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

Troy Medicare for Dual-eligible Beneficiaries, 2027

H4676Contract002Plan

HMO D-SNP · special needs plan, dual-eligible · 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 for Dual-eligible Beneficiaries (H4676-002) costs $13.30 a month in 2027, down $18 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 get	2026	2027	Change
Monthly premium	$31.30	$13.30	down $18
In-network out-of-pocket limit	$9,250	$9,850	up $600
Drug deductible	$615	$700	up $85
18 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
Emergency room	20% of the cost	20% of the cost	no change
Medical deductible, in network	none	none	no change
Hospital stay, in network	not filed	not filed	no change
Skilled nursing facility, in network	not filed	not filed	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	$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	$1,380 a year	$1,380 a year	no change
Counties served	35	35	no change
Drug tier 1, preferred generic	$0	$0	no change
Drug tier 2, generic	25% of the cost	25% of the cost	no change
Drug tier 3, preferred brand	25% of the cost	25% of the cost	no change
Drug tier 4, non-preferred drug	25% of the cost	25% of the cost	no change
Drug tier 5, specialty tier	25% of the cost	25% 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
Tier	What the tier holds	2026	2027
Tier 1	Preferred Generic	$0	$0
Tier 2	Generic	25% of the cost	25% of the cost
Tier 3	Preferred Brand	25% of the cost	25% of the cost
Tier 4	Non-Preferred Drug	25% of the cost	25% of the cost
Tier 5	Specialty Tier	25% of the cost	25% 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, 26 dual-eligible special needs plans are sold for 2027, this one included. Against the others, 4 plans have a lower out-of-pocket limit, 21 the same. On the premium, 18 plans have a lower premium, 6 the same, 1 a higher one.

Out-of-pocket limits of the 26 dual-eligible special needs plans

$0 to under $2,0000 plans

$2,000 to under $4,0000 plans

$4,000 to under $6,0001 plan

$6,000 to under $8,0002 plans

$8,000 to $10,000 (this plan)23 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: $13.30 a month and $9,850.

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: H4676-002
Legal name of the contract: Troy Health, Inc.
Sold as: Troy Medicare
Parent company: Troy Holdings, Inc.
Plan type: HMO D-SNP
2026 star rating of the contract: 3 of 5 overall; health plan 3 of 5, drug plan 3 of 5
Members, September 2026: 333
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 Cumberland, 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.