Medicare contract · plan years 2026 and 2027CMS landscape and crosswalk
Capital Health Plan (H5938)
H5938Contract
A company of Guidewell Mutual Holding Corporation, sold as Capital Health Plan
4 plans in 2027 (4 in 2026) · 14,878 members in September 2026
Capital Health Plan is the Guidewell Mutual Holding Corporation company that holds Medicare contract H5938, sold as Capital Health Plan. In 2027 it offers 4 plans (4 in 2026); every one of its 2026 plans continues in 2027. 14,878 people were in its plans in September 2026.
What plans does H5938 offer for 2027?
| Plan | Type | Monthly premium | Out-of-pocket limit | Area | For 2027 |
|---|---|---|---|---|---|
| Capital Health Plan Advantage PlusH5938-001 | HMO | $39 | $6,000 | 9 counties | renews |
| Capital Health Plan Preferred AdvantageH5938-006 | HMO | $105 | $6,000 | 9 counties | renews |
| Capital Health Plan Silver AdvantageH5938-008 | HMO | $0 | $6,500 | 9 counties | renews |
| Capital Health Plan Giveback AdvantageH5938-009 | HMO | $0 | $7,000 | 9 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).
Which employer and union group plans does it hold?
H5938 also holds 4 group plans offered through former employers and unions, with 11,650 members in September 2026 (plans with fewer than 11 not counted). They are not sold to individuals, so the landscape files list no premiums or benefits for them; the employer or union sends their 2027 terms.
| Plan ID | Plan name | Members, Sept. 2026 | 2027 |
|---|---|---|---|
| H5938-802 | Capital Health Plan Retiree Advantage | 9,987 | renews |
| H5938-803 | Capital Health Plan Retiree Advantage | fewer than 11 | renews |
| H5938-804 | Capital Health Plan Retiree Advantage | 1,663 | renews |
| H5938-805 | 805 Emp-only SOF Capital Health Plan Retiree Advan | fewer than 11 | renews |
Source: CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11); 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 5 of 5, drug plan 4.5 of 5). Of its 42 rated measures, the lowest and the highest:
| Lowest-rated measures | Stars |
|---|---|
| Improving or Maintaining Physical Health | 2 |
| Reducing the Risk of Falling | 2 |
| Statin Therapy for Patients with Cardiovascular Disease | 3 |
| Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions | 3 |
| Highest-rated measures | Stars |
|---|---|
| MPF Price Accuracy | 5 |
| Rating of Drug Plan | 5 |
| Members Choosing to Leave the Plan | 5 |
| Complaints about the Drug Plan | 5 |
Source: CMS Part C and D Star Ratings data tables, 2026 (October 2025).
What else should you check?
- All Capital Health Plan 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