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

L.A. Care Medicare Plus, 2027

H1224Contract001Plan

HMO D-SNP · special needs plan, dual-eligible · 1 county in California

Run by Local Initiative Health Authority for la County (contract H1224), sold as L.A. Care Health Plan, owned by Local Initiative Health Authority for LA County

Renews for 2027

2026 star rating, contract H1224: 3 of 5

L.A. Care Medicare Plus (H1224-001) costs $7.30 a month in 2027, up $1.10 from 2026, with an in-network out-of-pocket limit of $9,850 ($9,250 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 get20262027Change
Monthly premium$6.20$7.30up $1.10
In-network out-of-pocket limit$9,250$9,850up $600
Drug deductible$615$700up $85
Over-the-counter items, yearly$1,320 a year$1,440 a yearup $120
Drug tier 1, preferred generic$025% of the costchanged
16 lines do not change
Part B premium reduction, monthlynonenoneno change
Primary care visit20% of the cost20% of the costno change
Specialist visit20% of the cost20% of the costno change
Emergency room20% of the cost20% of the costno change
Medical deductible, in networknonenoneno change
Hospital stay, in networknot filednot filedno change
Skilled nursing facility, in networknot filednot filedno change
Ground ambulance, in network20% of the cost20% of the costno change
Comprehensive dental, yearly limitnot offerednot offeredno change
Eyewear, yearly limit$250 a year$250 a yearno change
Hearing aids, yearly limit for both earsnot offerednot offeredno change
Counties served11no change
Drug tier 2, generic25% of the cost25% of the costno change
Drug tier 3, preferred brand25% of the cost25% of the costno change
Drug tier 4, non-preferred drug25% of the cost25% of the costno change
Drug tier 5, specialty tier25% of the cost25% of the costno 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
TierWhat the tier holds20262027
Tier 1Preferred Generic$025% of the cost
Tier 2Generic25% of the cost25% of the cost
Tier 3Preferred Brand25% of the cost25% of the cost
Tier 4Non-Preferred Drug25% of the cost25% of the cost
Tier 5Specialty Tier25% of the cost25% 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, 8 dual-eligible special needs plans are sold for 2027, this one included. Against the others, 1 plan has a lower out-of-pocket limit, 6 the same. On the premium, 6 plans have a lower premium, 1 the same.

Out-of-pocket limits of the 8 dual-eligible special needs plans

$0 to under $2,0000 plans
$2,000 to under $4,0000 plans
$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: $7.30 a month and $9,850.

California

Los Angeles

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
H1224-001
Legal name of the contract
Local Initiative Health Authority for la County
Sold as
L.A. Care Health Plan
Parent company
Local Initiative Health Authority for LA County
Plan type
HMO D-SNP
2026 star rating of the contract
3 of 5 overall; health plan 3 of 5, drug plan 4 of 5
Members, September 2026
30,615
Plan website, as filed with CMS
medicare.lacare.org

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?

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.