Health New England Medicare Premium No Rx (HMO) Medicare Advantage Plan H8578-003 • 2027 • Hampshire County, MA
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $4500.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Not Included
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Hampshire County, MA
- Local Enrollment
- 21 beneficiaries in Hampshire County
Health New England Medicare Premium No Rx (HMO) Introduction
CMS Plan ID H8578-003 identifies Health New England Medicare Premium No Rx, a Medicare Advantage HMO plan offered by Health New England Medicare Advantage Plans. The plan uses a Health Maintenance Organization (HMO) provider network and comes without prescription drug coverage. Its costs for the 2027 plan year include a $0.00 monthly premium, $0.00 medical deductible, and $4500.00 in-network maximum out-of-pocket.
This plan is available to eligible beneficiaries who live in Hampshire County, Massachusetts. CMS reports local enrollment of 21 beneficiaries for this plan in Hampshire County. New members can contact the plan at (877)443-3314 (TTY 711) for help and additional plan information.
Compare Similar Plans in Hampshire County
Compare this plan with the two most-enrolled HMO plans available in Hampshire County, Massachusetts. Enrollment is based on CMS local enrollment data.
| Plan Detail | Health New England Medicare Premium No Rx | Health New England Medicare Value | Health New England Medicare Plus |
|---|---|---|---|
| CMS Plan ID | H8578-003-0 |
H8578-012-0 |
H8578-004-0 |
| Local Enrollment | 21 | 840 | 461 |
| Monthly Premium | $0.00 | $15.00 | $138.00 |
| Medical Deductible | $0.00 | $0.00 | $0.00 |
| Maximum Out-of-Pocket | $4,500.00 | $9,000.00 | $5,500.00 |
| Part B Giveback | Not offered | Not offered | Not offered |
| Primary Care | $0 copay | $20 copay | $20 copay |
| Specialist | $20 copay | $50 copay | $40 copay |
| Part D Deductible | Not Applicable | $490.00 | $350.00 |
| CMS Star Rating | Not yet rated | Not yet rated | Not yet rated |
| Dental | $0 copay | $0 copay | $0 copay |
| Vision | $0 copay | $0 copay | $0 copay |
| Hearing | $0 copay | $0 copay | $0 copay |
Plan Benefits
Health New England Medicare Premium No Rx has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The tables below detail the most common in-network out-of-pocket expenses for plan H8578-003.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H8578-003-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
- Specialist
- In-network: $20 copay
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
- Telehealth benefit
- In-network: $0-$20 copay
- Routine chiropractic
- Not covered
- Fitness benefits
- Coming soon
- Health education
- Not covered
- Counseling services
- Not covered
- 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: $0-$175 copay
- Lab services
- In-network: $0 copay
- Outpatient x-rays
- In-network: $20 copay
- Diagnostic tests and procedures
- In-network: $0 copay
Emergency and Urgent Care Services
- Emergency room care
- $130 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $50 copay
- Inpatient hospital care
- Tier 1
$150 per day for days 1-6
$0 per day for days 7-90
$0 per stay - Skilled Nursing Facility
- Tier 1
$0 per day for days 1-20
$150 per day for days 21-50
$0 per day for days 51-100 - Ground ambulance
- In-network: $340 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $20 copay
- Outpatient group therapy
- In-network: $20 copay
- Inpatient psychiatric hospital care
- Tier 1
$150 per day for days 1-6
$0 per day for days 7-90
$0 per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $20 copay
- Occupational therapy
- In-network: $20 copay
Medical Equipment and Supplies
- Diabetes supplies
- In-network: $0 copay
- Durable medical equipment
- In-network: 20% coinsurance
- Prosthetics
- In-network: 20% 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: $0 copay
- Endodontics
- In-network: $0 copay
- Restorative services
- In-network: $0 copay
- Implant services
- In-network: $0 copay
- Orthodontics
- In-network: $0 copay
- Oral/Maxillofacial surgery
- In-network: $0 copay
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
- In-network: $0 copay
- Fitting/evaluation
- In-network: $0 copay
- Prescription hearing aids
- In-network: $499-$999 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
- Not covered
- Massage therapy
- Not covered
- Home/bathroom safety devices
- Not covered
Certain preventive services are covered 100% by Health New England Medicare Premium No Rx 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: H8578)
The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage (Part C) and Part D prescription drug plans each year using a 5-star system. These ratings measure plan performance in areas such as preventive care, management of chronic conditions, 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 Health New England Medicare Advantage Plans
- Website
- Health New England Medicare Advantage Plans Plan Page
- Providers
- Health New England Medicare Advantage Plans Providers Page
- Formulary
- Health New England Medicare Advantage Plans Formulary Page
- Pharmacy
- Health New England Medicare Advantage Plans Pharmacy Page
- New Member Health Plan Help
- (877)443-3314
- 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
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | October 5, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Health New England Medicare Advantage Plans (official source) | http://www.healthnewengland.org/medic | October 4, 2026 |
| Medicare.gov | Compare types of Medicare Advantage Plans | 25 May, 2025 |
| NCOA.org | 5 Steps to Choosing the Right Medicare Plan for You | 25 May, 2025 |
| Medicare.gov | Compare Original Medicare & Medicare Advantage | 25 May, 2025 |
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