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

Wellcare Specialty Simple Focus, 2027

H0562Contract138Plan

HMO C-SNP · special needs plan, chronic or disabling condition · 1 county in California

Run by Health Net of California, Inc. (contract H0562), sold as Wellcare, owned by Centene Corporation

Renews for 2027

2026 star rating, contract H0562: 3.5 of 5

Wellcare Specialty Simple Focus (H0562-138) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $9,250.

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
Drug deductible	$615	$700	up $85
Skilled nursing facility, in network	$0 a day for days 1–20, then $218 a day for days 21–70, then $0 a day for days 71–100	$0 a day for days 1–20, then $221 a day for days 21–70, then $0 a day for days 71–100	up $30for a 30-day stay
Ground ambulance, in network	$200 copay	$150 copay	down $50
Hearing aids, yearly limit for both ears	not offered	$350 a year	added
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	39% of the cost	up 14 points
Drug tier 4, injectable drugs	35% of the cost	15% of the cost	down 20 points
14 lines do not change
Monthly premium	$0	$0	no change
In-network out-of-pocket limit	$9,250	$9,250	no change
Part B premium reduction, monthly	none	none	no change
Primary care visit	$0 copay	$0 copay	no change
Specialist visit	$25 copay	$25 copay	no change
Emergency room	$115 copay	$115 copay	no change
Medical deductible, in network	none	none	no change
Hospital stay, in network	$800 a day for days 1–2, then $0 a day for days 3–90	$800 a day for days 1–2, then $0 a day for days 3–90	no change
Comprehensive dental, yearly limit	not offered	not offered	no change
Eyewear, yearly limit	$100 a year	$100 a year	no change
Over-the-counter items, yearly	not offered	not offered	no change
Counties served	1	1	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?

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	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	39% of the cost	39% of the cost
Tier 4	Injectable Drugs	35% of the cost	15% of the cost	15% 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, 13 chronic or disabling condition special needs plans are sold for 2027, this one included. Against the others, 5 plans have a lower out-of-pocket limit, 7 a higher one. On the premium, 8 the same, 4 a higher one.

Out-of-pocket limits of the 13 chronic or disabling condition special needs plans

$0 to under $2,0004 plans

$2,000 to under $4,0001 plan

$4,000 to under $6,0000 plans

$6,000 to under $8,0000 plans

$8,000 to $10,000 (this plan)8 plans

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 1 county: $0 a month and $9,250.

California

San Francisco

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: H0562-138
Legal name of the contract: Health Net of California, Inc.
Sold as: Wellcare
Parent company: Centene Corporation
Plan type: HMO C-SNP
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: 43
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 Francisco, 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.