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Medicare Advantage · D-SNP · HMO · 2027

Community Health Plan of WA Dual Select (HMO D-SNP)

Community Health Plan of WA Medicare Advantage H5826-0173.5 CMS rating for 2027
Is it offered where you live?

At a glance: $6.30 monthly premium and $1,000/yr hearing aid allowance.

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. See who can enroll

Monthly premium
$6.30
Part B premium separate
Yearly limit
$9,850
Most you’d pay for in-network care
Hearing
$1,000/yr
Hearing aid allowance
Doctor visits
20%
Primary care · specialists 20%

Check this plan for you

Referral needed to see a specialist

Add your doctors and prescriptions to see how they work with this plan.

Your doctors
Not checked yetSee if they’re in this plan’s network
Your prescriptions
Not checked yetSee your drug tier and monthly cost
Extra benefits
5 includedHearing · Dental · Vision · Transportation · Meals

Enter your ZIP code to see how you can enroll

Enrollment options depend on where you live. Enter your ZIP code so we can show the right ways to enroll in this plan.

Who can enroll

Eligibility for this Special Needs Plan

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
CO
Some partial-dual categories accepted
Verify the exact Medicaid levels in the official plan documents.

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

Costs and copays

Deductible, yearly limit, visits and drug tiers
Drug deductiblePer year
$700
Yearly limitIn-network care, not counting drugs
$9,850
Primary doctorPer visit
20%
SpecialistPer visit · referral needed
20%
Outpatient surgeryPer procedure
20%
Emergency roomPer visit
20% (max $115/visit)
Urgent carePer visit
20% (max $40/visit)
Tier 1 · Preferred Generic30-day supply at a retail pharmacy
25%
Tier 2 · Generic30-day supply at a retail pharmacy
25%
Tier 3 · Preferred Brand30-day supply at a retail pharmacy, after deductible
25%
Tier 4 · Non-Pref Brand30-day supply at a retail pharmacy, after deductible
25%
Tier 5 · Specialty30-day supply at a retail pharmacy, after deductible
25%
Tier 6 · Drugs30-day supply at a retail pharmacy, after deductible
$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.

Our take

Where this plan shines, and what to know

Things to know before you enroll

  • This plan’s out-of-pocket maximum is above the national median.
  • You’ll need to use in-network providers except in emergencies.
  • Limited coverage while traveling outside the plan’s service area.

Similar plans

Other Medicare Advantage plans offered in Washington

Common questions

6 answers about this plan

What does Community Health Plan of WA Dual Select (HMO D-SNP) cover?

Community Health Plan of WA Dual Select (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 6 formulary tiers. Published supplemental benefits include dental ($500/yr preventive & comprehensive dental allowance), vision ($250/yr eyewear allowance), hearing ($1,000/yr hearing aid allowance), and transportation (40 one-way trips/year). Review the plan documents for covered services, limits, and rules. Coverage can change each plan year.

Learn about Medicare Advantage

How much does Community Health Plan of WA Dual Select (HMO D-SNP) cost in 2027?

The published 2027 monthly plan premium for Community Health Plan of WA Dual Select (HMO D-SNP) is $6.30. Any Medicare premiums you owe are separate from the listed plan premium. The listed Part D deductible is $700. The in-network medical out-of-pocket maximum is $9,850; it does not include Part D drug spending. Published visit costs include primary care 20% and specialist visits 20%. 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 Community Health Plan of WA Dual Select (HMO D-SNP)?

CMS lists Community Health Plan of WA Dual Select (HMO D-SNP) as a HMO plan. The plan record says specialist referrals are required. 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 Community Health Plan of WA Dual Select (HMO D-SNP)?

Community Health Plan of WA Dual Select (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 Community Health Plan of WA Dual Select (HMO D-SNP) offer for dual-eligible members?

The current plan record for Community Health Plan of WA Dual Select (HMO D-SNP) lists dental ($500/yr preventive & comprehensive dental allowance), vision ($250/yr eyewear allowance), hearing ($1,000/yr hearing aid allowance), transportation (40 one-way trips/year), 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 Community Health Plan of WA Dual Select (HMO D-SNP)?

Community Health Plan of WA Dual Select (HMO D-SNP) is a 2027 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

Plan documents

Summary of Benefits and Evidence of Coverage

Enter your ZIP code to see how you can enroll

Enrollment options depend on where you live. Enter your ZIP code so we can show the right ways to enroll in this plan.

Community Health Plan of WA Dual Select H5826-017 (HMO D-SNP) — 2027