Aspire Health Protect (HMO)
Aspire Health · HMO · 2027 coverage
The big numbers
The plan premium is on top of your Part B premium.
- Monthly premium
- $0
- Tied for lowest here
- Most you pay in a year for covered care in network
- $7,150
- Highest of 6 plans here
- Drug deductible
- $250
- Medicare star rating
- No rating yet
In plain English
Compared with the 5 other plans in Monterey County that the same person could join.
What stands out
- No monthly premium, tied for lowest here
Watch out for
- Up to $7,150 a year for covered care, highest of 6 plans here
- $1,950 for a 5-day hospital stay, highest of 6 plans here
- $50 for specialist visits, highest of 6 plans here
- $8 for primary care visits, highest of 6 plans here
What a year could cost
Premiums plus the plan’s copays for three example years. Medicines are not included.
- A light year$56$0 in premiums + $56 for careLower than most plans here2 checkups and 2 lab tests.
- A busier year$357$0 in premiums + $357 for careLower than most plans here4 checkups, 4 specialist visits, 4 lab tests, 1 X-ray and 1 urgent care visit.
- A hard year$3,198$0 in premiums + $3,198 for careLower than most plans here6 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: MRI, CT and other scans.
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 visit$8Highest of 6 plans here
- Specialist visit$50Highest of 6 plans herePlan approval may be needed
- Urgent care$25Tied for highest here
- Emergency room$130Not charged if you stay in the hospital within 24 hours
- Hospital stay$600 a day for days 1 to 2, then $375 a day for days 3 to 4, then $0 for days 5 to 90Highest of 6 plans herePlan approval may be needed
- Lab tests$20Tied for highest herePlan approval may be needed
More care: surgery, X-rays, scans, ambulance, nursing home
- Outpatient surgery center$120 to $300Depends on the servicePlan approval may be needed
- Outpatient hospital care$120 or 20%
- X-rays$20Tied for highest herePlan approval may be needed
- MRI, CT and other scans15%Plan approval may be needed
- Ground ambulance$350Plan approval may be needed
- Skilled nursing facility$0 for days 1 to 20, then $220 a day for days 21 to 100Plan 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 5 other plans in Monterey County that the same person could join. Read the plan’s 2027 booklet (PDF)
What medicines cost
| Drug tier | Network pharmacy |
|---|---|
| 1Preferred Generic | $9 |
| 2Generic | $15 |
| 3Preferred Brand | $47 |
| 4Non-Preferred DrugAfter the deductible | 25% of the price |
| 5Specialty TierAfter the deductible | 30% of the price |
| 6Select Care Drugs | $0 |
For a 1-month supply. The $250 drug deductible applies only to the tiers marked. 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 Not included
- Hearing Not included
- Over-the-counter items Not included
- Fitness IncludedIncludes gym or fitness classes.
- Rides to care Included6 one-way rides to medical visits a year.
What changed from 2026
- Most you pay in a year2026$6,5002027$7,150
- Drug deductible2026$02027$250
- Primary care visit2026$52027$8
- Specialist visit2026$452027$50
- Emergency room2026$1152027$130
- Hospital stay2026$505 a day for days 1 to 2, then $300 a day for days 3 to 4, then $0 for days 5 to 902027$600 a day for days 1 to 2, then $375 a day for days 3 to 4, then $0 for days 5 to 90
- Outpatient surgery center2026$80 to $3002027$120 to $300
- Outpatient hospital care2026$80 or 20%2027$120 or 20%
- Ground ambulance2026$3252027$350
- Skilled nursing facility2026$0 for days 1 to 20, then $214 a day for days 21 to 1002027$0 for days 1 to 20, then $220 a day for days 21 to 100
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 Aspire Health Protect (HMO), plan number H8764-004, for 2027?”