Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
HealthSun HealthAdvantage Plus, 2027
H5431Contract017Plan
HMO · 1 county in Florida
Run by HealthSun Health Plans, Inc. (contract H5431), sold as HealthSun Health Plans, Inc., owned by Elevance Health, Inc.
HealthSun HealthAdvantage Plus (H5431-017) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $3,450.
What changes from 2026 to 2027?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| Part B premium reduction, monthly | $185 | $202.90 | ▲up $17.90 |
| Emergency room | $120 copay | $150 copay | ▲up $30 |
| Skilled nursing facility, in network | $0 a day for days 1–20, then $60 a day for days 21–100 | $0 a day for days 1–20, then $221 a day for days 21–100 | ▲up $1,610for a 30-day stay |
| Over-the-counter items, yearly | $1,140 a year | $1,080 a year | ▼down $60 |
| Drug tier 3, preferred brand | $5 | $47 | ▲up $42 |
| Drug tier 4, non-preferred drug | $55 | $100 | ▲up $45 |
| 16 lines do not change | |||
| Monthly premium | $0 | $0 | no change |
| In-network out-of-pocket limit | $3,450 | $3,450 | no change |
| Drug deductible | $0 | $0 | 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 | $0 a stay | $0 a stay | no change |
| Ground ambulance, in network | $150 copay | $150 copay | 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 | $2,000 a year | $2,000 a year | no change |
| Counties served | 1 | 1 | no change |
| Drug tier 1, preferred generic | $0 | $0 | no change |
| Drug tier 2, generic | $0 | $0 | no change |
| Drug tier 5, specialty tier | 33% of the cost | 33% of the cost | no change |
| Drug tier 6, supplemental drugs | $0 | $0 | 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, standard pharmacy | 2027, standard pharmacy | 2027, preferred pharmacy |
|---|---|---|---|---|
| Tier 1 | Preferred Generic | $0 | $0 | $0 |
| Tier 2 | Generic | $0 | $0 | $0 |
| Tier 3 | Preferred Brand | $5 | $47 | $42 |
| Tier 4 | Non-Preferred Drug | $55 | $100 | $95 |
| Tier 5 | Specialty Tier | 33% of the cost | 33% of the cost | 33% of the cost |
| Tier 6 | Supplemental Drugs | $0 | $0 | $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, 41 plans open to everyone are sold for 2027, this one included. Against the others, 14 plans have a lower out-of-pocket limit, 2 the same, 24 a higher one. On the premium, 34 the same, 6 a higher one.
Out-of-pocket limits of the 41 plans open to everyone
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 $3,450.
Florida
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
- H5431-017
- Legal name of the contract
- HealthSun Health Plans, Inc.
- Sold as
- HealthSun Health Plans, Inc.
- Parent company
- Elevance Health, Inc.
- Plan type
- HMO
- 2026 star rating of the contract
- 4.5 of 5 overall; health plan 4.5 of 5, drug plan 3.5 of 5
- Members, September 2026
- 7,153
- Plan website, as filed with CMS
- www.HealthSun.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 Miami-Dade, FLWhere most of its members live; premiums and limits side by side
- Every HealthSun Health Plans, Inc. plan for 2027Its contracts, counties and plans that end
- The other 10 plans of contract H5431Same 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.