TotalCare (HMO D-SNP) (2027)

Dual Special Needs Plan (Medicare Advantage) from Central California Alliance for Health, plan ID H5692-001-000. Sold in 5 counties in California.

★★★★★Not yet rated

Who can join

Only for people who have both Medicare and Medicaid.

2027 costs

Monthly premium$7.30
Drug deductible$700
Medical deductible$0
Out-of-pocket maximum (in network)$9,850
Plan typeDual Special Needs Plan (Medicare Advantage), HMO
Referral needed to see a specialistYes
Plan IDH5692-001-000

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%
TelehealthNot covered

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

Extra benefits

DentalNot covered
VisionCovered — up to $200 every 2 yrs allowance
HearingNot covered
Over-the-counter itemsCovered — up to $100/quarter allowance
FitnessNot covered
Rides to appointmentsNot covered

Drug costs by tier

Tier30 days, standard pharmacy30 days, preferred pharmacy90 days by mail
1 Preferred Generic25%25%25%
2 Generic25%25%25%
3 Preferred Brand25%25%25%
4 Non-Preferred Drug25%25%25%
5 Specialty Tier25%25%N/A
6 Select Care Drugs$0$0$0

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.