Out-of-networkNot separately reported

Outpatient surgery / ASC

In-network20% coinsurance
Out-of-networkNot separately reported
Recovery & therapy5 benefits

Home health

In-networkCost share not reported
Out-of-networkNot separately reported

Skilled nursing facility

In-networkCost share not reported
Out-of-networkNot separately reported

Cardiac & pulmonary rehabilitation

In-network20% coinsurance
Out-of-networkNot separately reported

Occupational therapy

In-network20% coinsurance
Out-of-networkNot separately reported

Physical & speech therapy

In-network20% coinsurance
Out-of-networkNot separately reported
Behavioral health2 benefits

Mental health services

In-network20% coinsurance
Out-of-networkNot separately reported

Substance use treatment

In-network20% coinsurance
Out-of-networkNot separately reported
Specialty care2 benefits

Podiatry

In-networkCost share not reported
Out-of-networkNot separately reported

Chiropractic

In-network20% coinsurance
Out-of-networkNot separately reported
Supplemental benefits7 benefits

Dental

In-networkCost share not reported
Out-of-networkNot separately reported

Vision

In-networkCost share not reported
Out-of-networkNot separately reported

Hearing

In-networkCost share not reported
Out-of-networkNot separately reported

Transportation

In-networkCost share not reported
Out-of-networkNot separately reported

Fitness & wellness

Not reported in this CMS export

Not reported in this CMS export

Over-the-counter allowance

Not reported in this CMS export

Not reported in this CMS export

Meals

Not reported in this CMS export

Not reported in this CMS export

Plan costs & rulesCoverage overview

Premium & Part B giveback

$0 Part C premium / month · Part B giveback not separately reported

Maximum out-of-pocket (MOOP)

In-network$9,250
Combined in + outNot reported

Medical deductibles

In-networkNot reported
Out-of-networkNot reported

Network & referrals

HMO · Referrals: Not required · Out-of-network coverage: No

Prescription drugs0 tiers

Part D deductible

Not reported

Using this plan

Understand H9153-001-000

Plain-language context built from this plan’s 2026 CMS record. It is a guide to the reported benefits, not a personalized cost estimate.

Plan at a glance

A quick read on this plan

WV Senior Advantage (HMO I-SNP) is a 2026 HMO offered by West Virginia Senior Advantage in West Virginia (partial). The CMS record does not indicate routine out-of-network coverage. The plan record does not require referrals.

Common benefit costs

What you may pay

These are individual in-network benefit amounts. A real visit may involve more than one separately billed service.

Routine care

Primary care physician
20% coinsurance
Specialist
20% coinsurance
Laboratory services
Cost share not reported

Separate visits or services; costs are not added together.

Tests & outpatient care

Diagnostic procedures & tests
20% coinsurance
MRI, CT & PET imaging
20% coinsurance
Outpatient hospital
20% coinsurance

The service setting and billing details can change what you pay.

Emergency & hospital care

Emergency room
$100 copay

Actual costs depend on the care received and plan rules.

Helpful context

Terms worth knowing

Maximum out-of-pocket (MOOP)

This is the most you generally pay during the plan year for covered Part A and Part B medical services under the applicable network limit. Premiums and prescription drug costs generally do not count toward it.

Availability

Who can enroll

Service area
West Virginia (partial) (WV)
Plan type
HMO
Special Needs Plan
Institutional
Contract / plan
H9153-001
Coverage year
2026

This is a Institutional; enrollment requires the plan's specific eligibility criteria as well as residence in its service area. Confirm eligibility and the exact service area with the plan before enrolling.

Supplemental coverage

Extra benefits reported

Availability is summarized here; allowances, frequency limits, networks, and prior-authorization rules may apply.

DentalCost share not reported
VisionCost share not reported
HearingCost share not reported
TransportationCost share not reported

Plan-specific answers

Frequently asked questions

Where is H9153-001-000 available?

WV Senior Advantage (HMO I-SNP) is listed for West Virginia (partial) (WV). This is a Institutional; enrollment requires the plan's specific eligibility criteria as well as residence in its service area.

What is the in-network maximum out-of-pocket limit for H9153-001-000?

The 2026 CMS record lists an in-network medical maximum out-of-pocket limit of $9,250. Prescription drug spending generally does not count toward this medical limit.

What is the monthly plan premium for H9153-001-000?

The listed consolidated Part C and Part D premium is $32.70 per month. This does not replace the standard Medicare Part B premium.

What does an emergency room visit cost on H9153-001-000?

The plan record lists $100 copay, waived when an admission meets the plan's stated timing rule.

Does H9153-001-000 report extra benefits?

Yes. CMS reports dental, vision, hearing, transportation. See the detailed benefit rows and official plan documents for limits and conditions.

Source trail

Official CMS, Contract Year 2026

Plan identity and benefits come from CMS PBP data. Premium and MOOP figures are cross-checked against the August 2026 Landscape release; county identity is sourced from segment-level Landscape rows and stable codes are enriched from the aligned MA contract service-area release where matched. Quick-reference values should be confirmed in 2026 official plan documents.

PBP benefits ↗ Landscape data ↗ County service area ↗

Plan context

Where H9153-001-000 fits

Full CMS plan ID
H9153-001-000
Contract
H9153
Base plan code
H9153-001
Segment
000
Carrier
West Virginia Senior Advantage
Plan type
HMO
Service area
West Virginia (partial) (WV)

County/service-area foundation

CMS service-area entries

Named county entries are tied to this exact contract, plan, and segment in CMS Landscape data. County codes are enriched from the aligned CMS contract service-area release where a match exists.

  • Barbour, WV
  • Berkeley, WV
  • Boone, WV
  • Braxton, WV
  • Brooke, WV
  • Cabell, WV
  • Calhoun, WV
  • Clay, WV
  • Doddridge, WV
  • Fayette, WV
  • Gilmer, WV
  • Grant, WV

43 additional service-area entries are retained in the data record.

About this code

What H9153-001-000 identifies

H9153-001-000 is a Contract Year 2026 Medicare plan segment code. Searches written as H9153-001, H9153 001, or the compact full CMS ID H9153001000 refer to this plan or its base plan code.

Medicare Plan Lookup uses official CMS data as a quick reference. Benefit details, eligibility, service-area rules, and cost sharing should be confirmed in the current Summary of Benefits or Evidence of Coverage.