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

ATRIO Special Needs Plan, 2027

H3814Contract007Plan

HMO D-SNP · special needs plan, dual-eligible · 1 county in Oregon

Run by Atrio Health Plans (contract H3814), sold as ATRIO Health Plans, owned by ATRIO Health Plans

Renews for 2027

2026 star rating, contract H3814: 2 of 5

ATRIO Special Needs Plan (H3814-007) costs $0 a month in 2027, down $10.50 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.
What you pay or get20262027Change
Monthly premium$10.50$0down $10.50
In-network out-of-pocket limit$9,250$9,850up $600
Drug deductible$615$350down $265
Emergency room$90 copay$115 copayup $25
Over-the-counter items, yearly$620 a year$700 a yearup $80
11 lines do not change
Part B premium reduction, monthlynonenoneno change
Primary care visit20% of the cost20% of the costno change
Specialist visit20% of the cost20% of the costno change
Medical deductible, in networknonenoneno change
Hospital stay, in network$0 a stay$0 a stayno change
Skilled nursing facility, in network0% for days 1–20, then 10% for days 21–1000% for days 1–20, then 10% for days 21–100no change
Ground ambulance, in network20% of the cost20% of the costno change
Comprehensive dental, yearly limitnot offerednot offeredno change
Eyewear, yearly limit$125 a year$125 a yearno change
Hearing aids, yearly limit for both earsnot offerednot offeredno change
Counties served11no 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
TierWhat the tier holds20262027
Tier 1Preferred Genericnot offered$0
Tier 2Genericnot offered$10
Tier 3Preferred Brandnot offered$47
Tier 4Non-Preferred Drugnot offered$100
Tier 5Specialty Tiernot offered28% 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, 2 dual-eligible special needs plans are sold for 2027, this one included. Against the others, 1 plan has a lower out-of-pocket limit. On the premium, 1 the same.

Out-of-pocket limits of the 2 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 $8,0000 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?

The premium and the out-of-pocket limit are the same in all 1 county: $0 a month and $9,850.

Oregon

Klamath

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
H3814-007
Legal name of the contract
Atrio Health Plans
Sold as
ATRIO Health Plans
Parent company
ATRIO Health Plans
Plan type
HMO D-SNP
2026 star rating of the contract
2 of 5 overall; health plan 2 of 5, drug plan 2.5 of 5
Members, September 2026
795
Plan website, as filed with CMS
atriohp.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.