Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
Optimum Gold Plus Plan, 2027
H5594Contract032Plan
HMO · 2 counties in Florida
Run by Optimum Healthcare, Inc. (contract H5594), sold as Optimum HealthCare, Inc., owned by Elevance Health, Inc.
Optimum Gold Plus Plan (H5594-032) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $1,900.
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 |
| Over-the-counter items, yearly | $600 a year | $540 a year | ▼down $60 |
| Drug tier 2, preferred brand | $10 | $20 | ▲up $10 |
| Drug tier 3, non-preferred drug | $55 | $65 | ▲up $10 |
| 16 lines do not change | |||
| Monthly premium | $0 | $0 | no change |
| In-network out-of-pocket limit | $1,900 | $1,900 | no change |
| Drug deductible | $0 | $0 | no change |
| Primary care visit | $0 copay | $0 copay | no change |
| Specialist visit | $10 copay | $10 copay | no change |
| Emergency room | $150 copay | $150 copay | no change |
| Medical deductible, in network | none | none | no change |
| Hospital stay, in network | $75 a day for days 1–5, then $0 a day for days 6–90 | $75 a day for days 1–5, then $0 a day for days 6–90 | no change |
| Skilled nursing facility, in network | $0 a day for days 1–20, then $218 a day for days 21–100 | $0 a day for days 1–20, then $218 a day for days 21–100 | no change |
| Ground ambulance, in network | $200 copay | $200 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 | $750 a year | $750 a year | no change |
| Counties served | 2 | 2 | no change |
| Drug tier 1, preferred generic | $0 | $0 | no change |
| Drug tier 4, 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?
| Tier | What the tier holds | 2026, standard pharmacy | 2027, standard pharmacy | 2027, preferred pharmacy |
|---|---|---|---|---|
| Tier 1 | Preferred Generic | $0 | $0 | $0 |
| Tier 2 | Preferred Brand | $10 | $20 | $20 |
| Tier 3 | Non-Preferred Drug | $55 | $65 | $60 |
| Tier 4 | 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, 50 plans open to everyone are sold for 2027, this one included. Against the others, 1 plan has a lower out-of-pocket limit, 2 the same, 46 a higher one. On the premium, 45 the same, 4 a higher one.
Out-of-pocket limits of the 50 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 2 counties: $0 a month and $1,900.
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
- H5594-032
- Legal name of the contract
- Optimum Healthcare, Inc.
- Sold as
- Optimum HealthCare, 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 4 of 5
- Members, September 2026
- 5,458
- Plan website, as filed with CMS
- www.YourOptimumHealthcare.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 Hernando, FLWhere most of its members live; premiums and limits side by side
- Every Optimum HealthCare, Inc. plan for 2027Its contracts, counties and plans that end
- The other 12 plans of contract H5594Same 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.