Aspire Health Plus (HMO-POS) Medicare Advantage Plan H8764-002 • 2027 • Monterey County, CA
- Monthly Premium
- $382.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $4350.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Enhanced, $250.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Monterey County, CA
- Local Enrollment
- 614 beneficiaries in Monterey County
Aspire Health Plus (HMO-POS) Introduction
This Medicare Advantage HMO-POS plan, Aspire Health Plus, is offered by Aspire Health and uses a Health Maintenance Organization with a Point of Service (HMO-POS) provider network. It comes with prescription drug coverage. For the 2027 plan year, the monthly premium is $382.00, the medical deductible is $0.00, and the in-network maximum out-of-pocket is $4350.00. The plan is identified by CMS Plan ID H8764-002. The 2027 Part D prescription drug deductible is $250.00.
Qualifying residents of Monterey County, California may enroll in this plan. CMS enrollment data reports 614 plan members in Monterey County. New members can call the plan directly at (888)608-8995 (TTY 711) for assistance.
Compare Similar Plans in Monterey County
No other HMO-POS plans are available in Monterey County, California using the same plan-type comparison criteria.
Plan Benefits
Cost-sharing for Aspire Health Plus includes out-of-pocket expenses for covered healthcare services. The following tables provide a summary of typical in-network out-of-pocket costs for plan H8764-002.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H8764-002-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
Out-of-network: 30% coinsurance - Specialist
- In-network: $20 copay
Out-of-network: 30% coinsurance
Preventive and Wellness Services
- Annual wellness exam
- Not covered
- Telehealth benefit
- In-network: $0 copay
- Routine chiropractic
- In-network: $0 copay
- Fitness benefits
- Coming soon
- Health education
- In-network: $0 copay
- Counseling services
- Not covered
- Over-the-counter drug benefits
- Not covered
- Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: $30-$100 copay
Out-of-network: 30% coinsurance - Lab services
- In-network: $0 copay
Out-of-network: 30% coinsurance - Outpatient x-rays
- In-network: $0 copay
Out-of-network: 30% coinsurance - Diagnostic tests and procedures
- In-network: $0 copay
Out-of-network: 30% coinsurance
Emergency and Urgent Care Services
- Emergency room care
- $130 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $0 copay
- Inpatient hospital care
- In-network:
Tier 1
$600 per day for days 1-2
$250 per day for days 3-4
$0 per day for days 5-90
$0 per stay
Out-of-network:
30% per day for days 1-90
30% per stay - Skilled Nursing Facility
- In-network:
Tier 1
$0 per day for days 1-20
$160 per day for days 21-100
Out-of-network:
30% per day for days 1-100
30% per stay - Ground ambulance
- In-network: $350 copay
Out-of-network: $350 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $0 copay
Out-of-network: 30% coinsurance - Outpatient group therapy
- In-network: $0 copay
Out-of-network: 30% coinsurance - Inpatient psychiatric hospital care
- In-network:
Tier 1
$600 per day for days 1-2
$250 per day for days 3-4
$0 per day for days 5-90
$0 per stay
Out-of-network:
30% per day for days 1-90
30% per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $0 copay
Out-of-network: 30% coinsurance - Occupational therapy
- In-network: $0 copay
Out-of-network: 30% coinsurance
Medical Equipment and Supplies
- Diabetes supplies
- In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance - Durable medical equipment
- In-network: 20% coinsurance
Out-of-network: 30% coinsurance - Prosthetics
- In-network: 20% coinsurance
Out-of-network: 30% coinsurance
Medicare Part B Drugs
- Chemotherapy
- In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance - Other Part B drugs (Medicare-covered)
- In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance
Dental Services
- Oral exam
- Not covered
- Dental x-rays
- Not covered
- Cleaning
- Not covered
- Periodontics
- Not covered
- Endodontics
- Not covered
- Restorative services
- Not covered
- Implant services
- Not covered
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- Not covered
Vision Services
- Routine eye exam
- Not covered
- Contact lenses
- Not covered
- Eyeglass frames only
- Not covered
- Eyeglass lenses only
- Not covered
- Eyeglasses (frames & lenses)
- Not covered
- Upgrades
- Not covered
Hearing Services
- Hearing exam
- Not covered
- Fitting/evaluation
- Not covered
- Prescription hearing aids
- Not covered
- OTC hearing aids
- Not covered
Additional and Special Needs Services
- Adult day health services
- Not covered
- Home-based palliative care
- Not covered
- Personal emergency response system
- Coming soon
- Weight management programs
- Not covered
- Wigs for chemotherapy-related hair loss
- Coming soon
- Alternative therapies
- Not covered
- Massage therapy
- Not covered
- Home/bathroom safety devices
- Not covered
Certain preventive services are covered 100% by Aspire Health Plus as a Part B benefit.
Prescription Drug Coverage
Aspire Health Plus includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.
This plan includes an enhanced benefit Medicare Part D plan (PDP), providing coverage beyond the standard CMS-defined minimum.
Prescription Drug Plan Premium
The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.
| Part D Premium Component | Amount |
|---|---|
| Basic Part D Premium: | $48.70 |
| Supplemental Part D Premium: | $$31.20 |
| Total Part D Premium: | $79.90 |
| Low-Income Premium Subsidy: | $7.28 |
| Low-Income Premium Subsidy Paid by CMS: | $7.30 |
| Low-Income Subsidy Premium: | $72.60 |
For more details, visit the Social Security Extra Help program .
Prescription Drug Plan Deductible
This plan has a $250.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Aspire Health starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Aspire Health Plus may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | Coming soon |
| Generic | $10.00 copay | Coming soon |
| Preferred Brand | $45.00 copay | Coming soon |
| Non-Preferred Drug | 25% coinsurance | Coming soon |
| Specialty Tier | 30% coinsurance | Coming soon |
| Select Care Drugs | $0.00 copay | Coming soon |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H8764)
CMS evaluates Medicare Advantage (Part C) and Part D plans annually using a 5-star rating system. Ratings reflect performance in preventive care, chronic condition management, and member experience.
| CMS Measure | Star Rating |
|---|---|
| 2027 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
Contact Information for Aspire Health
- Website
- Aspire Health Plan Page
- Providers
- Aspire Health Providers Page
- Formulary
- Aspire Health Formulary Page
- Pharmacy
- Aspire Health Pharmacy Page
- New Member Health Plan Help
- (888)608-8995
- New Member Health Plan TTY
- 711
- New Member Part D Help
- (888)608-8995
- New Member Part D TTY Users
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | CMS Version |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | CY2027 Landscape (202609.1) |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | 2027 Star Ratings Data Tables |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | PBP Benefits-2027 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | 2026-09 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Aspire Health (official source) | http://www.aspirehealthplan.org | October 4, 2026 |
| CMS.gov | Medicare Advantage Plan Fact Sheet | 25 May, 2025 |
| AARP.org | The Big Choice: Original Medicare vs. Medicare Advantage | 25 May, 2025 |
| Medicare.gov | Your coverage options | 25 May, 2025 |
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