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
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?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| Monthly premium | $10.50 | $0 | ▼down $10.50 |
| In-network out-of-pocket limit | $9,250 | $9,850 | ▲up $600 |
| Drug deductible | $615 | $350 | ▼down $265 |
| Emergency room | $90 copay | $115 copay | ▲up $25 |
| Over-the-counter items, yearly | $620 a year | $700 a year | ▲up $80 |
| 11 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 |
| Medical deductible, in network | none | none | no change |
| Hospital stay, in network | $0 a stay | $0 a stay | no change |
| Skilled nursing facility, in network | 0% for days 1–20, then 10% for days 21–100 | 0% for days 1–20, then 10% for days 21–100 | 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 | $125 a year | $125 a year | no change |
| Hearing aids, yearly limit for both ears | not offered | not offered | no change |
| Counties served | 1 | 1 | 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 | not offered | $0 |
| Tier 2 | Generic | not offered | $10 |
| Tier 3 | Preferred Brand | not offered | $47 |
| Tier 4 | Non-Preferred Drug | not offered | $100 |
| Tier 5 | Specialty Tier | not offered | 28% of the cost |
| Tier 6 | Select Care Drugs | not 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
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
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?
- Other 2027 plans in Klamath, ORWhere most of its members live; premiums and limits side by side
- Every ATRIO Health Plans plan for 2027Its contracts, counties and plans that end
- The other 1 plan of contract H3814Same 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.