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

Clever Care Total+, 2027

H7607Contract016Plan

HMO C-SNP · special needs plan, chronic or disabling condition · 5 counties in California

Run by Clever Care of Golden State, Inc. (contract H7607), sold as Clever Care Health Plan, owned by Clever Care Health Plan, Inc.

Renews for 2027

2026 star rating, contract H7607: 4 of 5

Clever Care Total+ (H7607-016) 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 limitnot offered$350 a yearadded
Drug tier 2, generic10% of the cost$0changed
Drug tier 3, preferred brand25% of the cost23% of the costdown 2 points
17 lines do not change
Monthly premium$0$0no change
Part B premium reduction, monthlynonenoneno change
Primary care visit$0 copay$0 copayno change
Specialist visit$0 copay$0 copayno change
Emergency room$95 copay$95 copayno 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$600 a year$600 a yearno change
Over-the-counter items, yearlynot offerednot offeredno change
Counties served55no change
Drug tier 1, preferred generic$0$0no change
Drug tier 4, non-preferred drug25% of the cost25% of the costno 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 2Generic10% of the cost$0
Tier 3Preferred Brand25% of the cost23% of the cost
Tier 4Non-Preferred Drug25% of the cost25% 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, 59 chronic or disabling condition special needs plans are sold for 2027, this one included. Against the others, 37 plans have a lower out-of-pocket limit, 21 the same. On the premium, 50 the same, 8 a higher one.

Out-of-pocket limits of the 59 chronic or disabling condition special needs plans

$0 to under $2,00030 plans
$2,000 to under $4,0004 plans
$4,000 to under $6,0002 plans
$6,000 to under $8,0000 plans
$8,000 to $10,000 (this plan)23 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 5 counties: $0 a month and $9,850.

California

Los AngelesOrangeRiversideSan BernardinoSan Diego

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
H7607-016
Legal name of the contract
Clever Care of Golden State, Inc.
Sold as
Clever Care Health Plan
Parent company
Clever Care Health Plan, Inc.
Plan type
HMO C-SNP
2026 star rating of the contract
4 of 5 overall; health plan 3.5 of 5, drug plan 3.5 of 5
Members, September 2026
18,235
Plan website, as filed with CMS
www.clevercarehealthplan.com/plans

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.