Network Health Cares (PPO D-SNP) (2027)

Dual Special Needs Plan (Medicare Advantage) from Network Health Medicare Advantage Plans, plan ID H5215-007-000. Sold in 24 counties in Wisconsin.

★★★★★4.0

Who can join

Only for people who have both Medicare and Medicaid.

2027 costs

Monthly premium$6.30

Drug deductible$700

Medical deductible$0

Out-of-pocket maximum (in network)$9,850

Plan typeDual Special Needs Plan (Medicare Advantage), PPO

Referral needed to see a specialistNo

Plan IDH5215-007-000

With a Medicare Advantage plan you also keep paying your Medicare Part B premium, unless Medicaid pays it for you.

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 visit20%

Specialist visit20%

Preventive care$0

Urgent care20%

Emergency room20%

Hospital stay$0

Outpatient surgery20%

Lab tests20%

X-rays and scans20%

Mental health visit20%

Physical therapy20%

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 $400/yr allowance

HearingCovered — up to $75/yr allowance

Over-the-counter itemsCovered — up to $192/quarter allowance

FitnessCovered

Rides to appointmentsCovered — 52 one-way trips/yr

Drug costs by tier

Tier	30 days, standard pharmacy	30 days, preferred pharmacy	90 days by mail
1 Preferred Generic	25% (max $5.80)	25% (max $5.80)	25% (max $5.80)
2 Generic	25% (max $14.40)	25% (max $14.40)	25% (max $14.40)
3 Preferred Brand	25% (max $14.40)	25% (max $14.40)	25% (max $14.40)
4 Non-Preferred Brand	25% (max $14.40)	25% (max $14.40)	25% (max $14.40)
5 Specialty	25% (max $14.40)	25% (max $14.40)	25% (max $14.40)

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.

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.