Back to results
Medicare Advantage · HMO
Aspire Health
Plan year 2026
Aspire Health Value H8764-003 (HMO)
Monthly premium
$60
+ your Part B premium
Max out-of-pocket
$6,000
in-network annual cap
Primary care
$5
per visit copay
Specialist
$45
per visit
Your costs at a glanceIn-network, for the 2026 plan year
Rx deductible
$0
Inpatient hospital
Days 1-2: $500/day, Days 3-4: $300/day, Days 5-90: $0/day
Inpatient mental health
Days 1-5: $375/day, Days 6-90: $0/day
Outpatient surgery
$80
–$300
Emergency room
$115
Urgent care
$25
What's included, and what it's actually worth3 benefits included. Tap any card for the detail
Vision
Routine vision benefit
DetailsRoutine vision benefit
This is a supplemental benefit with plan-specific limits. See plan documents for details.
Transportation
6 one-way trips/year
Trips per year6 one-way trips/year
Meals
Meal benefit
See more details about this plan
Doctor Visits: PCP$5 copay
Doctor Visits: Specialist$45 copay
Inpatient Hospital$500/day, days 1–2
Outpatient Surgery$80–$300
Mental HealthDays 1-5: $375/day, Days 6-90: $0/day
Your coverageCheck your coverageFrom the doctors and prescriptions you added
Your plan's drug tiers30-day retail · after any applicable deductible
Tier 1
$9
Preferred Generic
Tier 2
$20
Generic
Tier 3
$47
Preferred Brand
Tier 4
25%
Non-Pref Brand
Tier 5
33%
Specialty
Tier 6
$11
Tier 6
Our take
Where this plan shines
No separate drug deductible.
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
Summary of Benefits
No online copy available — call the plan at (888)839-3991 to request the Summary of Benefits
Check Your Doctors
See if your doctors accept this plan
Documentos en español
Llame al (888)839-3991 (TTY: 711) para solicitar documentos en español