Zing Health First Look

$0 Premiums

• $0 Part C plan premium on all plans

Competitive Maximum Out-of-Pocket Limits (MOOP)

• Competitive MOOPs for all plans

Transportation

• All HMO plans include transportation benefits
• Unlimited transportation to and from dialysis treatments, doctor visits, and the pharmacy

Groceries, Utilities, and Over-the-Counter (OTC)

• Quarterly allowance for OTC items on all plans (no rollover)
• Monthly allowance for groceries and utilities on most C-SNPs*** (no rollover)

Formulary

• $0 insulin medications on most plans
• $0 for Tier 1 and Tier 6 formulary drugs on most C-SNPs for retail and mail order (up to a 100-day supply)
• Competitive Part D formulary design

No Referrals

• No referrals required for in and out-of-network office visits

Dialysis C-SNP

CMS allows C-SNPs to cover all stages of CKD, including Stage 5/ End-Stage Renal Disease (ESRD) which requires dialysis. Members with ESRD may receive extra benefits.

Benefits for members with CKD Stage 5/ESRD include:

• $0 copay for dialysis
• $0 copay for in-network primary care doctors and C-SNP specialists*
• Unlimited transportation
• 60 hours of in-home support services per year

Cardiovascular Disorders, Chronic Heart Failure, and Diabetes C-SNP

Zing offers C-SNPs to individuals with Chronic Heart Failure, Cardiovascular Disorders, and Diabetes.

These plans include benefits such as:

• $0 copay for insulin on most plans
• $0 or low copay for in-network primary care doctors and C-SNP specialists*
• FREE Continuous Glucose Monitor (CGM)**
• Up to 60 hours of in-home support services

Overweight, Obesity, or Metabolic Syndrome C-SNP

Zing offers a C-SNP for individuals living with obesity, overweight, or metabolic syndrome. To be considered overweight, an individual must have a Body Mass Index (BMI) between 25 and 29.9. A BMI of 30 or higher is classified as obese. Metabolic Syndrome is diagnosed when a person has three or more of the following conditions: abdominal obesity, high blood pressure, high blood sugar, high triglycerides, or low HDL (high-density lipoprotein) cholesterol.

This plan includes benefits such as:

• Low copay for C-SNP specialists*
• Free fitness membership*
• FREE activity tracker
• In-home support services

Duals Focused or LIS C-SNP

• Plan Type - Zing will continue to offer an HMO C-SNP for fully dual eligibles in Illinois counties only. New for 2027: C-SNP PSP with an LIS focus in select counties in all states.
• Eligibility - Members must have a qualifying chronic condition to enroll (Diabetes/CVD/CHF). Duals Focused plan will be attractive to those who receive Full Medicaid. LIS plan will not be attractive to those without LIS (Extra Help).
• Premiums - Part C Premium = $0; Part D Premium = LIS Target. Full dual members will have a $0 premium experience, premiums will be covered by LIS.
• Benefits - Duals Focused plans are filed with 20% coinsurance for Medicare Part A and Part B services. LIS focused plan will have copays for Part A and Part B services; Member will pay their LIS copays for Part D prescription drugs. Both plans offer advantaged supplemental benefits.

Provider Specific Plans (PSPs)

Uniquely designed HMO plans offering enhanced benefits for members choosing to work within a narrower subset of the overall Zing network.

• Comprised of value-based provider groups who specialize in quality focused care, such as Oak Street Health, CenterWell, Village Medical, and AbsoluteCare.
• At the time of enrollment, the member selects a primary care physician (PCP) affiliated with one of our value-based provider partner groups.
• Members must remain within the value-based PCP network except for Urgent / Emergency services or if prior authorization is received.
• Our PSPs are available in select counties across our service area.