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Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026

Anthem Medicare Advantage, 2027

H5854Contract019Plan

HMO · 8 counties in Connecticut

Run by Anthem Health Plans, Inc. (contract H5854), sold as Anthem Blue Cross and Blue Shield, owned by Elevance Health, Inc.

Renews for 2027

2026 star rating, contract H5854: 3.5 of 5

Anthem Medicare Advantage (H5854-019) costs $54 to $90 a month in 2027, up $18 from 2026, with an in-network out-of-pocket limit of $9,850 ($9,250 in 2026).

What changes from 2026 to 2027?

The changed lines are marked and come first. In-network amounts; members keep paying the Part B premium unless the plan reduces it. Where the plan files different amounts for parts of its area, the premium and limit show their range (your county's are in the table below). The plan files its benefits in parts for different counties, so lines marked ◆ show the most generous part of its area and some counties get less: the plan's Evidence of Coverage gives your county's amounts.
What you pay or get20262027Change
Monthly premium$36 to $63$54 to $90up $18
In-network out-of-pocket limit$9,250$9,850up $600
Drug deductible$215$400up $185
Primary care visit (best in its area)$5 copay$0 copaydown $5
Hospital stay, in network (best in its area)$425 a day for days 1–5, then $0 a day for days 6–90$490 a day for days 1–5, then $0 a day for days 6–90up $325for a 5-day stay
Skilled nursing facility, in network (best in its area)$0 a day for days 1–20, then $218 a day for days 21–100$0 a day for days 1–20, then $221 a day for days 21–100up $30for a 30-day stay
Counties served68up 2
Drug tier 1, preferred generic$5$0down $5
Drug tier 4, non-preferred drug30% of the cost27% of the costdown 3 points
Drug tier 5, specialty tier30% of the cost29% of the costdown 1 point
11 lines do not change
Part B premium reduction, monthly (best in its area)nonenoneno change
Specialist visit (best in its area)$50 copay$50 copayno change
Emergency room (best in its area)$115 copay$115 copayno change
Medical deductible, in network (best in its area)nonenoneno change
Ground ambulance, in network (best in its area)$285 copay$285 copayno change
Comprehensive dental, yearly limit (best in its area)not offerednot offeredno change
Eyewear, yearly limit (best in its area)$175 a year$175 a yearno change
Hearing aids, yearly limit for both ears (best in its area)$2,000 a year$2,000 a yearno change
Over-the-counter items, yearly (best in its area)not offerednot offeredno change
Drug tier 2, generic$10$10no change
Drug tier 3, preferred brand25% of the cost25% of the costno 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?

Your share for a 30-day supply at a retail pharmacy, as filed with CMS; tiers whose share changes are marked. The plan charges less at its preferred pharmacies
TierWhat the tier holds2026, standard pharmacy2027, standard pharmacy2027, preferred pharmacy
Tier 1Preferred Generic$5$0$0
Tier 2Generic$10$10$0
Tier 3Preferred Brand25% of the cost25% of the cost25% of the cost
Tier 4Non-Preferred Drug30% of the cost27% of the cost27% of the cost
Tier 5Specialty Tier30% of the cost29% of the cost29% 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, 26 plans open to everyone are sold for 2027, this one included. Against the others, 23 plans have a lower out-of-pocket limit, 2 the same. On the premium, 20 plans have a lower premium, 5 a higher one.

Out-of-pocket limits of the 26 plans open to everyone

$0 to under $2,0000 plans
$2,000 to under $4,0000 plans
$4,000 to under $6,0002 plans
$6,000 to under $8,00019 plans
$8,000 to $10,000 (this plan)5 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?

8 counties, grouped by what the plan costs there
Monthly premiumOut-of-pocket limitWhere
$54$9,850Hartford (CT), Litchfield (CT), Middlesex (CT), New London (CT), Tolland (CT), Windham (CT)
$90$9,850Fairfield (CT), New Haven (CT)

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
H5854-019
Legal name of the contract
Anthem Health Plans, Inc.
Sold as
Anthem Blue Cross and Blue Shield
Parent company
Elevance Health, Inc.
Plan type
HMO
2026 star rating of the contract
3.5 of 5 overall; health plan 3.5 of 5, drug plan 4 of 5
Members, September 2026
4,899
Plan website, as filed with CMS
https://shop.anthem.com/medicare

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?

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.