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

Passport Advantage, 2027

H1799Contract003Plan

HMO D-SNP · special needs plan, dual-eligible · 75 counties in Kentucky

Run by Molina Healthcare of Kentucky, Inc. (contract H1799), sold as Passport Advantage, owned by Molina Healthcare, Inc.

Renews for 2027

2026 star rating, contract H1799: 3.5 of 5

Passport Advantage (H1799-003) costs $17 a month in 2027, down $12.40 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. The plan files its benefits in parts for different counties, so lines marked ◆ show the most generous part of its area and some counties get less: the plan's Evidence of Coverage gives your county's amounts.
What you pay or get	2026	2027	Change
Monthly premium	$29.40	$17	down $12.40
In-network out-of-pocket limit	$9,250	$9,850	up $600
Drug deductible	$615	$700	up $85
Hospital stay, in network (best in its area)	not filed	$2,241 a stay	changed
Skilled nursing facility, in network (best in its area)	not filed	$0 a day for days 1–20, then $221 a day for days 21–100	changed
Drug tier 2, generic	20% of the cost	25% of the cost	up 5 points
Drug tier 3, preferred brand	20% of the cost	25% of the cost	up 5 points
Drug tier 4, non-preferred drug	30% of the cost	26% of the cost	down 4 points
14 lines do not change
Part B premium reduction, monthly (best in its area)	none	none	no change
Primary care visit (best in its area)	30% of the cost	30% of the cost	no change
Specialist visit (best in its area)	30% of the cost	30% of the cost	no change
Emergency room (best in its area)	30% of the cost	30% of the cost	no change
Medical deductible, in network (best in its area)	none	none	no change
Ground ambulance, in network (best in its area)	20% of the cost	20% of the cost	no change
Comprehensive dental, yearly limit (best in its area)	$4,000 a year	$4,000 a year	no change
Eyewear, yearly limit (best in its area)	$200 a year	$200 a year	no change
Hearing aids, yearly limit for both ears (best in its area)	not offered	not offered	no change
Over-the-counter items, yearly (best in its area)	not offered	not offered	no change
Counties served	75	75	no change
Drug tier 1, preferred generic	$0	$0	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
Tier	What the tier holds	2026	2027
Tier 1	Preferred Generic	$0	$0
Tier 2	Generic	20% of the cost	25% of the cost
Tier 3	Preferred Brand	20% of the cost	25% of the cost
Tier 4	Non-Preferred Drug	30% of the cost	26% of the cost
Tier 5	Specialty Tier	25% of the cost	25% of the cost
Tier 6	Select Care Drugs	$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, 18 dual-eligible special needs plans are sold for 2027, this one included. Against the others, 2 plans have a lower out-of-pocket limit, 15 the same. On the premium, 13 plans have a lower premium, 4 the same.

Out-of-pocket limits of the 18 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 $8,0002 plans

$8,000 to $10,000 (this plan)16 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 75 counties: $17 a month and $9,850.

Kentucky

Adair Anderson Barren Bath Bourbon Boyle Bracken Breathitt Breckinridge Bullitt Butler Carroll Carter Casey Clark Cumberland Edmonson Elliott Estill Fayette Fleming Franklin Gallatin Garrard Grant Grayson Green Hancock Hardin Harrison Hart Henry Jackson Jefferson Jessamine Larue Lawrence Lee Lewis Lincoln Madison Magoffin Marion McLean Meade Menifee Mercer Metcalfe Monroe Montgomery Morgan Nelson Nicholas Ohio Oldham Owen Owsley Pendleton Powell Pulaski Robertson Rockcastle Rowan Russell Scott Shelby Spencer Taylor Trimble Union Washington Wayne Webster Wolfe Woodford

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: H1799-003
Legal name of the contract: Molina Healthcare of Kentucky, Inc.
Sold as: Passport Advantage
Parent company: Molina Healthcare, Inc.
Plan type: HMO D-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: 1,410
Plan website, as filed with CMS: https://www.molinahealthcare.com/members/ky/en-us/

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 Jefferson, KYWhere most of its members live; premiums and limits side by side
Every Passport Advantage plan for 2027Its contracts, counties and plans that end
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.