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

Astiva Health C-SNP Fountain, 2027

H1993Contract019Plan

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

New for 2027

2026 star rating, contract H1993: 4 of 5

Astiva Health C-SNP Fountain (H1993-019) costs $0 a month in 2027, with an in-network out-of-pocket limit of $2,000. It is a new plan for 2027.

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 premiumnot offered$0new for 2027
In-network out-of-pocket limitnot filed$2,000new for 2027
Drug deductiblenot filed$0new for 2027
Primary care visitnot offered$0 copaychanged
Specialist visitnot offered$0 copaychanged
Emergency roomnot offered$75 copaychanged
Hospital stay, in networknot offered$100 a day for days 1–5, then $0 a day for days 6–90changed
Skilled nursing facility, in networknot offered$0 a day for days 1–20, then $221 a day for days 21–100changed
Ground ambulance, in networknot offered$50 copaychanged
Eyewear, yearly limitnot offered$150 a yearadded
Hearing aids, yearly limit for both earsnot offered$500 a yearadded
Over-the-counter items, yearlynot offered$3,180 a yearadded
4 lines do not change
Part B premium reduction, monthlynonenoneno change
Medical deductible, in networknonenoneno change
Comprehensive dental, yearly limitnot offerednot offeredno change
Counties servednot offered5new for 2027

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 Genericnot offered$0
Tier 2Genericnot offered$0
Tier 3Preferred Brandnot offered$20
Tier 4Non-Preferred Drugnot offered$45
Tier 5Specialty Tiernot offered33% of the cost
Tier 6Select Care Drugsnot offered$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, 30 plans have a lower out-of-pocket limit, 2 the same, 26 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

$0 to under $2,00030 plans
$2,000 to under $4,000 (this plan)4 plans
$4,000 to under $6,0002 plans
$6,000 to under $8,0000 plans
$8,000 to $10,00023 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 $2,000.

California

Los AngelesOrangeRiversideSan BernardinoSan Diego

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
H1993-019
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
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?

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.