Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
Senior Care, 2027
H4172Contract003Plan
HMO I-SNP · special needs plan, institutional · 93 counties in Missouri, North Carolina, South Carolina, Tennessee
Run by NHC Advantage, LLC (contract H4172), sold as NHC Advantage, owned by Missouri Healthcare Advisors, LLC
Senior Care (H4172-003) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $5,000.
What changes from 2026 to 2027?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| Drug deductible | $250 | $500 | ▲up $250 |
| Hospital stay, in network | $295 a day for days 1–6, then $0 a day for days 7–90 | $275 a day for days 1–5, then $0 a day for days 6–90 | ▼down $100for a 5-day stay |
| Over-the-counter items, yearly | $660 a year | $540 a year | ▼down $120 |
| Counties served | 89 | 93 | ▲up 4 |
| Drug tier 3, preferred brand | $45 | 25% of the cost | changed |
| Drug tier 4, non-preferred drug | $95 | 26% of the cost | changed |
| Drug tier 5, specialty tier | 30% of the cost | 28% of the cost | ▼down 2 points |
| 14 lines do not change | |||
| Monthly premium | $0 | $0 | no change |
| In-network out-of-pocket limit | $5,000 | $5,000 | no change |
| Part B premium reduction, monthly | none | none | no change |
| Primary care visit | $0 copay | $0 copay | no change |
| Specialist visit | $25 copay | $25 copay | no change |
| Emergency room | $90 copay | $90 copay | no change |
| Medical deductible, in network | none | none | no change |
| Skilled nursing facility, in network | $0 a stay | $0 a stay | no change |
| Ground ambulance, in network | $250 copay | $250 copay | no change |
| Comprehensive dental, yearly limit | not offered | not offered | no change |
| Eyewear, yearly limit | $350 a year | $350 a year | no change |
| Hearing aids, yearly limit for both ears | $1,500 a year | $1,500 a year | no change |
| Drug tier 1, preferred generic | $2 | $2 | no change |
| Drug tier 2, generic | $15 | $15 | 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 | $2 | $2 |
| Tier 2 | Generic | $15 | $15 |
| Tier 3 | Preferred Brand | $45 | 25% of the cost |
| Tier 4 | Non-Preferred Drug | $95 | 26% of the cost |
| Tier 5 | Specialty Tier | 30% 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, 21 institutional special needs plans are sold for 2027, this one included. Against the others, 1 plan has a lower out-of-pocket limit, 19 a higher one. On the premium, 9 the same, 11 a higher one.
Out-of-pocket limits of the 21 institutional 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 93 counties: $0 a month and $5,000.
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
- H4172-003
- Legal name of the contract
- NHC Advantage, LLC
- Sold as
- NHC Advantage
- Parent company
- Missouri Healthcare Advisors, LLC
- Plan type
- HMO I-SNP
- 2026 star rating of the contract
- 5 of 5 overall; health plan 5 of 5, drug plan 4.5 of 5
- Members, September 2026
- fewer than 11
- Plan website, as filed with CMS
- www.nhcadvantageplan.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 NHC Advantage plan for 2027Its contracts, counties and plans that end
- The other 1 plan of contract H4172Same 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.