Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
Astiva Health C-SNP WOW, 2027
H1993Contract008Plan
HMO C-SNP · special needs plan, chronic or disabling condition · 5 counties in California
Run by Astiva Health, Inc. (contract H1993), sold as Astiva Health, owned by Astiva Health Holdings Incorporated
Astiva Health C-SNP WOW (H1993-008) costs $0 a month in 2027, down $4.40 from 2026, with an in-network out-of-pocket limit of $9,250.
What changes from 2026 to 2027?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| Monthly premium | $4.40 | $0 | ▼down $4.40 |
| Drug deductible | $615 | $500 | ▼down $115 |
| Specialist visit | $0 copay | 20% of the cost | changed |
| Emergency room | $115 copay | 20% of the cost | changed |
| Hospital stay, in network | $0 a day for days 1–60, then $419 a day for days 61–90 | not filed | changed |
| 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 |
| Ground ambulance, in network | $200 copay | 20% of the cost | changed |
| Over-the-counter items, yearly | not offered | $3,180 a year | ▲added |
| Drug tier 2, generic | $15 | $0 | ▼down $15 |
| Drug tier 3, preferred brand | $35 | $20 | ▼down $15 |
| Drug tier 4, non-preferred drug | $95 | 42% of the cost | changed |
| Drug tier 5, specialty tier | 25% of the cost | 28% of the cost | ▲up 3 points |
| 10 lines do not 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 |
| Medical deductible, in network | none | none | no change |
| Comprehensive dental, yearly limit | not offered | not offered | no change |
| Eyewear, yearly limit | $150 a year | $150 a year | no change |
| Hearing aids, yearly limit for both ears | $750 a year | $750 a year | no change |
| Counties served | 5 | 5 | no change |
| Drug tier 1, preferred generic | $0 | $0 | 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?
| Tier | What the tier holds | 2026 | 2027 |
|---|---|---|---|
| Tier 1 | Preferred Generic | $0 | $0 |
| Tier 2 | Generic | $15 | $0 |
| Tier 3 | Preferred Brand | $35 | $20 |
| Tier 4 | Non-Preferred Drug | $95 | 42% of the cost |
| Tier 5 | Specialty Tier | 25% of the cost | 28% 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, 59 chronic or disabling condition special needs plans are sold for 2027, this one included. Against the others, 36 plans have a lower out-of-pocket limit, 22 a higher one. On the premium, 50 the same, 8 a higher one.
Out-of-pocket limits of the 59 chronic or disabling condition special needs 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 5 counties: $0 a month and $9,250.
California
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
- H1993-008
- Legal name of the contract
- Astiva Health, Inc.
- Sold as
- Astiva Health
- Parent company
- Astiva Health Holdings Incorporated
- Plan type
- HMO C-SNP
- 2026 star rating of the contract
- 4 of 5 overall; health plan 4 of 5, drug plan 3.5 of 5
- Members, September 2026
- 10,839
- Plan website, as filed with CMS
- astivahealth.com
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 Orange, CAWhere most of its members live; premiums and limits side by side
- Every Astiva Health plan for 2027Its contracts, counties and plans that end
- The other 7 plans of contract H1993Same 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.