2024 Medicare Advantage Plans

Benefits you want. Plans you need.

We know what you need is unique to you. Sonder Health Plans offers four plans to fit your health and lifestyle.

Explore our plans to find the right fit for you! You can see more details about each plan on the Summary of Benefits.

$0 Premiums on All Plans

$0 Copay on Your PCP Visits

$0 Copay on Specialist Visits

when you become a Sonder Diabetes Wellness member

24/7 Nurse Hotline Access

Vision, Hearing and Dental Benefits in Every Plan

Sonder Plan Details

Click on icons below to view and compare plan details.

HMO – H1748001
Sonder Complete Health
Medicare Advantage
C-SNP - H1748003
Sonder
Diabetes Wellness
C-SNP - H1748004
Sonder
Heart Healthy

HMO – H1748004

Sonder Heart Healthy

For Cardiovascular Disorders (C-SNP Plan)

Premium and Out of Pocket Limits
Monthly Plan Premium
$0 Copay
Annual Deductible
$0
Max-Out-Of-Pocket (MOOP)
$3,850
Provider Office Visits
Primary Care Physician (PCP) Visit
$0 Copay
Specialist Visit
$0 Copay
Urgent Care
$25 Copay
Wellness and Preventative Care
Annual Wellness Exam
$0 Copay – 100% Coverage by Plan
Preventative Screenings & Immunization
$0 Copay – 100% Coverage by Plan
Silver and Fit Gym Benefit
$0 Copay – 100% Coverage by Plan
Surgical and Emergency Care
Hospital Inpatient
$350/day (1-5); $0/day (6-90)
Hospital Outpatient
$280 Copay
Ambulatory Surgery Center (ASC)
$180 Copay
$225 Copay
Emergency Room
$120 Copay
Skilled Nursing Facility
$0/day (1-20); $184/day (21-100)
Home Health
$10 Copay with Referral
Rehab/DME and Lab/Radiology
Physical/Occupational/Speech Therapy
$40 Copay/$40 Copay/$40 Copay
Durable Medical Equipment
20% Coinsurance
Diagnostic Radiology (ie. CT or MRI)
$0 for diagnostic imaging (e.g., sonagrams, ultrasounds) – $275 for advanced imaging (e.g., CT, MRI, PET)
Diabetic Supplies
$0 Copay
Lab Services
$0 Copay
Outpatient X-Rays
$0 Copay
Rx Drug Coverage – Elixer Rx Options

(1-Month/3-Month/Mail Order)
Tier 1 Drugs – Preferred Generics
$0 Copay/$0 Copay/$0 Copay
Tier 2 – Non-Preferred Generics
$15 Copay/$45 Copay/$0 Copay
Tier 3 – Preferred Brands
$47 Copay/$141 Copay/$141 Copay
Tier 4 – Non-Preferred Brands
$100 Copay/$300 Copay/$300 Copay
Tier 5 – Specialty Drugs
33% Coinsurance/33% Coinsurance/33% Coinsurance
Tier 6 – Select Care Drugs, including all Brand Name and Generic Insulin
$0 Copay
Medicare Part B Drugs
20% Coinsurance/20% Coinsurance/20% Coinsurance
Additional Services
24/7 Nurse Hotline
Yes
Over the Counter (OTC) Allowance (non-rolling)
$125 per Quarter
Transportation Allowance (per year)
$0 Copay for up to 12 One-Way Trips
Grocery Card
$75 Monthly Benefit
Comprehensive & Preventative Dental Services
Exams
$0 Copay 1 every 6 months
Prophylaxis
$0 Copay 1 every 6 months
Fluoride
$0 Copay 1 every year
X-Rays
1 every 2 years
Non-Routine Services
$0 Copay
Diagnostic Services
$0 Copay
Restorative Services
$0 Copay
Endodontics
$0 Copay
Periodontics
$0 Copay
Extractions
$0 Copay
Prosthodontics, Other Oral/Maxillofacial Surgery
$0 Copay
Combined Maximum Benefit
$2000
Vision Services
Routine Eye
$0 Copay
Eyewear (Lenses, Frames, Contacts)
$200 Per Year Allowance
Hearing Services – Per Year
Hearing Exams
$0 Copay
Hearing Aids
$699 or $999 copay per hearing aid, depeding on device
Additional Benefits
Meals Covered
14 Days (28 Meals Max)
Podiatry Services (Medicare Covered)
$40 Copay
Chiropractic Services
$20 Copay
D-SNP – H1748005
Sonder
Dual Complete

