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Valor Health Plan HMO Special Needs Plan with Prescription Drug for Institutional Residents (2022)

Valor Health Plan (HMO-SNP) is a Medicare Advantage health plan designed specifically for Medicare beneficiaries that reside in a long-term care facility. Valor Health Plan is headquartered in Northeast Ohio and available in select Ohio CMS-approved counties.

The Valor Advantage

  • Low Cost Premium $33.50 premium for medical coverage
  • Physical, Occupational and Speech Therapy No annual limit
  • Skilled Nursing Care No prior hospital stay requirement
  • All-In-One Plan Covers original Medicare benefits plus Medicare Part D prescription drugs
  • Over-the-Counter (OTC) Benefit $105 per quarter OTC benefit
  • Local Care Team Hands-on RNs and Nurse Practitioners to assist with quality care coordination

Summary of Important Costs
Monthly Premium $33.50
Primary Care Visit 20% per visit
Specialist Visit 20% per visit
Inpatient Hospital Stays $1,484 deductible for days 1 – 60
$371 copay per day for days 61 – 90
$742 copay per lifetime reserve day
Part D Prescription Drugs Standard Benefit Coinsurance during the Initial Coverage Stage: 25%

Last Updated: Oct 14, 2021 @ 10:25 am

Enrollment Process

Enroll in a Medicare Advantage Special Needs Plan that’s right for you. Our dedicated licensed agents are here to guide you through the enrollment process. Simply call 1-800-485-3793 and set up an appointment to begin the enrollment process.

Valor Health Plan also accepts enrollment forms by fax or mail.

Once we confirm your eligibility with Medicare, you can expect to receive a confirmation letter by mail, identification card and your new member mailing within 10 days.

Call Member Services (available 8am – 8pm) at 1-800-485-3793.

Click the link below to download the enrollment form.

Download Enrollment Form

Last Updated: Oct 14, 2021 @ 11:28 am


Online Prior Authorization
Comprehensive FormularyLast updated 10/2021
Step Therapy CriteriaLast updated 10/2021
Quantity LimitLast updated 10/2021
Pharmacy Prior AuthorizationLast updated 10/2021
Formulary ChangesLast Updated 10/2021
Redetermination Request Form
Coverage Determination Request Form
Online Formulary Search Tool

Other Resources

Pharmacy Search
Medication Transition Policy
Medication Therapy Management
Safe Disposal

This section last modified: Oct 14, 2021 @ 11:24 am

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