Medicare Advantage · HMO
Upper Peninsula Health Plan (UPHP) MI Coordinated Health
Plan year 2026

Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) H3127-001

Monthly premium
$8.80
+ your Part B premium
Max out-of-pocket
$9,250
in-network annual cap
Primary care
$0
per visit copay
Specialist
$0
per visit
Eligibility required for this D-SNP
You must be entitled to Medicare Part A, enrolled in Part B, and have a Medicaid category this plan accepts. The plan must verify your Medicaid status. Eligibility alone does not create a year-round right to enroll.
Integration status
HIDE
Integrated-care plan
CMS data identifies this as an Applicable Integrated Plan.
Common dual-eligibility labels

These definitions are educational. They do not confirm which Medicaid categories this specific plan accepts.

FBDE
Full Medicaid benefits in addition to Medicare.
QMB+
QMB help with Medicare costs plus full Medicaid benefits.
SLMB+
SLMB help with the Part B premium plus full Medicaid benefits.
QMB
Help with Medicare premiums and Medicare-covered cost sharing.
Check the Summary of Benefits or Evidence of Coverage for the exact Medicaid levels this plan accepts.
Could a Medicare Savings Program help?

Medicare Savings Programs are run by each state. The 2026 federal baseline monthly income limits are:

  • QMB: $1,350 for one person or $1,824 for a married couple
  • SLMB: $1,616 for one person or $2,184 for a married couple
  • QI: $1,816 for one person or $2,455 for a married couple
Alaska, Hawaii, and some states use different limits or resource rules. Qualifying for an MSP does not by itself confirm eligibility for this D-SNP. Apply through your state Medicaid office.
Learn about QMB, SLMB, and QI

Your costs at a glanceIn-network, for the 2026 plan year

Rx deductible
$615
Outpatient surgery
$0
Emergency room
$0
Urgent care
$0

This plan is for people with Medicaid. What you pay depends on your Medicaid level: with QMB, your share of Medicare-covered services is covered; with full Medicaid benefits, your state may also cover Medicaid-covered services. Your state Medicaid office can confirm your level — or call us at 1-866-764-3312 (TTY 711) and a Licensed Medicare Advisor will help confirm it and discuss this plan's details with you. If you lose Medicaid eligibility, you may be billed the plan's cost sharing.

What's included, and what it's actually worth3 benefits included. Tap any card for the detail

OTC allowance

$42/month OTC allowance
Prepaid card$42/month OTC allowance
See more details about this plan
Doctor Visits: PCP$0 copay
In-network$0 copay per visit
Doctor Visits: Specialist$0 copay
In-network$0 copay per visit
Outpatient Surgery$0 copay
In-network$0 copay per procedure
VisionRoutine vision benefit
DetailsRoutine vision benefit
This is a supplemental benefit with plan-specific limits. See plan documents for details.
MealsMeal benefit

Your coverageCheck your coverageFrom the doctors and prescriptions you added

Your plan's drug tiers30-day retail · after any applicable deductible

Tier 1
$0
Preferred Generic

Our take

Where this plan shines

See your primary doctor for $0.
The specialist copay ($0) is among the more affordable options.

Things to know before you enroll

This plan’s out-of-pocket maximum is above the national median.
Network restriction — you’ll need to use in-network providers except in emergencies.
Limited coverage while traveling outside the plan’s service area.
Questions? Talk to a licensed agent at1-866-764-3312 (TTY: 711)

Plan documents

Plan questions

Common questions about Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP)

What does Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) cover?

Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) is a Dual Eligible Special Needs Plan, a Medicare Advantage plan for people who have Medicare and a Medicaid category the plan accepts. The plan record also identifies Part D prescription drug coverage. Its published drug benefit lists 1 formulary tiers. Published supplemental benefits include vision (Routine vision benefit), over-the-counter (OTC) ($42/month OTC allowance), and meals (Meal benefit). Review the plan documents for covered services, limits, and rules. Coverage can change each plan year.

Learn about Medicare Advantage

How much does Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) cost in 2026?

The published 2026 monthly plan premium for Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) is $8.80. The standard Part B premium is $202.90/month in 2026 for most people; assistance may pay it for some members. The listed Part D deductible is $615. The in-network medical out-of-pocket maximum is $9,250; it does not include Part D drug spending. Published visit costs include primary care $0 and specialist visits $0. Member costs can depend on the Medicaid category the plan accepts and verifies. These figures are plan data, not a personal yearly-cost estimate.

Understand Medicare drug-cost limits

Can I use my current doctors with Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP)?

CMS lists Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) as a HMO plan. A network label alone does not confirm that a specific doctor participates. Use the doctor lookup tool, then confirm with the doctor's office and the plan before receiving care. Provider networks and member costs can change. Emergency care and travel coverage can follow different network rules.

Check your doctors

Do I qualify for Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP)?

Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) is listed in the current plan record as a D-SNP. You must be entitled to Medicare Part A, enrolled in Part B, and have a Medicaid category this plan accepts. The plan must verify your Medicaid status. Eligibility alone does not create a year-round right to enroll.

Learn about Medicare Savings Programs

What extra benefits does Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) offer for dual-eligible members?

The current plan record for Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) lists vision (Routine vision benefit), over-the-counter (OTC) ($42/month OTC allowance), and meals (Meal benefit). Member costs can depend on the Medicaid category the plan accepts and verifies. The record identifies Part D prescription drug coverage. Review the plan documents for benefit limits, eligibility rules, and how Medicare and Medicaid coverage work together.

When can I enroll in Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP)?

Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) is a 2026 Medicare Advantage plan. The Annual Enrollment Period runs from October 15 through December 7, with changes taking effect January 1. The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 for people already enrolled in Medicare Advantage. Because this is a D-SNP, the plan must also verify its eligibility requirements. A qualifying circumstance may create a Special Enrollment Period, but eligibility alone does not guarantee a year-round right to enroll. Confirm the enrollment window and effective date that apply to you before changing coverage.

Review Medicare enrollment periods

More plan options

Browse the full 2026 Dual Eligible Special Needs Plan directory. This plan is offered in Michigan. Plan availability can vary by county.

Helpful next steps

Upper Peninsula Health Plan MI Coordinated Health H3127-001 (HMO D-SNP) — 2026