HMO – H1748005

Sonder Dual Complete

For Dual-Eligible for Medicare/Medicaid Members (D-SNP Plan)

Premium and Out of Pocket Limits
Monthly Plan Premium
$0 Copay
Annual Deductible
$0
Max-Out-Of-Pocket (MOOP)
$3,850
Provider Office Visits
Primary Care Physician (PCP) Visit
$0 Copay
Specialist Visit
$0 Copay
Urgent Care
$0 Copay
Wellness and Preventative Care
Annual Wellness Exam
$0 Copay – 100% Coverage by Plan
Preventative Screenings & Immunization
$0 Copay – 100% Coverage by Plan
Silver and Fit Gym Benefit
$0 Copay – 100% Coverage by Plan
Surgical and Emergency Care
Hospital Inpatient
$0 Copay
Hospital Outpatient
$0 Copay
Ambulatory Surgery Center (ASC)
$0 Copay
$0 Copay
Emergency Room
$0 Copay
Skilled Nursing Facility
$0 Copay
Home Health
$0 Copay
Rehab/DME and Lab/Radiology
Physical/Occupational/Speech Therapy
$0 Copay/$0 Copay/$0 Copay
Durable Medical Equipment
$0 Copay
Diagnostic Radiology (ie. CT or MRI)
$0 Copay
Lab Services
$0 Copay
Outpatient X-Rays
$0 Copay
Cardiovascular & Pulmonology Rehab
$0
Diabetic Supplies
$0 Copay
Rx Drug Coverage – Elixer Rx Options

(1-Month/3-Month/Mail Order)
Tier 1 Drugs – Preferred Generics
$0 Copay/$0 Copay/$0 Copay
Tier 2 – Non-Preferred Generics
$0 Copay/$0 Copay/$0 Copay
Tier 3 – Preferred Brands
$0 Copay/$0 Copay/$0 Copay
Tier 4 – Non-Preferred Brands
$0 Copay/$0 Copay/$0 Copay
Tier 5 – Specialty Drugs
0% Coinsurance/0% Coinsurance/0% Coinsurance
Additional Services
24/7 Nurse Hotline
Yes
Over the Counter
$500 per Quarter
Transportation Allowance (per year)
$0 Copay for up to 50 One-Way Trips
Grocery Card
$75 Monthly Benefit
Comprehensive & Preventative Dental Services
Exams
$0 Copay 1 every 6 months
Prophylaxis
$0 Copay 1 every 6 months
Fluoride
$0 Copay 1 every year
X-Rays
1 every 2 years
Non-Routine Services
$0 Copay
Diagnostic Services
$0 Copay
Restorative Services
$0 Copay
Endodontics
$0 Copay
Periodontics
$0 Copay
Extractions
$0 Copay
Prosthodontics, Other Oral/Maxillofacial Surgery
$0 Copay
Combined Maximum Benefit
$5,000
Vision Services

*$0 Copay and $3,500 allowance if vision option is selected
Routine Eye
$0 Copay
Eyewear (Lenses, Frames, Contacts)
$500 Per Year Allowance
Hearing Services

*$0 Copay and $3,000 allowance if hearing option is selected
Hearing Exams
$0 Copay
Hearing Aids
$0 Copay
Additional Benefits
Meals Covered
14 Days (28 Meals Max)
Podiatry Services (Medicare Covered)
$0 Copay
Chiropractic Services
$0 Copay
HMO – H1748010
Sonder
HMO "My Choice" Plan

HMO – H1748010

Sonder Tiers Medicare Advantage

Medicare Advantage Plans with Part D Prescription Drug Coverage

Premium and Out of Pocket Limits
Monthly Plan Premium
$0 Copay
Annual Deductible
$0
Max-Out-Of-Pocket (MOOP)
$6,700
Provider Office Visits
Primary Care Physician (PCP) Visit
$0 Copay
Specialist Visit
$0 Copay
Urgent Care
$30 Copay
Wellness and Preventative Care
Annual Wellness Exam
$0 Copay – 100% Coverage by Plan
Preventative Screenings & Immunization
$0 Copay – 100% Coverage by Plan
Silver and Fit Gym Benefit
$0 Copay – 100% Coverage by Plan
Surgical and Emergency Care
Hospital Inpatient
$350/day (1-5); $0/day (6-90)
Hospital Outpatient
$250 Copay
Ambulatory Surgery Center (ASC)
$150 Copay
$400 Copay
Emergency Room
$100 Copay
Skilled Nursing Facility
$0 days 1-20;$203 days 21-100
Home Health
$0 Copay
Rehab/DME and Lab/Radiology
Physical/Occupational/Speech Therapy
$25 Copay/$25 Copay/$25 Copay
Durable Medical Equipment
20% Coinsurance
Diagnostic Radiology (ie. CT or MRI)
$150 for diagnostic imaging (e.g., sonagrams, ultrasounds) – $300 for advanced imaging (e.g., CT, MRI, PET)
Lab Services
$0 Copay
Outpatient X-Rays
$0 -$100 Copay
Cardiovascular & Pulmonology Rehab
$20 Cardiac/Pulm/SET for PAD, $40 Intensive Cardiac Rehab ($15 Pulm)
Diabetic Supplies
20% Copay
Rx Drug Coverage – Elixer Rx Options

