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

NaviCare NHC, 2027

H8928Contract001Plan

HMO D-SNP · special needs plan, dual-eligible · 12 counties in Massachusetts

Run by Fallon Community Health Plan (contract H8928), sold as Fallon Health, owned by Fallon Community Health Plan, Inc.

Renews, split in two

2026 star rating, contract H8928: 4 of 5

NaviCare NHC (H8928-001) costs $25.20 a month in 2027, down $6 from 2026, with an in-network out-of-pocket limit of $9,850 ($7,550 in 2026). In 2026 it was called NaviCare. Some of its 2026 members move to H8928-002 instead (CMS crosswalk).

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
Plan name	NaviCare	NaviCare NHC	renamed
Monthly premium	$31.20	$25.20	down $6
In-network out-of-pocket limit	$7,550	$9,850	up $2,300
Drug deductible	$615	$700	up $85
13 lines do not change
Part B premium reduction, monthly	none	none	no change
Primary care visit	20% of the cost	20% of the cost	no change
Specialist visit	20% of the cost	20% of the cost	no change
Emergency room	20% of the cost	20% of the cost	no change
Medical deductible, in network	none	none	no change
Hospital stay, in network	not filed	not filed	no change
Skilled nursing facility, in network	not filed	not filed	no change
Ground ambulance, in network	20% of the cost	20% of the cost	no change
Comprehensive dental, yearly limit	not offered	not offered	no change
Eyewear, yearly limit	$403 a year	$403 a year	no change
Hearing aids, yearly limit for both ears	not offered	not offered	no change
Over-the-counter items, yearly	$1,500 a year	$1,500 a year	no change
Counties served	12	12	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.

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, 2 plans have a lower out-of-pocket limit, 14 the same. On the premium, 10 plans have a lower premium, 6 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 12 counties: $25.20 a month and $9,850.

Massachusetts

Barnstable Berkshire Bristol Essex Franklin Hampden Hampshire Middlesex Norfolk Plymouth Suffolk Worcester

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Where do its 2026 members go?

The CMS crosswalk moves the members of the 2026 plan into 2 plans for 2027. It names the plans but not which member goes to which; the counties show where each 2027 plan is sold, and the plan's Annual Notice of Change says which one is yours.

2027 plan	Sold in	Members in those counties, Sept. 2026	Premium 2027	Limit 2027
Stays in this plan	12 of its 12 2026 counties, in Massachusetts	10,095	$25.20	$9,850
NaviCareH8928-002	12 of its 12 2026 counties, in Massachusetts	10,095	$22.70	$9,850

Where the plans are sold in the same counties, the member counts overlap, so they add up to more than the plan's members.

Source: CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026); CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11).

Who runs this plan?

Plan ID: H8928-001
Legal name of the contract: Fallon Community Health Plan
Sold as: Fallon Health
Parent company: Fallon Community Health Plan, Inc.
Plan type: HMO D-SNP
2026 star rating of the contract: 4 of 5 overall; health plan 4 of 5, drug plan 4 of 5
Members, September 2026: 10,114
Plan website, as filed with CMS: fallonhealth.org/navicare

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 Worcester, MAWhere most of its members live; premiums and limits side by side
Every Fallon Health plan for 2027Its contracts, counties and plans that end
The other 1 plan of contract H8928Same 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.