Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
Wellcare Simple Focus, 2027
H0562Contract126Plan
HMO · 2 counties in California
Run by Health Net of California, Inc. (contract H0562), sold as Wellcare, owned by Centene Corporation
Wellcare Simple Focus (H0562-126) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $1,000 ($2,000 in 2026).
What changes from 2026 to 2027?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| In-network out-of-pocket limit | $2,000 | $1,000 | ▼down $1,000 |
| Drug deductible | $615 | $700 | ▲up $85 |
| Hospital stay, in network | $200 a day for days 1–4, then $0 a day for days 5–90 | $350 a stay | changed |
| Skilled nursing facility, in network | $0 a day for days 1–20, then $218 a day for days 21–30, then $0 a day for days 31–100 | $0 a day for days 1–20, then $25 a day for days 21–30, then $0 a day for days 31–100 | ▼down $1,930for a 30-day stay |
| Ground ambulance, in network | $300 copay | $75 copay | ▼down $225 |
| Eyewear, yearly limit | $100 a year | not offered | ▼dropped |
| Hearing aids, yearly limit for both ears | $350 a year | not offered | ▼dropped |
| Drug tier 1, generic | $5 | $10 | ▲up $5 |
| Drug tier 2, preferred brand | $10 | 25% of the cost | changed |
| Drug tier 3, non-preferred drug | 25% of the cost | 41% of the cost | ▲up 16 points |
| Drug tier 4, injectable drugs | 37% of the cost | 1% of the cost | ▼down 36 points |
| 11 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 |
| Comprehensive dental, yearly limit | not offered | not offered | no change |
| Over-the-counter items, yearly | not offered | not offered | no change |
| Counties served | 2 | 2 | no change |
| Drug tier 5, specialty tier | 25% of the cost | 25% of the cost | no change |
| Drug tier 6, select care drugs | $0 | $0 | 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?
| Tier | What the tier holds | 2026, standard pharmacy | 2027, standard pharmacy | 2027, preferred pharmacy |
|---|---|---|---|---|
| Tier 1 | Generic | $5 | $10 | $0 |
| Tier 2 | Preferred Brand | $10 | 25% of the cost | 25% of the cost |
| Tier 3 | Non-Preferred Drug | 25% of the cost | 41% of the cost | 39% of the cost |
| Tier 4 | Injectable Drugs | 37% of the cost | 1% of the cost | 1% of the cost |
| Tier 5 | Specialty Tier | 25% of the cost | 25% of the cost | 25% of the cost |
| Tier 6 | Select Care Drugs | $0 | $0 | $0 |
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, 54 plans open to everyone are sold for 2027, this one included. Against the others, 22 plans have a lower out-of-pocket limit, 2 the same, 29 a higher one. On the premium, 48 the same, 5 a higher one.
Out-of-pocket limits of the 54 plans open to everyone
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 $1,000.
California
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
- H0562-126
- Legal name of the contract
- Health Net of California, Inc.
- Sold as
- Wellcare
- Parent company
- Centene Corporation
- Plan type
- HMO
- 2026 star rating of the contract
- 3.5 of 5 overall; health plan 3.5 of 5, drug plan 4 of 5
- Members, September 2026
- 5,141
- Plan website, as filed with CMS
- go.wellcare.com/HealthNetCA
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 San Bernardino, CAWhere most of its members live; premiums and limits side by side
- Every Wellcare plan for 2027Its contracts, counties and plans that end
- The other 7 plans of contract H0562Same 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.