(1-Month/3-Month/Mail Order)
Tier 1 Drugs – Preferred Generics
$0 Copay/$0 Copay/$0 Copay
Tier 2 – Non-Preferred Generics
$10 Copay/$30 Copay/$0 Copay
Tier 3 – Preferred Brands
$44 Copay/$132 Copay/$88 Copay
Tier 4 – Non-Preferred Brands
$95 Copay/$285 Copay/$285 Copay
Tier 5 – Specialty Drugs
33% Coinsurance/33% Coinsurance/33% Coinsurance
Medicare Part B Drug
20% Coinsurance/20% Coinsurance/20% Coinsurance
Additional Services
24/7 Nurse Hotline
Yes
Over the Counter
$200 per Quarter
Grocery Card
$400 Monthly Benefit
Comprehensive & Preventative Dental Services

*$0 if dental option is selected
Exams
$0 Copay 1 every 6 months
Prophylaxis
$0 Copay 1 every 6 months
Fluoride
$0 Copay 1 every year
X-Rays
1 every 2 years
Non-Routine Services
$40 Copay*
Diagnostic Services
$40 Copay*
Restorative Services
$40 Copay*
Endodontics
$40 Copay*
Periodontics
$40 Copay*
Extractions
$40 Copay*
Prosthodontics, Other Oral/Maxillofacial Surgery
$40 Copay*
Combined Maximum Benefit
$4,000 (if selected)
Vision Services

*$0 Copay and $3,500 allowance if vision option is selected
Routine Eye
$0 Copay
Eyewear (Lenses, Frames, Contacts)
$40 Copay*
Hearing Services

*$0 Copay and $3,000 allowance if hearing option is selected
Hearing Exams
$40 Copay
Additional Benefits
Meals Covered
14 Days (28 Meals Max)
Podiatry Services (Medicare Covered)
$40 Copay
Chiropractic Services
$15 Copay

HMO – H1748004

Sonder Heart Healthy

For Cardiovascular Disorders (C-SNP Plan)

Premium and Out of Pocket Limits
Monthly Plan Premium
$0 Copay
Annual Deductible
$0
Max-Out-Of-Pocket (MOOP)
$3,850
Provider Office Visits
Primary Care Physician (PCP) Visit
$0 Copay
Specialist Visit
$0 Copay
Urgent Care
$25 Copay
Wellness and Preventative Care
Annual Wellness Exam
$0 Copay – 100% Coverage by Plan
Preventative Screenings & Immunization
$0 Copay – 100% Coverage by Plan
Silver and Fit Gym Benefit
$0 Copay – 100% Coverage by Plan
Surgical and Emergency Care
Hospital Inpatient
$350/day (1-5); $0/day (6-90)
Hospital Outpatient
$280 Copay
Ambulatory Surgery Center (ASC)
$180 Copay
$225 Copay
Emergency Room
$120 Copay
Skilled Nursing Facility
$0/day (1-20); $184/day (21-100)
Home Health
$10 Copay with Referral
Rehab/DME and Lab/Radiology
Physical/Occupational/Speech Therapy
$40 Copay/$40 Copay/$40 Copay
Durable Medical Equipment
20% Coinsurance
Diagnostic Radiology (ie. CT or MRI)
$0 for diagnostic imaging (e.g., sonagrams, ultrasounds) – $275 for advanced imaging (e.g., CT, MRI, PET)
Diabetic Supplies
$0 Copay
Lab Services
$0 Copay
Outpatient X-Rays
$0 Copay
Rx Drug Coverage – Elixer Rx Options

