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

Wellpoint Medicare Advantage, 2027

H1212Contract003Plan

HMO-POS · 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 Medicare Advantage (H1212-003) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $9,250 ($7,500 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	$7,500	$9,250	up $1,750
Drug deductible	$275	$325	up $50
Hospital stay, in network	$415 a day for days 1–5, then $0 a day for days 6–90	$395 a day for days 1–5, then $0 a day for days 6–90	down $100for a 5-day stay
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
Eyewear, yearly limit	$100 a year	not offered	dropped
Hearing aids, yearly limit for both ears	$2,000 a year	not offered	dropped
Drug tier 1, preferred generic	$5	$0	down $5
Drug tier 4, non-preferred drug	30% of the cost	27% of the cost	down 3 points
13 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	$45 copay	$45 copay	no change
Emergency room	$115 copay	$115 copay	no change
Medical deductible, in network	none	none	no change
Ground ambulance, in network	$325 copay	$325 copay	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	43	43	no change
Drug tier 2, generic	$10	$10	no change
Drug tier 3, preferred brand	25% of the cost	25% of the cost	no change
Drug tier 5, specialty tier	29% of the cost	29% 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	$0	$0
Tier 2	Generic	$10	$10	$0
Tier 3	Preferred Brand	25% of the cost	25% of the cost	25% of the cost
Tier 4	Non-Preferred Drug	30% of the cost	27% of the cost	27% of the cost
Tier 5	Specialty Tier	29% of the cost	29% of the cost	29% 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, 42 plans open to everyone are sold for 2027, this one included. Against the others, 28 plans have a lower out-of-pocket limit, 4 the same, 9 a higher one. On the premium, 25 the same, 16 a higher one.

Out-of-pocket limits of the 42 plans open to everyone

$0 to under $2,0000 plans

$2,000 to under $4,0000 plans

$4,000 to under $6,0001 plan

$6,000 to under $8,00023 plans

$8,000 to $10,000 (this plan)18 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 $9,250.

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: H1212-003
Legal name of the contract: Wellpoint West Virginia , Inc.
Sold as: Wellpoint
Parent company: Elevance Health, Inc.
Plan type: HMO-POS
2026 star rating of the contract: not rated (too new) overall; health plan not rated, drug plan not rated
Members, September 2026: 66
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.