HPSJ/MVHP Advantage D-SNP (HMO D-SNP)
Health Plan of San Joaquin / Mountain Valley Health Plan Advantage D-SNP (HMO) · HMO D-SNP · 2027 coverage
The big numbers
The plan premium is on top of your Part B premium.
- Monthly premium
- $7.30
- Most you pay in a year for covered care in network
- $9,850
- Drug deductible
- $700
- Medicare star rating
- No rating yet
This is a special needs plan. Only some people can join: Dual-Eligible.
What a year could cost
Premiums plus the plan’s copays for three example years. Medicines are not included.
- A light year$87.60$87.60 in premiums + $0 for care2 checkups and 2 lab tests.Not counted, because the plan charges a percentage: Primary care visit, Lab tests.
- A busier year$87.60$87.60 in premiums + $0 for care4 checkups, 4 specialist visits, 4 lab tests, 1 X-ray and 1 urgent care visit.Not counted, because the plan charges a percentage: Primary care visit, Specialist visit, Lab tests, X-rays, Urgent care.
- A hard year$87.60$87.60 in premiums + $0 for care6 checkups, 12 specialist visits, 6 lab tests, 2 scans, an ambulance ride, an ER visit and a 5-day hospital stay.Not counted, because the plan charges a percentage: Primary care visit, Specialist visit, Lab tests, MRI, CT and other scans, Ground ambulance, Emergency room, Hospital stay.
The visit counts are examples we chose to show how costs add up, not a prediction. Your costs depend on the care you get.
What you pay for care
Your cost each time, at doctors and hospitals in the plan’s network.
- Primary care visit20%
- Specialist visit20%
- Urgent care20%
- Emergency room20%
- Lab tests20%Plan approval may be needed
More care: surgery, X-rays, scans, ambulance, nursing home
- Outpatient surgery center20%Plan approval may be needed
- Outpatient hospital care20%
- X-rays20%Plan approval may be needed
- MRI, CT and other scans20%Plan approval may be needed
- Ground ambulance20%Plan approval may be needed
From the costs the plan filed with Medicare for 2027. A range like “$0 to $100” means the cost depends on the service or the place. “Lower than most” compares this plan with the 1 other plans in Alpine County that the same person could join. Read the plan’s 2027 booklet (PDF)
What medicines cost
| Drug tier | Network pharmacy |
|---|---|
| 1Preferred Generic | 25% of the price |
| 2Generic | 25% of the price |
| 3Preferred Brand | 25% of the price |
| 4Non-Preferred Brand | 25% of the price |
| 5Specialty Tier | 25% of the price |
| 6Select Care Drugs | 15% of the price |
For a 1-month supply. Covered insulin costs at most $35 for a month’s supply. Your medicine’s tier is on the plan’s drug list; check it below.
Check my medicines
See if this plan covers each medicine you take in 2027, and what a month costs.
Type the name on the bottle. Add the strength to narrow it down.
Add each medicine once. We’ll show if this plan covers it, what a month costs, and any rules.
Extras
Help Original Medicare doesn’t give you.
- Dental Not included
- Vision IncludedRoutine eye exam covered. Glasses or contacts covered.Eyewear has a limit; ask the plan.
- Hearing IncludedRoutine hearing test covered. Hearing aids covered.Hearing aids: plan pays up to $1,200 a year, both ears.
- Over-the-counter items IncludedUp to $145 every three months for things like vitamins, pain relief and bandages.Unused money does not carry over.
- Fitness Not included
- Rides to care Not included
What changed from 2026
In 2026 this plan was called Advantage D-SNP (HMO) (HMO D-SNP).
- Monthly premium2026$2.80 a month2027$7.30 a month
- Most you pay in a year2026$9,2502027$9,850
- Drug deductible2026$6152027$700
- Vision2026Routine eye exam covered. Glasses or contacts covered. Eyewear: plan pays up to $300 every two years2027Routine eye exam covered. Glasses or contacts covered. Eyewear has a limit; ask the plan
- Hearing2026Routine hearing test covered. Hearing aids covered. Hearing aids: plan pays up to $1,500 a year, both ears2027Routine hearing test covered. Hearing aids covered. Hearing aids: plan pays up to $1,200 a year, both ears
- Over-the-counter items2026Up to $150 every three months for things like vitamins, pain relief and bandages. Unused money does not carry over2027Up to $145 every three months for things like vitamins, pain relief and bandages. Unused money does not carry over
Is my doctor in this plan?
Look up your doctors, then confirm with their office.
Call each doctor’s office and ask:
“Do you take HPSJ/MVHP Advantage D-SNP (HMO D-SNP), plan number H5734-001, for 2027?”