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

Wellpoint Dual Advantage, 2027

H1212Contract002Plan

HMO D-SNP · special needs plan, dual-eligible · 43 counties in West Virginia

Run by Wellpoint West Virginia , Inc. (contract H1212), sold as Wellpoint, owned by Elevance Health, Inc.

Renews for 2027

2026 star rating, contract H1212: not rated (too new)

Wellpoint Dual Advantage (H1212-002) costs $0 a month in 2027, down $32.70 from 2026, with an in-network out-of-pocket limit of $6,440 ($5,400 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
Monthly premium	$32.70	$0	down $32.70
In-network out-of-pocket limit	$5,400	$6,440	up $1,040
Drug deductible	$615	$105	down $510
Skilled nursing facility, in network	$0 a day for days 1–20, then $218 a day for days 21–100	$0 a day for days 1–20, then $221 a day for days 21–100	up $30for a 30-day stay
Drug tier 2, generic	25% of the cost	$0	changed
Drug tier 5, specialty tier	25% of the cost	32% of the cost	up 7 points
15 lines do not 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	$130 copay	$130 copay	no change
Medical deductible, in network	none	none	no change
Hospital stay, in network	$295 a day for days 1–7, then $0 a day for days 8–90	$295 a day for days 1–7, then $0 a day for days 8–90	no change
Ground ambulance, in network	$260 copay	$260 copay	no change
Comprehensive dental, yearly limit	not offered	not offered	no change
Eyewear, yearly limit	$225 a year	$225 a year	no change
Hearing aids, yearly limit for both ears	$2,500 a year	$2,500 a year	no change
Over-the-counter items, yearly	not offered	not offered	no change
Counties served	43	43	no change
Drug tier 1, preferred generic	$0	$0	no change
Drug tier 3, preferred brand	25% of the cost	25% of the cost	no change
Drug tier 4, non-preferred drug	25% of the cost	25% 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
Tier	What the tier holds	2026	2027
Tier 1	Preferred Generic	$0	$0
Tier 2	Generic	25% of the cost	$0
Tier 3	Preferred Brand	25% of the cost	25% of the cost
Tier 4	Non-Preferred Drug	25% of the cost	25% of the cost
Tier 5	Specialty Tier	25% of the cost	32% 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, 15 dual-eligible special needs plans are sold for 2027, this one included. Against the others, 1 plan has a lower out-of-pocket limit, 13 a higher one. On the premium, 10 the same, 4 a higher one.

Out-of-pocket limits of the 15 dual-eligible special needs plans

$0 to under $2,0000 plans

$2,000 to under $4,0000 plans

$4,000 to under $6,0001 plan

$6,000 to under $8,000 (this plan)1 plan

$8,000 to $10,00013 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 43 counties: $0 a month and $6,440.

West Virginia

Boone Braxton Brooke Cabell Calhoun Clay Doddridge Fayette Gilmer Grant Greenbrier Hampshire Hancock Hardy Jackson Kanawha Lewis Lincoln Logan Marshall Mason McDowell Mingo Monroe Morgan Nicholas Ohio Pendleton Pleasants Pocahontas Preston Putnam Ritchie Roane Summers Tucker Tyler Wayne Webster Wetzel Wirt Wood Wyoming

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: H1212-002
Legal name of the contract: Wellpoint West Virginia , Inc.
Sold as: Wellpoint
Parent company: Elevance Health, Inc.
Plan type: HMO D-SNP
2026 star rating of the contract: not rated (too new) overall; health plan not rated, drug plan not rated
Members, September 2026: 12
Plan website, as filed with CMS: https://shop.wellpoint.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 Kanawha, WVWhere most of its members live; premiums and limits side by side
Every Wellpoint plan for 2027Its contracts, counties and plans that end
The other 2 plans of contract H1212Same 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.