Carrier Profile
Imperial Health Plan
Founded by a Harvard-trained cardiologist. NCQA accredited. Named one of the Best Medicare Advantage Plans in California by U.S. News & World Report. Imperial brings a physician’s perspective to every benefit, and their Dynamic Plan’s cost structure is unlike anything else in the market.
NCQA
Accredited, April 2025
U.S. News
Best Medicare 2026 (CA)
~$297
MOOP · Dynamic Plan
5 Stars
Care Continuity · U.S. News
The Physician-Founded Difference
Built by a Doctor.
Designed for Patients.
Imperial Health Plan was founded by Dr. Paveljit S. Bindra, MD, MBA, a Harvard Medical School graduate, Wharton-trained MBA, and board-certified cardiologist. Before founding Imperial, Dr. Bindra served as Chief Medical Officer and Chief Information Officer of a three-hospital health system and was recognized by Modern Healthcare magazine as one of the industry’s rising leaders.
That clinical background shapes everything about how Imperial operates. When a physician designs a health plan, the emphasis shifts from administrative efficiency toward genuine care continuity, preventive intervention, and whole-person wellness. Imperial’s 5-star Care Continuity rating from U.S. News & World Report reflects that focus.
Imperial’s mission: “To deliver valuable care so that members are healthy in mind, body, and spirit to achieve their inherent potential.” That isn’t a slogan, it’s the organizing principle behind plan design decisions, benefit choices, and the proactive diagnostics programs Imperial offers to members.
NCQA Accreditation (April 2025)
National Committee for Quality Assurance (NCQA) accreditation is the gold standard in health plan evaluation, covering patient care, care coordination, quality measures, and health outcomes. Imperial earned full accreditation in April 2025.
U.S. News Best Medicare 2026, California
Imperial was named one of the Best Medicare Advantage Plans in California by U.S. News & World Report for 2026, earning 5 stars for Care Continuity, 4.5 stars for Screening & Prevention, and 4 stars overall.
50 of 58 California Counties
Imperial serves members across a remarkably broad footprint, 50 of California’s 58 counties, covering Northern, Central, and Southern California from Sacramento to San Diego to the Bay Area and beyond.
Plan Spotlight
The Imperial Dynamic Plan
The Dynamic Plan may offer the most favorable cost structure of any $0-premium Medicare Advantage plan in California. The numbers are striking, and they’re real.
$0
Monthly premium (plus your standard Part B)
~$297
Annual out-of-pocket maximum, among the lowest available
$0
Copay for Primary Care, Specialists, and Urgent Care
What a $297 MOOP Actually Means
Most Medicare Advantage plans set their annual out-of-pocket maximum between $3,500 and $9,350. The Imperial Dynamic Plan’s MOOP of approximately $297 means that once you’ve spent that amount on covered medical services, you pay nothing for the rest of the calendar year, no matter how many doctor visits, specialist appointments, hospital days, or procedures you need.
For context: a single specialist visit with a $30 copay multiplied by 10 visits would be $300, you’d have already exceeded the Dynamic Plan’s MOOP. From that point forward, care is free. For members who see multiple doctors or face a health event, this protection is extraordinary.
Combined with $0 copays for primary care, specialists, and urgent care, and a $0 drug deductible, the Dynamic Plan offers a genuinely low-cost, low-surprise Medicare Advantage experience.
Plan Options
Imperial’s Plan Lineup
Imperial offers plans designed for different needs, from the ultra-low-cost Dynamic Plan to SNP plans tailored for specific populations. All include drug coverage and Part B as a combined benefit.
Imperial Dynamic Plan
HMO
Premium
$0 / month
MOOP
~$297
Part B Rebate
N/A
One of the lowest MOOPs in CA Medicare Advantage
- ✓$0 copay, Primary Care
- ✓$0 copay, Specialist visits
- ✓$0 copay, Urgent Care
- ✓$125, Emergency Room
- ✓$0, Inpatient hospital (days 1-90)
- ✓$0 Drug deductible
- ✓$140/quarter OTC allowance
- ✓100 one-way transportation trips/year
Imperial Giveback Plan
HMO
Premium
$0 / month
MOOP
$9,350
Part B Rebate
$100 / month
In-network maximum
- ✓$100/month Part B premium reduction
- ✓$75/quarter OTC allowance
- ✓$500 dental annual maximum
- ✓$2,000 orthodontics maximum
- ✓$500 vision annual maximum
- ✓Rx delivery included
Imperial Senior Value (C-SNP)
HMO · Chronic Condition SNP
Premium
$0 / month
MOOP
Varies
Part B Rebate
Varies
Designed for members with cardiovascular disorders, CHF, or diabetes
- ✓Tailored drug formulary for qualifying conditions
- ✓Coordinated care team
- ✓Enhanced care management
- ✓Condition-specific benefit design
- ✓Enroll any time of year if you qualify
Imperial Dual Plan (D-SNP)
HMO · Dual-Eligible SNP
Premium
$0 / month
MOOP
Minimal
Part B Rebate
Varies
For members with both Medicare and Medicaid
- ✓Designed for dual-eligible members
- ✓Integrated Medicare and Medicaid benefits
- ✓Low or no cost sharing
- ✓Dedicated care coordination
- ✓Enroll any time of year if you qualify
Plan details shown are representative of recent plan years. Benefits vary by year and county. Contact us for current plan-year specifics in your area.
