HealthSun HealthAdvantage Plus H5431-020 (HMO)
Your costs at a glanceIn-network, for the 2026 plan year
What's included, and what it's actually worth8 benefits included. Tap any card for the detail
Part B giveback
$185/month
Dental
$5,000/yr preventive dental allowance
Hearing
$2,000/yr hearing aid allowance
OTC allowance
$85/month OTC allowance
Vision
$200/yr eyewear allowance
See more details about this plan
Doctor Visits: PCP$0 copay
Doctor Visits: Specialist$15 copay
Inpatient Hospital$150/day, days 1–5
Outpatient Surgery$200 copay
Mental Health$0 copay
TransportationNon-emergency transportation benefit
Your coverageCheck your coverageFrom the doctors and prescriptions you added
Your plan's drug tiers30-day retail · after any applicable deductible
Our take
Where this plan shines
Things to know before you enroll
Plan documents
Plan questions
Common questions about HealthSun HealthAdvantage Plus (HMO)
What does HealthSun HealthAdvantage Plus (HMO) cover?
HealthSun HealthAdvantage Plus (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 dental allowance), vision ($200/yr eyewear allowance), hearing ($2,000/yr hearing aid allowance), and over-the-counter (OTC) ($85/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 Plus (HMO) cost in 2026?
The published 2026 monthly plan premium for HealthSun HealthAdvantage Plus (HMO) is $0. 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 $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 $15. These figures are plan data, not a personal yearly-cost estimate.
Understand Medicare drug-cost limitsCan I use my current doctors with HealthSun HealthAdvantage Plus (HMO)?
CMS lists HealthSun HealthAdvantage Plus (HMO) 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 doctorsDoes HealthSun HealthAdvantage Plus (HMO) cover my prescriptions?
HealthSun HealthAdvantage Plus (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 $5, 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 Plus (HMO) include?
The current plan record for HealthSun HealthAdvantage Plus (HMO) lists dental ($5,000/yr preventive dental allowance), vision ($200/yr eyewear allowance), and hearing ($2,000/yr hearing aid allowance). It also lists over-the-counter (OTC) ($85/month OTC allowance). It also lists a Part B premium reduction of $185 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 Plus (HMO)?
HealthSun HealthAdvantage Plus (HMO) 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. 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 periodsMore plan options
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