Plan year 2026 · coverage ends Dec. 31, 2026CMS crosswalk of Oct. 1, 2026
Wellcare Simple Open is not offered under this ID in 2027
H5439Contract022Plan
PPO · served 12 counties in Oregon in 2026
Run by Health Net Life Insurance Company (contract H5439), sold as Wellcare, owned by Centene Corporation
CMS crosswalk: renews as H5439-023 in 3 of its 12 counties; in the others the plan ends
Wellcare Simple Open (H5439-022) is not offered under this ID in 2027. The CMS plan crosswalk of October 1, 2026 moves its members into Wellcare Low Premium Value Open (H5439-023) (the plan renews under a new ID), in the 3 counties where that plan is sold (4,502 members in September 2026). In its other 9 counties (7,671 members) there is no plan to move into: coverage ends December 31, 2026, and members there need to choose a new plan.
What changes for its members in Wellcare Low Premium Value Open?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| Plan name | Wellcare Simple Open | Wellcare Low Premium Value Open | renamed |
| Monthly premium | $0 | $22 | ▲up $22 |
| In-network out-of-pocket limit, by county | $6,750 to $8,500 | $7,900 | ▼down $600 at the top |
| Drug deductible | $615 | $700 | ▲up $85 |
| Specialist visit (best in its area) | $30 copay | $35 copay | ▲up $5 |
| Skilled nursing facility, in network (best in its area) | $0 a day for days 1–20, then $218 a day for days 21–60, then $0 a day for days 61–100 | $0 a day for days 1–20, then $221 a day for days 21–60, then $0 a day for days 61–100 | ▲up $30for a 30-day stay |
| Comprehensive dental, yearly limit (best in its area) | $1,500 a year | not offered | ▼dropped |
| Eyewear, yearly limit (best in its area) | $200 a year | not offered | ▼dropped |
| Hearing aids, yearly limit for both ears (best in its area) | $750 a year | $350 a year | ▼down $400 |
| Counties served | 12 | 3 | ▼down 9 |
| Drug tier 1, generic | $5 | $10 | ▲up $5 |
| Drug tier 2, preferred brand | $10 | 25% of the cost | changed |
| Drug tier 3, non-preferred drug | 25% of the cost | 50% of the cost | ▲up 25 points |
| Drug tier 4, injectable drugs | 36% of the cost | 1% of the cost | ▼down 35 points |
| 9 lines do not change | |||
| Part B premium reduction, monthly (best in its area) | none | none | no change |
| Primary care visit (best in its area) | $0 copay | $0 copay | no change |
| Emergency room (best in its area) | $115 copay | $115 copay | no change |
| Medical deductible, in network (best in its area) | $150 | $150 | no change |
| Hospital stay, in network (best in its area) | $600 a day for days 1–4, then $0 a day for days 5–90 | $600 a day for days 1–4, then $0 a day for days 5–90 | no change |
| Ground ambulance, in network (best in its area) | $325 copay | $325 copay | no change |
| Over-the-counter items, yearly (best in its area) | not offered | not offered | no change |
| Drug tier 5, specialty tier | 25% of the cost | 25% of the cost | no change |
| Drug tier 6, select care drugs | $0 | $0 | no change |
Source: CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026); 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. Your plan's Annual Notice of Change is the letter that confirms your 2027 plan; confirm on Medicare Plan Finder.
What can members do, and by when?
If you live in Lane (OR), Linn (OR), Yamhill (OR)
- If you do nothing
- You are moved into Wellcare Low Premium Value Open on January 1, 2027.
- October 15 to December 7, 2026
- Open enrollment: choose another Medicare Advantage plan, or Original Medicare with a drug plan, instead.
If you live in Benton (OR), Clackamas (OR), Douglas (OR), Jackson (OR), Josephine (OR), Marion (OR), Multnomah (OR), Polk (OR), Washington (OR)
- Your coverage
- Ends December 31, 2026: Wellcare Low Premium Value Open is not sold where you live.
- October 15 to December 7, 2026
- Open enrollment: join another Medicare Advantage plan, or Original Medicare with a drug plan. Coverage starts January 1, 2027.
- December 8, 2026 to the end of February 2027
- A special enrollment period because the plan is leaving: you can still join a plan, but coverage starts the first day of the month after you join, so choose by December 31 to have no gap.
- If you do nothing
- You are enrolled in Original Medicare when the plan ends, without a drug plan unless you join one (with Extra Help or full Medicaid, Medicare enrolls you in one).
- Without a drug plan
- Going 63 days or more in a row without drug coverage can mean a late enrollment penalty if you join a drug plan later; joining by the end of February keeps a January and February gap under 63 days, waiting longer does not.
Source: Medicare.gov, “Special enrollment periods” and “Joining a plan” (read Oct. 7, 2026).
Where did its members live?
Where its members lived in September 2026; each county and state page lists the 2027 plans sold there.
| County | Members, Sept. 2026 | For 2027 |
|---|---|---|
| Linn, OR | 3,308 | moves into H5439-023 |
| Josephine, OR | 1,921 | plan ends here |
| Jackson, OR | 1,695 | plan ends here |
| Douglas, OR | 1,068 | plan ends here |
| Lane, OR | 1,047 | moves into H5439-023 |
| Benton, OR | 915 | plan ends here |
| Marion, OR | 879 | plan ends here |
| Multnomah, OR | 402 | plan ends here |
| Clackamas, OR | 324 | plan ends here |
| Polk, OR | 314 | plan ends here |
| Washington, OR | 153 | plan ends here |
| Yamhill, OR | 147 | moves into H5439-023 |
Source: CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11).
What else should you check?
- 2027 plans in Linn, ORThe plans you can join instead
- Wellcare plans for 2027Plans the same company still offers
- Every plan not offered in 2027764 Medicare Advantage and drug plans