Medicare contract · plan years 2026 and 2027CMS landscape and crosswalk
Optimum Healthcare, Inc. (H5594)
H5594Contract
A company of Elevance Health, Inc., sold as Optimum HealthCare, Inc.
13 plans in 2027 (15 in 2026) · 80,666 members in September 2026
Optimum Healthcare, Inc. is the Elevance Health, Inc. company that holds Medicare contract H5594, sold as Optimum HealthCare, Inc.. In 2027 it offers 13 plans (15 in 2026); every one of its 2026 plans continues in 2027. 80,666 people were in its plans in September 2026.
What plans does H5594 offer for 2027?
| Plan | Type | Monthly premium | Out-of-pocket limit | Area | For 2027 |
|---|---|---|---|---|---|
| Optimum Gold Rewards PlanH5594-001 | HMO | $0 | $1,900 | 6 counties | renews |
| Optimum Platinum PlanH5594-002 | HMO | $0 | $1,000 | 6 counties | renews |
| Optimum Emerald PartialH5594-016 | HMO D-SNP | $0 | $500 | 24 counties | renews |
| Optimum Emerald FullH5594-017 | HMO D-SNP | $7.30 | $500 | 1 county | takes in other plans |
| Optimum Gold PlanH5594-019 | HMO | $0 | $4,450 | 3 counties | renews |
| Optimum Gold Rewards PlanH5594-022 | HMO | $0 | $4,450 | 4 counties | renews |
| Optimum Gold Rewards PlanH5594-026 | HMO | $0 | $4,450 | 3 counties | renews |
| Optimum Diamond RewardsH5594-028 | HMO C-SNP | $0 | $1,750 | 5 counties | renews |
| Optimum Diamond Rewards COPDH5594-029 | HMO C-SNP | $0 | $1,750 | 5 counties | renews |
| Optimum Diamond SavingsH5594-030 | HMO C-SNP | $0 | $5,000 | 18 counties | takes in other plans |
| Optimum Diamond Savings COPDH5594-031 | HMO C-SNP | $0 | $5,000 | 14 counties | takes in other plans |
| Optimum Gold Plus PlanH5594-032 | HMO | $0 | $1,900 | 2 counties | renews |
| Optimum DiamondH5594-036 | HMO C-SNP | $0 | $1,000 | 5 counties | renews |
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 crosswalk from 2026 to 2027 (Oct. 1, 2026).
How did CMS rate it for 2026?
The overall rating is 4.5 of 5 (health plan 4.5 of 5, drug plan 4 of 5). Of its 42 rated measures, the lowest and the highest:
| Lowest-rated measures | Stars |
|---|---|
| Monitoring Physical Activity | 3 |
| Special Needs Plan (SNP) Care Management | 3 |
| Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions | 3 |
| Getting Needed Care | 3 |
| Highest-rated measures | Stars |
|---|---|
| Medication Adherence for Cholesterol (Statins) | 5 |
| Medication Adherence for Diabetes Medications | 5 |
| Rating of Drug Plan | 5 |
| Drug Plan Quality Improvement | 5 |
Source: CMS Part C and D Star Ratings data tables, 2026 (October 2025).
What else should you check?
- All Optimum HealthCare, Inc. plansEvery contract of the brand
- Star ratings of every contractThe 2026 ratings, and 2027 when CMS publishes them
- Find a plan by its IDFrom the card or a letter