Medicare Advantage · HMO · 2027
HealthSun HealthAdvantage Plan (HMO)
At a glance: $0 monthly premium, a Part B giveback of up to $35 a month, and $0 primary care visits.
- Monthly premium
- $0
- Part B premium separate
- Yearly limit
- $3,450
- Most you’d pay for in-network care
- Part B giveback
- Up to$35/mo
- Up to $420 a year
- Doctor visits
- $0
- Primary care · specialists $0
Check this plan for you
Referral needed to see a specialist
Add your doctors and prescriptions to see how they work with this plan.
- Part B givebackThis plan includes a Part B giveback, which lowers what you pay for your Medicare Part B premium by up to $35 a month.Depending on how you pay Part B, the reduction may appear in your Social Security payment or on your Part B bill. Processing can take time; confirm the amount and timing with the plan.
- $35/month
- DentalPreventive & comprehensive dental allowance
- $5,000/yr
- HearingHearing aid allowance
- $2,000/yr
- OTC allowance
- $55/month
- VisionEyewear allowance
- $300/yr
- Fitness$0 fitness benefit
- Included
- TransportationNon-emergency transportation benefit
- Included
- MealsMeal benefit
- Included
This is a supplemental benefit with plan-specific limits. See plan documents for details.
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A licensed agent can review this plan and other plans in your area that fit your needs.
TTY: 711 · Monday to Friday, 8:00 AM to 6:00 PM CST
Costs and copays
Deductibles, yearly limit, visits, hospital stays and drug tiers
- DeductiblesMedical · $0 for drugs
- $0
- Yearly limitIn-network care, not counting drugs
- $3,450
- Primary doctorPer visit
- $0
- SpecialistPer visit · referral needed
- $0
- Hospital stayPer stay
- Days 1-6: $20/day, Days 7-90: $0/day
- Inpatient mental healthHospital stay
- $0 copay
- Outpatient surgeryPer procedure
- $15
- Emergency roomPer visit
- $150
- Urgent carePer visit
- $0
- Tier 1 · Preferred Generic30-day supply at a retail pharmacy
- $0
- Tier 2 · Generic30-day supply at a retail pharmacy
- $0
- Tier 3 · Preferred Brand30-day supply at a retail pharmacy
- $10
- Tier 4 · Non-Pref Brand30-day supply at a retail pharmacy
- $50
- Tier 5 · Specialty30-day supply at a retail pharmacy
- 33%
- Tier 6 · Drugs30-day supply at a retail pharmacy
- $0
Our take
Where this plan shines, and what to know
Where this plan shines
- This plan has a $0 monthly premium.
- This plan’s out-of-pocket maximum ($3,450) is among the lowest available.
- See your primary doctor for $0.
- The specialist copay ($0) is among the more affordable options.
- No separate drug deductible.
- No separate medical deductible.
- Highly rated by CMS (4.5 stars).
Things to know before you enroll
- 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 Florida
Browse the full 2027 Medicare Advantage with drug coverage directory. This plan is offered in Florida. Plan availability can vary by county.
More Medicare Advantage with drug coverage options
These plans are offered in at least one of the same states. Check your ZIP or county before choosing a plan.
- HealthSun HealthAdvantage Plan (HMO)HealthSun Health Plans, Inc. · H5431-001Offered in Florida
- HealthSun HealthAdvantage Plan (HMO)HealthSun Health Plans, Inc. · H5431-012Offered in Florida
- HealthSun HealthAdvantage Plus (HMO)HealthSun Health Plans, Inc. · H5431-017Offered in Florida
- HealthSun HealthAdvantage Plus (HMO)HealthSun Health Plans, Inc. · H5431-018Offered in Florida
- HealthSun HealthAdvantage Plus (HMO)HealthSun Health Plans, Inc. · H5431-020Offered in Florida
- HealthSun MediMax (HMO)HealthSun Health Plans, Inc. · H5431-006Offered in Florida
Common questions
6 answers about this plan
What does HealthSun HealthAdvantage Plan (HMO) cover?
HealthSun HealthAdvantage Plan (HMO) is a Medicare Advantage plan that the current plan record identifies as including Part D prescription drug coverage. The plan record also identifies Part D prescription drug coverage. Its published drug benefit lists 6 formulary tiers. Published supplemental benefits include dental ($5,000/yr preventive & comprehensive dental allowance), vision ($300/yr eyewear allowance), hearing ($2,000/yr hearing aid allowance), and over-the-counter (OTC) ($55/month OTC allowance). Review the plan documents for covered services, limits, and rules. Coverage can change each plan year.
Learn about Medicare AdvantageHow much does HealthSun HealthAdvantage Plan (HMO) cost in 2027?
The published 2027 monthly plan premium for HealthSun HealthAdvantage Plan (HMO) is $0. Any Medicare premiums you owe are separate from the listed plan premium. The listed medical deductible is $0. The listed Part D deductible is $0. The in-network medical out-of-pocket maximum is $3,450; it does not include Part D drug spending. Published visit costs include primary care $0 and specialist visits $0. These figures are plan data, not a personal yearly-cost estimate.
Understand Medicare drug-cost limitsCan I use my current doctors with HealthSun HealthAdvantage Plan (HMO)?
CMS lists HealthSun HealthAdvantage Plan (HMO) 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 doctorsDoes HealthSun HealthAdvantage Plan (HMO) cover my prescriptions?
HealthSun HealthAdvantage Plan (HMO) has 6 published formulary tiers in the current plan record. Published preferred-pharmacy 30-day retail costs include Tier 1 at $0, Tier 2 at $0, Tier 3 at $10, Tier 4 at $50, and Tier 5 at 33%. The listed Part D deductible is $0. A tier listing does not confirm that a specific prescription is covered. Check each medication against the plan's current formulary, restrictions, pharmacy network, and costs before enrolling.
Check your prescriptionsWhat dental, vision, and hearing benefits does HealthSun HealthAdvantage Plan (HMO) include?
The current plan record for HealthSun HealthAdvantage Plan (HMO) lists dental ($5,000/yr preventive & comprehensive dental allowance), vision ($300/yr eyewear allowance), and hearing ($2,000/yr hearing aid allowance). It also lists over-the-counter (OTC) ($55/month OTC allowance). It also lists a Part B premium reduction of $35 per month. Benefit allowances, frequency, eligibility, and participating providers can have additional limits, so review the Summary of Benefits or Evidence of Coverage for the complete rules.
When can I enroll in HealthSun HealthAdvantage Plan (HMO)?
HealthSun HealthAdvantage Plan (HMO) 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. A qualifying circumstance may create a Special Enrollment Period outside those dates. Confirm the enrollment window and effective date that apply to you before changing coverage.
Review Medicare enrollment periodsPlan documents
Summary of Benefits and Evidence of Coverage
- Summary of Benefits (PDF)Download the plan's official Summary of Benefits document
- Evidence of Coverage (PDF)Complete plan details and rules
- Check Your DoctorsSee if your doctors accept this plan
- Documentos en españolLlame a The Pocket Protector al 1-866-764-3312 (TTY: 711) para recibir ayuda con documentos en español
Talk to a licensed agent
Talk with a licensed advisor
A licensed agent can review this plan and other plans in your area that fit your needs.
TTY: 711 · Monday to Friday, 8:00 AM to 6:00 PM CST