(1-Month/3-Month/Mail Order)
Tier 1 Drugs – Preferred Generics
$0 Copay/$0 Copay/$0 Copay
Tier 2 – Non-Preferred Generics
$15 Copay/$45 Copay/$0 Copay
Tier 3 – Preferred Brands
$47 Copay/$141 Copay/$141 Copay
Tier 4 – Non-Preferred Brands
$100 Copay/$300 Copay/$300 Copay
Tier 5 – Specialty Drugs
33% Coinsurance/33% Coinsurance/33% Coinsurance
Tier 6 – Select Care Drugs, including all Brand Name and Generic Insulin
$0 Copay
Medicare Part B Drugs
20% Coinsurance/20% Coinsurance/20% Coinsurance
Additional Services
24/7 Nurse Hotline
Yes
Over the Counter (OTC) Allowance (non-rolling)
$125 per Quarter
Transportation Allowance (per year)
$0 Copay for up to 12 One-Way Trips
Grocery Card
$75 Monthly Benefit
Comprehensive & Preventative Dental Services
Exams
$0 Copay 1 every 6 months
Prophylaxis
$0 Copay 1 every 6 months
Fluoride
$0 Copay 1 every year
X-Rays
1 every 2 years
Non-Routine Services
$0 Copay
Diagnostic Services
$0 Copay
Restorative Services
$0 Copay
Endodontics
$0 Copay
Periodontics
$0 Copay
Extractions
$0 Copay
Prosthodontics, Other Oral/Maxillofacial Surgery
$0 Copay
Combined Maximum Benefit
$2000
Vision Services
Routine Eye
$0 Copay
Eyewear (Lenses, Frames, Contacts)
$200 Per Year Allowance
Hearing Services – Per Year
Hearing Exams
$0 Copay
Hearing Aids
$699 or $999 copay per hearing aid, depeding on device
Additional Benefits
Meals Covered
14 Days (28 Meals Max)
Podiatry Services (Medicare Covered)
$40 Copay
Chiropractic Services
$20 Copay

HMO – H1748005

Sonder Dual Complete

For Dual-Eligible for Medicare/Medicaid Members (D-SNP Plan)

Premium and Out of Pocket Limits
Monthly Plan Premium
$0 Copay
Annual Deductible
$0
Max-Out-Of-Pocket (MOOP)
$3,850
Provider Office Visits
Primary Care Physician (PCP) Visit
$0 Copay
Specialist Visit
$0 Copay
Urgent Care
$0 Copay
Wellness and Preventative Care
Annual Wellness Exam
$0 Copay – 100% Coverage by Plan
Preventative Screenings & Immunization
$0 Copay – 100% Coverage by Plan
Silver and Fit Gym Benefit
$0 Copay – 100% Coverage by Plan
Surgical and Emergency Care
Hospital Inpatient
$0 Copay
Hospital Outpatient
$0 Copay
Ambulatory Surgery Center (ASC)
$0 Copay
$0 Copay
Emergency Room
$0 Copay
Skilled Nursing Facility
$0 Copay
Home Health
$0 Copay
Rehab/DME and Lab/Radiology
Physical/Occupational/Speech Therapy
$0 Copay/$0 Copay/$0 Copay
Durable Medical Equipment
$0 Copay
Diagnostic Radiology (ie. CT or MRI)
$0 Copay
Lab Services
$0 Copay
Outpatient X-Rays
$0 Copay
Cardiovascular & Pulmonology Rehab
$0
Diabetic Supplies
$0 Copay
Rx Drug Coverage – Elixer Rx Options

(1-Month/3-Month/Mail Order)
Tier 1 Drugs – Preferred Generics
$0 Copay/$0 Copay/$0 Copay
Tier 2 – Non-Preferred Generics
$0 Copay/$0 Copay/$0 Copay
Tier 3 – Preferred Brands
$0 Copay/$0 Copay/$0 Copay
Tier 4 – Non-Preferred Brands
$0 Copay/$0 Copay/$0 Copay
Tier 5 – Specialty Drugs
0% Coinsurance/0% Coinsurance/0% Coinsurance
Additional Services
24/7 Nurse Hotline
Yes
Over the Counter
$500 per Quarter
Transportation Allowance (per year)
$0 Copay for up to 50 One-Way Trips
Grocery Card
$75 Monthly Benefit
Comprehensive & Preventative Dental Services
Exams
$0 Copay 1 every 6 months
Prophylaxis
$0 Copay 1 every 6 months
Fluoride
$0 Copay 1 every year
X-Rays
1 every 2 years
Non-Routine Services
$0 Copay
Diagnostic Services
$0 Copay
Restorative Services
$0 Copay
Endodontics
$0 Copay
Periodontics
$0 Copay
Extractions
$0 Copay
Prosthodontics, Other Oral/Maxillofacial Surgery
$0 Copay
Combined Maximum Benefit
$5,000
Vision Services

