Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026

Blue Shield Inspire, 2027

H0504Contract043Plan

HMO · 2 counties in California

Run by California Physicians' Service (contract H0504), sold as Blue Shield of California, owned by California Physicians' Service

Renews for 2027

2026 star rating, contract H0504: 4 of 5

Blue Shield Inspire (H0504-043) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $499 ($599 in 2026).

What changes from 2026 to 2027?

The changed lines are marked and come first. In-network amounts; members keep paying the Part B premium unless the plan reduces it.
What you pay or get	2026	2027	Change
In-network out-of-pocket limit	$599	$499	down $100
Drug deductible	$250	$300	up $50
Over-the-counter items, yearly	$400 a year	$340 a year	down $60
Drug tier 3, preferred brand	20% of the cost	21% of the cost	up 1 point
Drug tier 4, non-preferred drug	25% of the cost	26% of the cost	up 1 point
16 lines do not change
Monthly premium	$0	$0	no change
Part B premium reduction, monthly	none	none	no change
Primary care visit	$0 copay	$0 copay	no change
Specialist visit	$0 copay	$0 copay	no change
Emergency room	$150 copay	$150 copay	no change
Medical deductible, in network	none	none	no change
Hospital stay, in network	$0 a stay	$0 a stay	no change
Skilled nursing facility, in network	$0 a day for days 1–20, then $75 a day for days 21–100	$0 a day for days 1–20, then $75 a day for days 21–100	no change
Ground ambulance, in network	$200 copay	$200 copay	no change
Comprehensive dental, yearly limit	not offered	not offered	no change
Eyewear, yearly limit	not offered	not offered	no change
Hearing aids, yearly limit for both ears	not offered	not offered	no change
Counties served	2	2	no change
Drug tier 1, preferred generic	$5	$5	no change
Drug tier 2, generic	$10	$10	no change
Drug tier 5, specialty tier	30% of the cost	30% of the cost	no change

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026; CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026). Plan details can change during the year; confirm on Medicare Plan Finder.

What will prescriptions cost?

Your share for a 30-day supply at a retail pharmacy, as filed with CMS; tiers whose share changes are marked. The plan charges less at its preferred pharmacies
Tier	What the tier holds	2026, standard pharmacy	2027, standard pharmacy	2027, preferred pharmacy
Tier 1	Preferred Generic	$5	$5	$0
Tier 2	Generic	$10	$10	$0
Tier 3	Preferred Brand	20% of the cost	21% of the cost	21% of the cost
Tier 4	Non-Preferred Drug	25% of the cost	26% of the cost	26% of the cost
Tier 5	Specialty Tier	30% of the cost	30% of the cost	30% of the cost

Source: CMS plan benefit package files, 2027 and 2026. Insulin is capped at $35 a month by law. A drug's tier is set by the plan's formulary.

How does it compare with plans sold where it is?

In the counties it serves, 82 plans open to everyone are sold for 2027, this one included. Against the others, 11 plans have a lower out-of-pocket limit, 6 the same, 64 a higher one. On the premium, 69 the same, 12 a higher one.

Out-of-pocket limits of the 82 plans open to everyone

$0 to under $2,000 (this plan)48 plans

$2,000 to under $4,00020 plans

$4,000 to under $6,0008 plans

$6,000 to under $8,0005 plans

$8,000 to $10,0001 plan

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Where is it sold, and what does it cost there?

The premium and the out-of-pocket limit are the same in all 2 counties: $0 a month and $499.

California

Los Angeles Orange

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Who runs this plan?

Plan ID: H0504-043
Legal name of the contract: California Physicians' Service
Sold as: Blue Shield of California
Parent company: California Physicians' Service
Plan type: HMO
2026 star rating of the contract: 4 of 5 overall; health plan 3.5 of 5, drug plan 4.5 of 5
Members, September 2026: 15,884
Plan website, as filed with CMS: blueshieldca.com/medicare

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS 2026 Star Ratings (October 2025); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11). CMS publishes the 2027 Star Ratings in October 2026.

What else should you check?

Other 2027 plans in Orange, CAWhere most of its members live; premiums and limits side by side
Every Blue Shield of California plan for 2027Its contracts, counties and plans that end
The other 16 plans of contract H0504Same company, same contract
Is your prescription covered?Coverage share and tier for 2,259 drugs

Data, not advice. These are the plan's filed amounts, not a quote for you; confirm on Medicare Plan Finder or call the plan before you enroll.