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Martin's Point Generations Advantage Alliance (HMO) Medicare Advantage Plan H5591-003 • 2027 • Somerset County, ME

CMS Rating: ☆☆☆☆☆ (3.5 out of 5 stars*)
Monthly Premium
$0.00Plus Part B premium.
Medical Deductible
$0.00
Maximum Out-of-Pocket
$5000.00In-network
Part B Giveback
−$50.00 reduction
Prescription Coverage
Not Included
Additional Benefits
Dental, Vision, Hearing
Service Area
Somerset County, ME
Local Enrollment
329 beneficiaries in Somerset County
Last update:

Martin's Point Generations Advantage Alliance (HMO) Introduction

This Medicare Advantage HMO plan, Martin's Point Generations Advantage Alliance, is offered by Martin's Point Generations Advantage and uses a Health Maintenance Organization (HMO) provider network. It comes without prescription drug coverage. For the 2027 plan year, the monthly premium is $0.00, the medical deductible is $0.00, and the in-network maximum out-of-pocket is $5000.00. The plan is identified by CMS Plan ID H5591-003.

Qualifying residents of Somerset County, Maine may enroll in this plan. CMS enrollment data reports 329 plan members in Somerset County. New members can call the plan directly at (888)618-2049 (TTY 711) for assistance.

Compare Similar Plans in Somerset County

Compare this plan with the two most-enrolled HMO plans available in Somerset County, Maine. Enrollment is based on CMS local enrollment data.

HMO plan comparison for Somerset County, Maine
Plan Detail Martin's Point Generations Advantage Alliance Anthem I MaineHealth Advantage Plus Humana Gold Plus H5619-001
CMS Plan ID H5591-003-0 H9065-008-0 H5619-001-0
Local Enrollment 329 619 358
Monthly Premium $0.00 $33.00 $0.00
Medical Deductible $0.00 $0.00 $0.00
Maximum Out-of-Pocket $5,000.00 $6,800.00 $7,150.00
Part B Giveback −$50.00 reduction Not offered Not offered
Primary Care $0 copay $0 copay $0 copay
Specialist $15 copay $50 copay $60 copay
Part D Deductible Not Applicable $235.00 $700.00
CMS Star Rating 3.5 3.5 4.0
Dental $0 copay Not covered $0 copay
Vision $0 copay $0 copay $0 copay
Hearing Not covered $0 copay $0 copay

Plan Benefits

Cost-sharing for Martin's Point Generations Advantage Alliance 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 H5591-003.

You can also compare 2027 costs and coverage with last year, side-by-side: Plan H5591-003-0 Cost Compare.

Office Visits

Primary care
In-network: $0 copay
Specialist
In-network: $15 copay

Preventive and Wellness Services

Annual wellness exam
In-network: $0 copay
Telehealth benefit
In-network: $0-$15 copay
Routine chiropractic
In-network: $20 copay
Fitness benefits
Coming soon
Health education
Not covered
Counseling services
In-network: $0 copay
Over-the-counter drug benefits
In-network: $0 copay
Health transportation (non-emergency)
Coming soon

Diagnostic, Lab, and Imaging Services

Diagnostic radiology services
In-network: 20% coinsurance
Lab services
In-network: $0-$5 copay, 0%-20% coinsurance
Outpatient x-rays
In-network: 5% coinsurance
Diagnostic tests and procedures
In-network: 0%-5% coinsurance

Emergency and Urgent Care Services

Emergency room care
$125 copay
Worldwide emergency care
Coming soon
Urgent care
$0 copay
Inpatient hospital care
Tier 1
$350 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Skilled Nursing Facility
Tier 1
$10 per day for days 1-20
$221 per day for days 21-100
Ground ambulance
In-network: $325 copay

Mental Health Services

Outpatient individual therapy
In-network: $0 copay
Outpatient group therapy
In-network: $0 copay
Inpatient psychiatric hospital care
Tier 1
$350 per day for days 1-5
$0 per day for days 6-90
$0 per stay

Rehabilitation Services

Physical therapy and speech and language therapy
In-network: $0 copay
Occupational therapy
In-network: $0 copay

Medical Equipment and Supplies

Diabetes supplies
In-network: $0 copay
Durable medical equipment
In-network: 10% coinsurance
Prosthetics
In-network: 10% coinsurance

Medicare Part B Drugs

Chemotherapy
In-network: 0%-20% coinsurance
Other Part B drugs (Medicare-covered)
In-network: 0%-20% coinsurance

Dental Services

Oral exam
In-network: $0 copay
Dental x-rays
In-network: $0 copay
Cleaning
In-network: $0 copay
Periodontics
In-network: 20% coinsurance
Endodontics
In-network: 20% coinsurance
Restorative services
In-network: 50% coinsurance
Implant services
Not covered
Orthodontics
Not covered
Oral/Maxillofacial surgery
In-network: 50% coinsurance

Vision Services

Routine eye exam
In-network: $0 copay
Contact lenses
In-network: $0 copay
Eyeglass frames only
In-network: $0 copay
Eyeglass lenses only
In-network: $0 copay
Eyeglasses (frames & lenses)
In-network: $0 copay
Upgrades
In-network: $0 copay

Hearing Services

Hearing exam
Not covered
Fitting/evaluation
In-network: $0 copay
Prescription hearing aids
In-network: $0 copay
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
In-network: $0 copay
Wigs for chemotherapy-related hair loss
Coming soon
Alternative therapies
In-network: $0 copay
Massage therapy
Not covered
Home/bathroom safety devices
In-network: $0 copay

Certain preventive services are covered 100% by Martin's Point Generations Advantage Alliance as a Part B benefit.

Prescription Drug Coverage

This plan does not include a Medicare Part D plan for prescriptions.

CMS 5-Star Performance Ratings (Contract ID: H5591)

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.

2027 Medicare Star Ratings for Contract H5591
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 Martin's Point Generations Advantage

Website
Martin's Point Generations Advantage Plan Page
Providers
Martin's Point Generations Advantage Providers Page
Formulary
Martin's Point Generations Advantage Formulary Page
Pharmacy
Martin's Point Generations Advantage Pharmacy Page
New Member Health Plan Help
(888)618-2049
New Member Health Plan TTY
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
Primary CMS datasets used for this Medicare Advantage Plan resource.
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.

Official plan information and secondary Medicare references.
Publisher Reference Last Accessed
Martin's Point Generations Advantage (official source) http://www.martinspoint.org/medicare 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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Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.