*$0 Copay and $3,500 allowance if vision option is selected
Routine Eye
$0 Copay
Eyewear (Lenses, Frames, Contacts)
$500 Per Year Allowance
Hearing Services

*$0 Copay and $3,000 allowance if hearing option is selected
Hearing Exams
$0 Copay
Hearing Aids
$0 Copay
Additional Benefits
Meals Covered
14 Days (28 Meals Max)
Podiatry Services (Medicare Covered)
$0 Copay
Chiropractic Services
$0 Copay

HMO – H1748010

Sonder Tiers Medicare Advantage

Medicare Advantage Plans with Part D Prescription Drug Coverage

Premium and Out of Pocket Limits
Monthly Plan Premium
$0 Copay
Annual Deductible
$0
Max-Out-Of-Pocket (MOOP)
$6,700
Provider Office Visits
Primary Care Physician (PCP) Visit
$0 Copay
Specialist Visit
$0 Copay
Urgent Care
$30 Copay
Wellness and Preventative Care
Annual Wellness Exam
$0 Copay – 100% Coverage by Plan
Preventative Screenings & Immunization
$0 Copay – 100% Coverage by Plan
Silver and Fit Gym Benefit
$0 Copay – 100% Coverage by Plan
Surgical and Emergency Care
Hospital Inpatient
$350/day (1-5); $0/day (6-90)
Hospital Outpatient
$250 Copay
Ambulatory Surgery Center (ASC)
$150 Copay
$400 Copay
Emergency Room
$100 Copay
Skilled Nursing Facility
$0 days 1-20;$203 days 21-100
Home Health
$0 Copay
Rehab/DME and Lab/Radiology
Physical/Occupational/Speech Therapy
$25 Copay/$25 Copay/$25 Copay
Durable Medical Equipment
20% Coinsurance
Diagnostic Radiology (ie. CT or MRI)
$150 for diagnostic imaging (e.g., sonagrams, ultrasounds) – $300 for advanced imaging (e.g., CT, MRI, PET)
Lab Services
$0 Copay
Outpatient X-Rays
$0 -$100 Copay
Cardiovascular & Pulmonology Rehab
$20 Cardiac/Pulm/SET for PAD, $40 Intensive Cardiac Rehab ($15 Pulm)
Diabetic Supplies
20% Copay
Rx Drug Coverage – Elixer Rx Options

(1-Month/3-Month/Mail Order)
Tier 1 Drugs – Preferred Generics
$0 Copay/$0 Copay/$0 Copay
Tier 2 – Non-Preferred Generics
$10 Copay/$30 Copay/$0 Copay
Tier 3 – Preferred Brands
$44 Copay/$132 Copay/$88 Copay
Tier 4 – Non-Preferred Brands
$95 Copay/$285 Copay/$285 Copay
Tier 5 – Specialty Drugs
33% Coinsurance/33% Coinsurance/33% Coinsurance
Medicare Part B Drug
20% Coinsurance/20% Coinsurance/20% Coinsurance
Additional Services
24/7 Nurse Hotline
Yes
Over the Counter
$200 per Quarter
Grocery Card
$400 Monthly Benefit
Comprehensive & Preventative Dental Services

*$0 if dental option is selected
Exams
$0 Copay 1 every 6 months
Prophylaxis
$0 Copay 1 every 6 months
Fluoride
$0 Copay 1 every year
X-Rays
1 every 2 years
Non-Routine Services
$40 Copay*
Diagnostic Services
$40 Copay*
Restorative Services
$40 Copay*
Endodontics
$40 Copay*
Periodontics
$40 Copay*
Extractions
$40 Copay*
Prosthodontics, Other Oral/Maxillofacial Surgery
$40 Copay*
Combined Maximum Benefit
$4,000 (if selected)
Vision Services

*$0 Copay and $3,500 allowance if vision option is selected
Routine Eye
$0 Copay
Eyewear (Lenses, Frames, Contacts)
$40 Copay*
Hearing Services

*$0 Copay and $3,000 allowance if hearing option is selected
Hearing Exams
$40 Copay
Additional Benefits
Meals Covered
14 Days (28 Meals Max)
Podiatry Services (Medicare Covered)
$40 Copay
Chiropractic Services
$15 Copay

Do You Have Plan & Benefit Questions?

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1 (888) 428-4440
TTY/TDD 711

Monday through Friday, 8:00 a.m. to 6:00 p.m.

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(888) 217-7110 7 days a week 8:00 a.m. to 6:00 p.m.

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