Medicare Advantage · HMO
Banner Medicare Advantage
Plan year 2026

Banner Medicare Advantage Prime H5843-001 (HMO)

3.5 · 2026 Star Rating · source: CMS · Ratings are updated annually
Monthly premium
$0
+ your Part B premium
Max out-of-pocket
$2,995
in-network annual cap
Primary care
$0
per visit copay
Specialist
$15
per visit

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

Rx deductible
$440
Inpatient hospital
Days 1-7: $275/day, Days 8-90: $0/day
Inpatient mental health
Days 1-7: $275/day, Days 8-90: $0/day
Outpatient surgery
$200
Emergency room
$120
Urgent care
$0

What's included, and what it's actually worth4 benefits included. Tap any card for the detail

Dental

$1,000/yr preventive dental allowance
Details$1,000/yr preventive dental allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.

Hearing

$1,000/yr hearing aid allowance
Hearing aid allowance$1,000/yr hearing aid allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.

Vision

$250/yr eyewear allowance
Eyewear allowance$250/yr eyewear allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.
See more details about this plan
Doctor Visits: PCP$0 copay
In-network$0 copay per visit
Doctor Visits: Specialist$15 copay
In-network$15 copay per visit
Inpatient Hospital$275/day, days 1–7
In-networkDays 1-7: $275/day, Days 8-90: $0/day
Outpatient Surgery$200 copay
In-network$200 copay per procedure
Mental HealthDays 1-7: $275/day, Days 8-90: $0/day
Inpatient psychiatricDays 1-7: $275/day, Days 8-90: $0/day
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
Tier 2
$5
Generic
Tier 3
$47
Preferred Brand· after deductible
Tier 4
50%
Non-Pref Brand· after deductible
Tier 5
28%
Specialty· after deductible

Our take

Where this plan shines

This plan has a $0 monthly premium.
This plan’s out-of-pocket maximum ($2,995) is among the lowest available.
See your primary doctor for $0.
The specialist copay ($15) is among the more affordable options.

Things to know before you enroll

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 Banner Medicare Advantage Prime (HMO)

What does Banner Medicare Advantage Prime (HMO) cover?

Banner Medicare Advantage Prime (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 5 formulary tiers. Published supplemental benefits include dental ($1,000/yr preventive dental allowance), vision ($250/yr eyewear allowance), hearing ($1,000/yr hearing aid 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 Banner Medicare Advantage Prime (HMO) cost in 2026?

The published 2026 monthly plan premium for Banner Medicare Advantage Prime (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 $440. The in-network medical out-of-pocket maximum is $2,995; 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 limits

Can I use my current doctors with Banner Medicare Advantage Prime (HMO)?

CMS lists Banner Medicare Advantage Prime (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 doctors

Does Banner Medicare Advantage Prime (HMO) cover my prescriptions?

Banner Medicare Advantage Prime (HMO) has 5 published formulary tiers in the current plan record. Published preferred-pharmacy 30-day retail costs include Tier 1 at $0, Tier 2 at $5, Tier 3 at $47, Tier 4 at 50%, and Tier 5 at 28%. The listed Part D deductible is $440. 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 prescriptions

What dental, vision, and hearing benefits does Banner Medicare Advantage Prime (HMO) include?

The current plan record for Banner Medicare Advantage Prime (HMO) lists dental ($1,000/yr preventive dental allowance), vision ($250/yr eyewear allowance), and hearing ($1,000/yr hearing aid allowance). 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 Banner Medicare Advantage Prime (HMO)?

Banner Medicare Advantage Prime (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 periods

More plan options

Browse the full 2026 Medicare Advantage with drug coverage directory. This plan is offered in Arizona. Plan availability can vary by county.

Helpful next steps

Banner Medicare Advantage Prime H5843-001 (HMO) — 2026 Medicare Plan