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

Medica DUAL Solution, 2027

H2458Contract002Plan

HMO D-SNP · special needs plan, dual-eligible · 54 counties in Minnesota

Run by Medica Health Plans (contract H2458), sold as Medica, owned by Medica Holding Company

Renews in fewer counties

2026 star rating, contract H2458: 3 of 5

Medica DUAL Solution (H2458-002) costs $24.60 a month in 2027, down $16.90 from 2026, with an in-network out-of-pocket limit of $9,850 ($9,200 in 2026). It leaves Lac qui Parle, MN, a county it served in 2026; they choose another plan for 2027 (the counties are listed below).

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
Monthly premium	$41.50	$24.60	down $16.90
In-network out-of-pocket limit	$9,200	$9,850	up $650
Drug deductible	$615	$700	up $85
Counties served	50	54	up 4
18 lines do not change
Part B premium reduction, monthly	none	none	no change
Primary care visit	20% of the cost	20% of the cost	no change
Specialist visit	20% of the cost	20% of the cost	no change
Emergency room	20% of the cost	20% of the cost	no change
Medical deductible, in network	none	none	no change
Hospital stay, in network	not filed	not filed	no change
Skilled nursing facility, in network	not filed	not filed	no change
Ground ambulance, in network	20% of the cost	20% of the cost	no change
Comprehensive dental, yearly limit	not offered	not offered	no change
Eyewear, yearly limit	not offered	not offered	no change
Hearing aids, yearly limit for both ears	not offered	not offered	no change
Over-the-counter items, yearly	not offered	not offered	no change
Drug tier 1, preferred generic	25% of the cost	25% of the cost	no change
Drug tier 2, generic	25% of the cost	25% of the cost	no change
Drug tier 3, preferred brand	25% of the cost	25% of the cost	no change
Drug tier 4, non-preferred drug	25% of the cost	25% of the cost	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	25% of the cost	25% of the cost
Tier 2	Generic	25% of the cost	25% of the cost
Tier 3	Preferred Brand	25% of the cost	25% of the cost
Tier 4	Non-Preferred Drug	25% of the cost	25% 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, 3 dual-eligible special needs plans are sold for 2027, this one included. Against the others, 1 plan has a lower out-of-pocket limit, 1 the same. On the premium, 1 plan has a lower premium, 1 the same.

Out-of-pocket limits of the 3 dual-eligible special needs plans

$0 to under $2,0001 plan

$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)2 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?

It stops serving 1 county it served in 2026 (listed in the next section).

The premium and the out-of-pocket limit are the same in all 54 counties: $24.60 a month and $9,850.

Minnesota

Aitkin Anoka Becker Benton Blue Earth Carlton Carver Cass Chisago Clay Cook Crow Wing Dakota Faribault Fillmore Freeborn Hennepin Houston Isanti Kittson Koochiching Lake Lake of the Woods Le Sueur Mahnomen Marshall Martin Mille Lacs Morrison Mower Murray Nicollet Norman Olmsted Otter Tail Pennington Pine Polk Ramsey Red Lake Rice Rock Roseau Scott Sherburne St. Louis Stearns Todd Wadena Washington Watonwan Wilkin Winona Wright

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

What if you live in a county it leaves?

Its 2026 members in the county listed below cannot stay in it for 2027; each county page lists the 2027 plans sold there.

Your coverage: This plan ends for you on December 31, 2026, because it is no longer sold where you live.
October 15 to December 7, 2026: Open enrollment: join another Medicare Advantage plan, or Original Medicare with a drug plan. Coverage starts January 1, 2027.
December 8, 2026 to the end of February 2027: A special enrollment period because the plan is leaving: you can still join a plan, but coverage starts the first day of the month after you join, so choose by December 31 to have no gap.
If you do nothing: You are enrolled in Original Medicare when the plan ends, and because you have Medicaid, Medicare enrolls you in a drug plan.
If you choose Original Medicare: You have a guaranteed right to buy Medigap Plan A, B, C, D, F, G, K or L sold in your state by any insurance company; if you were new to Medicare on or after January 1, 2020, Plans D and G take the place of C and F. Apply from 60 days before to 63 days after the plan ends; the policy starts once your Medicare Advantage coverage ends. Other Medigap plans are not covered by this right.
If you have Medicaid or Extra Help: You can switch to a different drug plan, or leave a Medicare Advantage plan for Original Medicare with a drug plan, once a calendar month; the change starts the first day of the next month.

The 1 county it leaves, most members first
County	Members, Sept. 2026
Lac qui Parle, MN	fewer than 11

Source: CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11); Medicare.gov, “Special enrollment periods” and “When can I buy Medigap?” (read Oct. 7, 2026).

Who runs this plan?

Plan ID: H2458-002
Legal name of the contract: Medica Health Plans
Sold as: Medica
Parent company: Medica Holding Company
Plan type: HMO D-SNP
2026 star rating of the contract: 3 of 5 overall; health plan 3.5 of 5, drug plan 3.5 of 5
Members, September 2026: 16,356
Plan website, as filed with CMS: medica.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 Hennepin, MNWhere most of its members live; premiums and limits side by side
Every Medica 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.