Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
HealthSun MediSun Full Dual Extra, 2027
H5431Contract026Plan
HMO D-SNP · special needs plan, dual-eligible · 3 counties in Florida
Run by HealthSun Health Plans, Inc. (contract H5431), sold as HealthSun Health Plans, Inc., owned by Elevance Health, Inc.
HealthSun MediSun Full Dual Extra (H5431-026) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $3,450. It takes in the members of H5427-087, H5431-025, H5471-127, H5471-130, H5471-132, H5471-134, H5471-137, H5594-017.
What changes from 2026 to 2027?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| Drug deductible | $0 | $700 | ▲up $700 |
| Over-the-counter items, yearly | $1,500 a year | $1,344 a year | ▼down $156 |
| Counties served | 2 | 3 | ▲up 1 |
| Drug tier 5, specialty tier | 33% of the cost | 25% of the cost | ▼down 8 points |
| 18 lines do not change | |||
| Monthly premium | $0 | $0 | no change |
| In-network out-of-pocket limit | $3,450 | $3,450 | 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 |
| Emergency room | $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 |
| Skilled nursing facility, in network | $0 a day for days 1–100 | $0 a day for days 1–100 | no change |
| Ground ambulance, in network | $0 copay | $0 copay | no change |
| Comprehensive dental, yearly limit | not offered | not offered | no change |
| Eyewear, yearly limit | $400 a year | $400 a year | no change |
| Hearing aids, yearly limit for both ears | $2,000 a year | $2,000 a year | no change |
| Drug tier 1, preferred generic | $0 | $0 | no change |
| Drug tier 2, generic | $0 | $0 | no change |
| Drug tier 3, preferred brand | $5 | $5 | no change |
| Drug tier 4, non-preferred drug | $50 | $50 | 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 | 2027 |
|---|---|---|---|
| Tier 1 | Preferred Generic | $0 | $0 |
| Tier 2 | Generic | $0 | $0 |
| Tier 3 | Preferred Brand | $5 | $5 |
| Tier 4 | Non-Preferred Drug | $50 | $50 |
| Tier 5 | Specialty Tier | 33% of the cost | 25% of the cost |
| Tier 6 | Supplemental Drugs | $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, 51 dual-eligible special needs plans are sold for 2027, this one included. Against the others, 15 plans have a lower out-of-pocket limit, 3 the same, 32 a higher one. On the premium, 42 the same, 8 a higher one.
Out-of-pocket limits of the 51 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 3 counties: $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).
Which 2026 plans move into it, and what changes for their members?
For 2027 this plan takes in the members of 8 other plans, beside its own 21,330 members. In 2027 it costs $0 a month with a $3,450 limit; each row compares that with the plan its members had in 2026.
| 2026 plan | Members, Sept. 2026 | Members who move | Premium 2026 | Premium change | Limit 2026 | Limit change |
|---|---|---|---|---|---|---|
| Freedom Medi-Medi FullH5427-087 | 1,396 | 13 | $0 | no change | $500 | ▲up $2,950 |
| HealthSun MediSun Full Dual PlusH5431-025 | 624 | 620 | $0 | no change | $3,450 | no change |
| Simply IntegratedH5471-127 | 1,545 | 1,544 | $0 | no change | $500 | ▲up $2,950 |
| Simply IntegratedH5471-130 | 176 | 175 | $4.80 | ▼down $4.80 | $500 | ▲up $2,950 |
| Simply IntegratedH5471-132 | 32 | 32 | $4.80 | ▼down $4.80 | $500 | ▲up $2,950 |
| Simply Integrated PlatinumH5471-134 | 2,605 | 2,597 | $4.80 | ▼down $4.80 | $500 | ▲up $2,950 |
| Simply Integrated PlatinumH5471-137 | 309 | 305 | $4.80 | ▼down $4.80 | $500 | ▲up $2,950 |
| Optimum Emerald FullH5594-017 | 1,078 | fewer than 11 a county | $0 | no change | $500 | ▲up $2,950 |
Only the members of Freedom Medi-Medi Full (H5427-087) who live in the 2 counties where this plan is sold move into it (13 of its 1,396 members); in its other 22 counties the plan ends and members choose a new one. What happens where.
Only the members of Optimum Emerald Full (H5594-017) who live in the 2 counties where this plan is sold move into it (0 of its 1,078 members); in its other 22 counties the plan ends and members choose a new one. What happens where.
Source: CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11); CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision). Each moving plan's own page lists every line that changes for its members.
Who runs this plan?
- Plan ID
- H5431-026
- Legal name of the contract
- HealthSun Health Plans, Inc.
- Sold as
- HealthSun Health Plans, Inc.
- Parent company
- Elevance Health, Inc.
- Plan type
- HMO D-SNP
- 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
- 21,330
- 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.