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

Essence Advantage Plus, 2027

H2610Contract006Plan

HMO · 21 counties in Illinois, Missouri

Run by Essence Healthcare, Inc. (contract H2610), sold as Essence Healthcare, owned by Lumeris Group Holdings Corporation

Renews for 2027

2026 star rating, contract H2610: 4.5 of 5

Essence Advantage Plus (H2610-006) costs $59 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $2,900.

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
Drug deductible	$0	$450	up $450
Specialist visit	$30 copay	$0 copay	down $30
Over-the-counter items, yearly	$160 a year	$100 a year	down $60
Counties served	18	21	up 3
Drug tier 5, specialty tier	33% of the cost	28% of the cost	down 5 points
16 lines do not change
Monthly premium	$59	$59	no change
In-network out-of-pocket limit	$2,900	$2,900	no change
Part B premium reduction, monthly	none	none	no change
Primary care visit	$0 copay	$0 copay	no change
Emergency room	$125 copay	$125 copay	no change
Medical deductible, in network	none	none	no change
Hospital stay, in network	$250 a day for days 1–7, then $0 a day for days 8–90	$250 a day for days 1–7, then $0 a day for days 8–90	no change
Skilled nursing facility, in network	$0 a day for days 1–20, then $125 a day for days 21–100	$0 a day for days 1–20, then $125 a day for days 21–100	no change
Ground ambulance, in network	$160 copay	$160 copay	no change
Comprehensive dental, yearly limit	$2,000 a year	$2,000 a year	no change
Eyewear, yearly limit	$300 a year	$300 a year	no change
Hearing aids, yearly limit for both ears	$500 a year	$500 a year	no change
Drug tier 1, preferred generic	$4	$4	no change
Drug tier 2, generic	$12	$12	no change
Drug tier 3, preferred brand	$47	$47	no change
Drug tier 4, non-preferred drug	$100	$100	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. The plan charges less at its preferred pharmacies
Tier	What the tier holds	2026, standard pharmacy	2027, standard pharmacy	2027, preferred pharmacy
Tier 1	Preferred Generic	$4	$4	$0
Tier 2	Generic	$12	$12	$3
Tier 3	Preferred Brand	$47	$47	$45
Tier 4	Non-Preferred Drug	$100	$100	$95
Tier 5	Specialty Tier	33% of the cost	28% of the cost	28% 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, 70 plans open to everyone are sold for 2027, this one included. Against the others, 2 plans have a lower out-of-pocket limit, 1 the same, 66 a higher one. On the premium, 61 plans have a lower premium, 1 the same, 7 a higher one.

Out-of-pocket limits of the 70 plans open to everyone

$0 to under $2,0000 plans

$2,000 to under $4,000 (this plan)7 plans

$4,000 to under $6,00035 plans

$6,000 to under $8,00023 plans

$8,000 to $10,0005 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 21 counties: $59 a month and $2,900.

Illinois

Bond Calhoun Clinton Jersey Macoupin Madison Monroe Montgomery St. Clair Washington

Missouri

Crawford Franklin Gasconade Jefferson Lincoln Montgomery St. Charles St. Louis St. Louis City Warren Washington

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: H2610-006
Legal name of the contract: Essence Healthcare, Inc.
Sold as: Essence Healthcare
Parent company: Lumeris Group Holdings Corporation
Plan type: HMO
2026 star rating of the contract: 4.5 of 5 overall; health plan 4.5 of 5, drug plan 3.5 of 5
Members, September 2026: 1,380
Plan website, as filed with CMS: www.essencehealthcare.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 St. Louis, MOWhere most of its members live; premiums and limits side by side
Every Essence Healthcare plan for 2027Its contracts, counties and plans that end
The other 6 plans of contract H2610Same 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.