What Sets Imperial Apart
Benefits Worth Noticing
100 Transportation Trips / Year
Imperial provides up to 100 one-way trips per year to plan-approved medical facilities. Most Medicare Advantage plans offer 24–48 rides annually. Imperial's transportation benefit is among the most generous available anywhere in the market, a meaningful difference for members who depend on rides to appointments.
At-Home Diagnostic Testing
Through a partnership with Simple HealthKit, Imperial Health Plan members receive comprehensive at-home diagnostic tests, including HbA1c blood tests for diabetes detection and FIT colon cancer screenings. Results return within 24 hours with next-step guidance. This proactive approach to early detection is a standout benefit not offered by most larger carriers.
$140 / Quarter OTC Allowance
Imperial Dynamic Plan members receive $140 per quarter ($560 annually) to spend on over-the-counter health products through the plan's OTC catalog. This allowance covers items like pain relievers, vitamins, wound care, cold and flu medications, and other approved health supplies.
Prescription Delivery
Prescription delivery is included as a standard benefit across Imperial plans, with medications delivered directly to your door at no additional charge. Combined with the $0 deductible on the Dynamic Plan and $0 Tier 1 generic copays, managing prescriptions with Imperial is as convenient as it gets.
Silver & Fit Fitness Program
Imperial plans include the Silver & Fit program, providing access to participating fitness centers, YMCAs, and digital fitness tools. Classes, personalized fitness plans, and wellness resources are available to help members stay active and healthy.
Telehealth Included
Virtual care is covered across Imperial plans, giving members on-demand access to physicians for non-emergency concerns without leaving home. Telehealth has become an essential benefit for managing routine care, follow-up consultations, and prescription renewals efficiently.
Awards & Accreditations
Health Plan Accreditation
The gold standard in health plan quality evaluation, awarded April 2025 to Imperial and all affiliated entities
Best Medicare 2026, California
5 stars for Care Continuity · 4.5 stars for Screening & Prevention · 4 stars Overall Performance
"Up & Comers", Dr. Bindra
Founder and CEO Dr. Paveljit Bindra was recognized by Modern Healthcare as a rising leader in health system operations
Is Imperial Right for You?
✓ Imperial tends to work well for…
- • California Medicare beneficiaries seeking the lowest possible out-of-pocket costs
- • Members who want $0 copays for every routine care visit: PCP, specialists, urgent care
- • People who depend on transportation to medical appointments (100 trips/year)
- • Beneficiaries with diabetes, heart conditions, or other chronic conditions who qualify for the C-SNP
- • Dual-eligible members on both Medicare and Medicaid (D-SNP option)
- • Members who value proactive, preventive care and early disease detection
- • Those who want an OTC allowance for health supplies ($560/year on Dynamic Plan)
i Worth knowing before you enroll…
- • Imperial is an HMO plan only, you must use in-network providers and obtain referrals for specialists
- • Coverage is currently centered in California (50 of 58 counties), verify availability in your county
- • Always confirm your specific doctors are in-network before enrolling in any HMO plan
- • The Dynamic Plan’s extraordinarily low MOOP applies to covered in-network services
- • CMS overall star rating is 3.5, plans are improving; U.S. News rates specific quality measures more highly
- • Prescription drug costs on the Giveback Plan differ from the Dynamic Plan, compare both for your medications
Plan availability, benefits, premiums, and MOOP figures vary by county, ZIP code, and plan year. Benefits shown are representative of recent plan years and are subject to annual change. CMS star ratings, U.S. News rankings, and NCQA accreditation cited reflect most recently available data at time of publication. Insurance Innovators LLC does not represent all Imperial Health Plan products in all markets. Contact us for a review specific to your location and situation. Imperial Health Plan is a trademark of Imperial Health Holdings. HMO plans require in-network provider use. Verify provider network status before enrolling.
See If Imperial Is Available in Your Area
Imperial’s Dynamic Plan offers one of the lowest out-of-pocket exposures available in California Medicare Advantage. If Imperial is available in your county, and your doctors are in-network, it may be one of the most compelling plans we can offer you. Let’s find out together.