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

Prominence Giveback, 2027

H7680Contract012Plan

HMO · 8 counties in Texas

Run by Prominence Healthfirst of Texas (contract H7680), sold as Prominence Health Plan, owned by Universal Health Services, Inc.

Renews for 2027

2026 star rating, contract H7680: 4.5 of 5

Prominence Giveback (H7680-012) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $7,000 ($6,200 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 get	2026	2027	Change
In-network out-of-pocket limit	$6,200	$7,000	up $800
Part B premium reduction, monthly	$130	$140	up $10
Hospital stay, in network	$250 a day for days 1–6, then $0 a day for days 7–90	$275 a day for days 1–6, then $0 a day for days 7–90	up $125for a 5-day stay
Skilled nursing facility, in network	$10 a day for days 1–20, then $218 a day for days 21–100	$10 a day for days 1–20, then $221 a day for days 21–100	up $30for a 30-day stay
Eyewear, yearly limit	$200 a year	$100 a year	down $100
Drug tier 2, generic	$15	$11	down $4
Drug tier 4, non-preferred drug	50% of the cost	35% of the cost	down 15 points
15 lines do not change
Monthly premium	$0	$0	no change
Drug deductible	$0	$0	no change
Primary care visit	$0 copay	$0 copay	no change
Specialist visit	$45 copay	$45 copay	no change
Emergency room	$130 copay	$130 copay	no change
Medical deductible, in network	none	none	no change
Ground ambulance, in network	$325 copay	$325 copay	no change
Comprehensive dental, yearly limit	not offered	not offered	no change
Hearing aids, yearly limit for both ears	$600 a year	$600 a year	no change
Over-the-counter items, yearly	not offered	not offered	no change
Counties served	8	8	no change
Drug tier 1, preferred generic	$0	$0	no change
Drug tier 3, preferred brand	25% of the cost	25% of the cost	no change
Drug tier 5, specialty tier	33% of the cost	33% of the cost	no change
Drug tier 6, select care drugs	$0	$0	no 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
Tier	What the tier holds	2026	2027
Tier 1	Preferred Generic	$0	$0
Tier 2	Generic	$15	$11
Tier 3	Preferred Brand	25% of the cost	25% of the cost
Tier 4	Non-Preferred Drug	50% of the cost	35% of the cost
Tier 5	Specialty Tier	33% of the cost	33% of the cost
Tier 6	Select 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, 47 plans open to everyone are sold for 2027, this one included. Against the others, 26 plans have a lower out-of-pocket limit, 20 a higher one. On the premium, 34 the same, 12 a higher one.

Out-of-pocket limits of the 47 plans open to everyone

$0 to under $2,0000 plans

$2,000 to under $4,00010 plans

$4,000 to under $6,0006 plans

$6,000 to under $8,000 (this plan)22 plans

$8,000 to $10,0009 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 8 counties: $0 a month and $7,000.

Texas

Cooke Deaf Smith Fannin Gray Grayson Moore Potter Randall

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: H7680-012
Legal name of the contract: Prominence Healthfirst of Texas
Sold as: Prominence Health Plan
Parent company: Universal Health Services, Inc.
Plan type: HMO
2026 star rating of the contract: 4.5 of 5 overall; health plan 4 of 5, drug plan 4 of 5
Members, September 2026: 363
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?

Other 2027 plans in Potter, TXWhere most of its members live; premiums and limits side by side
Every Prominence Health Plan plan for 2027Its contracts, counties and plans that end
The other 12 plans of contract H7680Same company, same contract
Is your prescription covered?Coverage share and tier for 2,259 drugs

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.