Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
The Health Plan SecureChoice Optimum, 2027
H8604Contract014Plan
PPO · 132 counties in Ohio, West Virginia
Run by Thp Insurance Company (contract H8604), sold as The Health Plan, owned by The Health Plan of West Virginia, Inc.
The Health Plan SecureChoice Optimum (H8604-014) costs $0 to $45 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $7,000 ($5,900 to $6,500 in 2026). It takes in the members of H8604-011.
What changes from 2026 to 2027?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| In-network out-of-pocket limit, by county | $5,900 to $6,500 | $7,000 | ▲up $500 at the top |
| Drug deductible | $150 | $425 | ▲up $275 |
| Primary care visit (best in its area) | $0 copay | $10 copay | ▲up $10 |
| Specialist visit (best in its area) | $40 copay | $45 copay | ▲up $5 |
| Emergency room (best in its area) | $125 copay | $130 copay | ▲up $5 |
| Hospital stay, in network (best in its area) | $375 a day for days 1–5, then $0 a day for days 6–90 | $395 a day for days 1–6, then $0 a day for days 7–90 | ▲up $100for 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 21–100 | ▲up $30for a 30-day stay |
| Comprehensive dental, yearly limit (best in its area) | $1,500 a year | $1,000 a year | ▼down $500 |
| Eyewear, yearly limit (best in its area) | $200 a year | $150 a year | ▼down $50 |
| Over-the-counter items, yearly (best in its area) | $420 a year | $200 a year | ▼down $220 |
| Drug tier 3, preferred brand | 25% of the cost | 20% of the cost | ▼down 5 points |
| Drug tier 4, non-preferred drug | 40% of the cost | 25% of the cost | ▼down 15 points |
| Drug tier 5, specialty tier | 31% of the cost | 28% of the cost | ▼down 3 points |
| 8 lines do not change | |||
| Monthly premium | $0 | $0 to $45 | no change |
| Part B premium reduction, monthly (best in its area) | none | none | no change |
| Medical deductible, in network (best in its area) | none | none | no change |
| Ground ambulance, in network (best in its area) | $250 copay | $250 copay | no change |
| Hearing aids, yearly limit for both ears (best in its area) | not offered | not offered | no change |
| Counties served | 132 | 132 | no change |
| Drug tier 1, preferred generic | $13 | $13 | no change |
| Drug tier 2, generic | $20 | $20 | 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?
| Tier | What the tier holds | 2026, standard pharmacy | 2027, standard pharmacy | 2027, preferred pharmacy |
|---|---|---|---|---|
| Tier 1 | Preferred Generic | $13 | $13 | $0 |
| Tier 2 | Generic | $20 | $20 | $5 |
| Tier 3 | Preferred Brand | 25% of the cost | 20% of the cost | 20% of the cost |
| Tier 4 | Non-Preferred Drug | 40% of the cost | 25% of the cost | 25% of the cost |
| Tier 5 | Specialty Tier | 31% of the cost | 28% of the cost | 28% 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, 158 plans open to everyone are sold for 2027, this one included. Against the others, 92 plans have a lower out-of-pocket limit, 1 the same, 64 a higher one. On the premium, 100 the same, 57 a higher one.
Out-of-pocket limits of the 158 plans open to everyone
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?
| Monthly premium | Out-of-pocket limit | Where |
|---|---|---|
| $0 | $7,000 | Barbour (WV), Berkeley (WV), Boone (WV), Braxton (WV), Brooke (WV), Cabell (WV), Calhoun (WV), Clay (WV), Doddridge (WV), Fayette (WV), Gilmer (WV), Grant (WV), Greenbrier (WV), Hampshire (WV), Hancock (WV), Hardy (WV), Harrison (WV), Jackson (WV), Jefferson (WV), Kanawha (WV), Lewis (WV), Lincoln (WV), Logan (WV), Marion (WV), Marshall (WV), Mason (WV), McDowell (WV), Mercer (WV), Mineral (WV), Mingo (WV), Monongalia (WV), Monroe (WV), Morgan (WV), Nicholas (WV), Ohio (WV), Pendleton (WV), Pleasants (WV), Pocahontas (WV), Preston (WV), Putnam (WV), Raleigh (WV), Randolph (WV), Ritchie (WV), Roane (WV), Summers (WV), Taylor (WV), Tucker (WV), Tyler (WV), Upshur (WV), Wayne (WV), Webster (WV), Wetzel (WV), Wirt (WV), Wood (WV), Wyoming (WV) |
| $45 | $7,000 | Adams (OH), Allen (OH), Ashland (OH), Ashtabula (OH), Athens (OH), Auglaize (OH), Belmont (OH), Brown (OH), Butler (OH), Carroll (OH), Champaign (OH), Clark (OH), Clermont (OH), Clinton (OH), Columbiana (OH), Coshocton (OH), Crawford (OH), Cuyahoga (OH), Darke (OH), Delaware (OH), Fairfield (OH), Fayette (OH), Franklin (OH), Fulton (OH), Gallia (OH), Geauga (OH), Greene (OH), Guernsey (OH), Hardin (OH), Harrison (OH), Henry (OH), Highland (OH), Hocking (OH), Holmes (OH), Jackson (OH), Jefferson (OH), Knox (OH), Lake (OH), Lawrence (OH), Licking (OH), Logan (OH), Lorain (OH), Madison (OH), Mahoning (OH), Medina (OH), Meigs (OH), Mercer (OH), Miami (OH), Monroe (OH), Montgomery (OH), Morgan (OH), Morrow (OH), Muskingum (OH), Noble (OH), Ottawa (OH), Paulding (OH), Perry (OH), Pickaway (OH), Pike (OH), Portage (OH), Preble (OH), Putnam (OH), Richland (OH), Ross (OH), Scioto (OH), Seneca (OH), Shelby (OH), Stark (OH), Summit (OH), Trumbull (OH), Tuscarawas (OH), Van Wert (OH), Vinton (OH), Warren (OH), Washington (OH), Wayne (OH), Wyandot (OH) |
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
Which 2026 plans move into it, and what changes for their members?
For 2027 this plan takes in the members of 1 other plan, beside its own 5,437 members. In 2027 it costs $0 to $45 a month with a $7,000 limit; each row compares that with the plan its members had in 2026.
| 2026 plan | Members, Sept. 2026 | Members who move | Premium 2026 | Premium change | Limit 2026 | Limit change |
|---|---|---|---|---|---|---|
| The Health Plan SecureChoice: Option IIH8604-011 | 400 | 238 | $109 | ▼down $109 | $6,700 | ▲up $300 |
Source: CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11); CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision). Each moving plan's own page lists every line that changes for its members.
Who runs this plan?
- Plan ID
- H8604-014
- Legal name of the contract
- Thp Insurance Company
- Sold as
- The Health Plan
- Parent company
- The Health Plan of West Virginia, Inc.
- Plan type
- PPO
- 2026 star rating of the contract
- 3.5 of 5 overall; health plan 3.5 of 5, drug plan 3.5 of 5
- Members, September 2026
- 5,437
- Plan website, as filed with CMS
- www.healthplan.org/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?
- Other 2027 plans in Coshocton, OHWhere most of its members live; premiums and limits side by side
- Every The Health Plan plan for 2027Its contracts, counties and plans that end
- The other 1 plan of contract H8604Same 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.