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

Prominence Dual, 2027

H5945Contract018Plan

HMO D-SNP · special needs plan, dual-eligible · 1 county in Nevada

Run by Prominence Healthfirst (contract H5945), sold as Prominence Health Plan, owned by Universal Health Services, Inc.

Renews for 2027

2026 star rating, contract H5945: 4.5 of 5

Prominence Dual (H5945-018) costs $0 a month in 2027, the same as in 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.
What you pay or get20262027Change
In-network out-of-pocket limit$9,250$9,850up $600
Drug deductible$615$700up $85
Eyewear, yearly limit$510 a year$150 a yeardown $360
Over-the-counter items, yearly$1,848 a year$1,700 a yeardown $148
Drug tier 3, preferred brand24% of the cost25% of the costup 1 point
Drug tier 4, non-preferred drug48% of the cost40% of the costdown 8 points
16 lines do not change
Monthly premium$0$0no change
Part B premium reduction, monthlynonenoneno change
Primary care visit20% of the cost20% of the costno change
Specialist visit20% of the cost20% of the costno change
Emergency room20% of the cost20% of the costno change
Medical deductible, in networknonenoneno change
Hospital stay, in networknot filednot filedno change
Skilled nursing facility, in networknot filednot filedno change
Ground ambulance, in network20% of the cost20% of the costno change
Comprehensive dental, yearly limitnot offerednot offeredno change
Hearing aids, yearly limit for both ears$3,000 a year$3,000 a yearno change
Counties served11no change
Drug tier 1, preferred generic$0$0no change
Drug tier 2, generic$0$0no change
Drug tier 5, specialty tier25% of the cost25% of the costno change
Drug tier 6, select care drugs$0$0no 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
TierWhat the tier holds20262027
Tier 1Preferred Generic$0$0
Tier 2Generic$0$0
Tier 3Preferred Brand24% of the cost25% of the cost
Tier 4Non-Preferred Drug48% of the cost40% of the cost
Tier 5Specialty Tier25% of the cost25% of the cost
Tier 6Select Care Drugs$0$0

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, 17 dual-eligible special needs plans are sold for 2027, this one included. Against the others, 1 plan has a lower out-of-pocket limit, 15 the same. On the premium, 15 the same, 1 a higher one.

Out-of-pocket limits of the 17 dual-eligible special needs plans

$0 to under $2,0000 plans
$2,000 to under $4,0000 plans
$4,000 to under $6,0000 plans
$6,000 to under $8,0000 plans
$8,000 to $10,000 (this plan)17 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?

The premium and the out-of-pocket limit are the same in all 1 county: $0 a month and $9,850.

Nevada

Washoe

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
H5945-018
Legal name of the contract
Prominence Healthfirst
Sold as
Prominence Health Plan
Parent company
Universal Health Services, Inc.
Plan type
HMO D-SNP
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
797
Plan website, as filed with CMS
www.prominencemedicare.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?

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.