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

Troy Medicare, 2027

H4676Contract001Plan

HMO · 35 counties in North Carolina

Run by Troy Health, Inc. (contract H4676), sold as Troy Medicare, owned by Troy Holdings, Inc.

Renews for 2027

2026 star rating, contract H4676: 3 of 5

Troy Medicare (H4676-001) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $4,950 ($3,950 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 get	2026	2027	Change
In-network out-of-pocket limit	$3,950	$4,950	up $1,000
Emergency room	$110 copay	$130 copay	up $20
Skilled nursing facility, in network	$0 a day for days 1–20, then $214 a day for days 21–100	$0 a day for days 1–20, then $221 a day for days 21–100	up $70for a 30-day stay
Ground ambulance, in network	$255 copay	$350 copay	up $95
17 lines do not change
Monthly premium	$0	$0	no change
Drug deductible	$0	$0	no change
Part B premium reduction, monthly	none	none	no change
Primary care visit	$0 copay	$0 copay	no change
Specialist visit	$0 copay	$0 copay	no change
Medical deductible, in network	none	none	no change
Hospital stay, in network	$400 a day for days 1–5, then $0 a day for days 6–90	$400 a day for days 1–5, then $0 a day for days 6–90	no change
Comprehensive dental, yearly limit	not offered	not offered	no change
Eyewear, yearly limit	$200 a year	$200 a year	no change
Hearing aids, yearly limit for both ears	not offered	not offered	no change
Over-the-counter items, yearly	$240 a year	$240 a year	no change
Counties served	35	35	no change
Drug tier 1, preferred generic	$10	$10	no change
Drug tier 2, generic	$20	$20	no change
Drug tier 3, preferred brand	$40	$40	no change
Drug tier 4, non-preferred drug	$100	$100	no change
Drug tier 5, specialty tier	33% of the cost	33% of the cost	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	$10	$10	$0
Tier 2	Generic	$20	$20	$5
Tier 3	Preferred Brand	$40	$40	$25
Tier 4	Non-Preferred Drug	$100	$100	$100
Tier 5	Specialty Tier	33% of the cost	33% of the cost	33% 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, 98 plans open to everyone are sold for 2027, this one included. Against the others, 15 plans have a lower out-of-pocket limit, 2 the same, 80 a higher one. On the premium, 76 the same, 21 a higher one.

Out-of-pocket limits of the 98 plans open to everyone

$0 to under $2,0000 plans

$2,000 to under $4,0005 plans

$4,000 to under $6,000 (this plan)29 plans

$6,000 to under $8,00025 plans

$8,000 to $10,00039 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 35 counties: $0 a month and $4,950.

North Carolina

Alexander Anson Bladen Buncombe Burke Caldwell Catawba Chatham Columbus Cumberland Durham Franklin Granville Harnett Haywood Henderson Hoke Iredell Jackson Lee McDowell Mitchell Montgomery Moore Orange Person Polk Richmond Robeson Sampson Scotland Swain Transylvania Vance Yancey

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: H4676-001
Legal name of the contract: Troy Health, Inc.
Sold as: Troy Medicare
Parent company: Troy Holdings, Inc.
Plan type: HMO
2026 star rating of the contract: 3 of 5 overall; health plan 3 of 5, drug plan 3 of 5
Members, September 2026: 1,344
Plan website, as filed with CMS: www.troymedicare.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 Richmond, NCWhere most of its members live; premiums and limits side by side
Every Troy Medicare plan for 2027Its contracts, counties and plans that end
The other 1 plan of contract H4676Same 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.