PruittHealth Premier Advantage (HMO I-SNP) (2027)

Institutional Special Needs Plan (Medicare Advantage) from PruittHealth Premier, plan ID H3291-003-000. Sold in 118 counties in Georgia.

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Who can join

Only for people who live in a nursing home or similar facility, or need that level of care at home.

2027 costs

Monthly premium$0

Drug deductible$350

Medical deductible$0

Out-of-pocket maximum (in network)$5,900

Plan typeInstitutional Special Needs Plan (Medicare Advantage), HMO

Referral needed to see a specialistYes

Plan IDH3291-003-000

With a Medicare Advantage plan you also keep paying your Medicare Part B premium.

What this plan would cost for your prescriptions

Add your prescriptions to see this plan's estimated yearly cost for them, which of them are on its drug list, and how each compares with Cost Plus Drugs prices.

See this plan with my prescriptions

What you pay for medical care

Primary care visit$0

Specialist visit$15

Preventive care$0

Urgent care$35

Emergency room$100

Hospital stay$311/day

Outpatient surgery$40–$298

Lab tests$95

X-rays and scans$95

Mental health visit$10

Physical therapy$15

Medical equipment20%

TelehealthCovered

In-network amounts. A range means it depends on the service or provider.

Extra benefits

DentalCovered — up to $3000 allowance

VisionCovered — up to $500/yr allowance

HearingCovered — up to $2500 every 2 yrs allowance

Over-the-counter itemsCovered

FitnessCovered

Rides to appointmentsCovered — 36 one-way trips/yr

Drug costs by tier

Tier	30 days, standard pharmacy	30 days, preferred pharmacy	90 days by mail
1 Preferred Generic	$0	$0	$0
2 Generic	$7	$7	$21
3 Preferred Brand	25%	25%	25%
4 Non-Preferred Drug	25%	25%	25%
5 Specialty Tier	29%	29%	N/A

A percentage is coinsurance: your share of the drug's price. The drug deductible may apply first, depending on the tier. Your Part D out-of-pocket costs are capped at $2,400 for 2027.

Where it's sold

Georgia (118 counties)

Plan costs and benefits are from CMS's 2027 Medicare plan data (data as of October 27, 2026). Star ratings are CMS's 2027 Star Ratings. Every year, Medicare evaluates plans based on a 5-star rating system. Benefits, premiums and copays can change from year to year; check the plan's Evidence of Coverage, call the plan, or use Medicare.gov before you enroll.