Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
Jefferson Health Plans Elite, 2027
H9207Contract018Plan
HMO · 8 counties in New Jersey
Run by Health Partners Plans, Inc. (contract H9207), sold as Jefferson Health Plans, owned by Thomas Jefferson University
Jefferson Health Plans Elite (H9207-018) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $9,850 ($6,000 in 2026).
What changes from 2026 to 2027?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| In-network out-of-pocket limit | $6,000 | $9,850 | ▲up $3,850 |
| Specialist visit | $0 copay | $20 copay | ▲up $20 |
| Hospital stay, in network | $450 a stay | $300 a day for days 1–5, then $0 a day for days 6–90 | changed |
| Over-the-counter items, yearly | $500 a year | not offered | ▼dropped |
| Drug tier 4, non-preferred drug | 34% of the cost | 30% of the cost | ▼down 4 points |
| 16 lines do not change | |||
| Monthly premium | $0 | $0 | no change |
| Drug deductible | $0 | $0 | no change |
| Part B premium reduction, monthly | none | none | no change |
| Primary care visit | $0 copay | $0 copay | no change |
| Emergency room | $100 copay | $100 copay | no change |
| Medical deductible, in network | none | none | no change |
| Skilled nursing facility, in network | $0 a day for days 1–20, then $185 a day for days 21–100 | $0 a day for days 1–20, then $185 a day for days 21–100 | no change |
| Ground ambulance, in network | $210 copay | $210 copay | no change |
| Comprehensive dental, yearly limit | not offered | not offered | no change |
| Eyewear, yearly limit | not offered | not offered | no change |
| Hearing aids, yearly limit for both ears | not offered | not offered | no change |
| Counties served | 8 | 8 | no change |
| Drug tier 1, preferred generic | $0 | $0 | no change |
| Drug tier 2, 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 |
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 | 2027 |
|---|---|---|---|
| Tier 1 | Preferred Generic | $0 | $0 |
| Tier 2 | Generic | $0 | $0 |
| Tier 3 | Preferred Brand | 25% of the cost | 25% of the cost |
| Tier 4 | Non-Preferred Drug | 34% of the cost | 30% of the cost |
| Tier 5 | Specialty Tier | 33% of the cost | 33% 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, 52 plans open to everyone are sold for 2027, this one included. Against the others, 24 plans have a lower out-of-pocket limit, 27 the same. On the premium, 28 the same, 23 a higher one.
Out-of-pocket limits of the 52 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?
The premium and the out-of-pocket limit are the same in all 8 counties: $0 a month and $9,850.
New Jersey
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
- H9207-018
- Legal name of the contract
- Health Partners Plans, Inc.
- Sold as
- Jefferson Health Plans
- Parent company
- Thomas Jefferson University
- Plan type
- HMO
- 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
- 1,744
- Plan website, as filed with CMS
- JeffersonHealthPlans.com/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 Camden, NJWhere most of its members live; premiums and limits side by side
- Every Jefferson Health Plans plan for 2027Its contracts, counties and plans that end
- The other 6 plans of contract H9207Same 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.