Trinity Health Plan of Michigan Cash Back (HMO) Medicare Advantage Plan H9179-002 • 2027 • Lake County, MI
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $635
- Maximum Out-of-Pocket
- $9850.00In-network
- Part B Giveback
- −$145.00 reduction
- Prescription Coverage
- Enhanced, $375.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Lake County, MI
- Local Enrollment
- 15 beneficiaries in Lake County
Trinity Health Plan of Michigan Cash Back (HMO) Introduction
Trinity Health Plan of Michigan Cash Back is a Medicare Advantage HMO plan offered by Trinity Health Plan of Michigan. It uses a Health Maintenance Organization (HMO) provider network and comes with prescription drug coverage. For the 2027 plan year it has a $0.00 monthly premium, $635 medical deductible, and $9850.00 in-network maximum out-of-pocket. CMS Plan ID H9179-002 identifies this plan. The 2027 Part D prescription drug deductible is $375.00.
You must live in Lake County, Michigan to enroll in this plan. CMS reports 15 beneficiaries enrolled in this plan in Lake County. For assistance with this plan, new members can call (800)964-4525 (TTY 711).
Compare Similar Plans in Lake County
Compare this plan with the two most-enrolled HMO plans available in Lake County, Michigan. Enrollment is based on CMS local enrollment data.
| Plan Detail | Trinity Health Plan of Michigan Cash Back | HAP Medicare Superior | Trinity Health Plan of Michigan No Premium |
|---|---|---|---|
| CMS Plan ID | H9179-002-0 |
H2354-028-0 |
H9179-001-0 |
| Local Enrollment | 15 | 25 | 14 |
| Monthly Premium | $0.00 | $0.00 | $0.00 |
| Medical Deductible | $635 | $0.00 | $0.00 |
| Maximum Out-of-Pocket | $9,850.00 | $5,800.00 | $6,500.00 |
| Part B Giveback | −$145.00 reduction | Not offered | Not offered |
| Primary Care | $0 copay | $0 copay | $0 copay |
| Specialist | $50 copay | $40 copay | $40 copay |
| Part D Deductible | $375.00 | $200.00 | $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
Trinity Health Plan of Michigan Cash Back 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 H9179-002.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H9179-002-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
- Specialist
- In-network: $50 copay
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
- Telehealth benefit
- In-network: $0-$50 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: $495 copay
- Lab services
- In-network: $0 copay
- Outpatient x-rays
- In-network: $40 copay
- Diagnostic tests and procedures
- In-network: $40 copay
Emergency and Urgent Care Services
- Emergency room care
- $115 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $40 copay
- Inpatient hospital care
- Tier 1
$450 per day for days 1-5
$0 per day for days 6-90
$0 per stay - Skilled Nursing Facility
- Tier 1
$0 per day for days 1-20
$221 per day for days 21-65
$0 per day for days 66-100 - Ground ambulance
- In-network: $300 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $40 copay
- Outpatient group therapy
- In-network: $40 copay
- Inpatient psychiatric hospital care
- Tier 1
$450 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: $35 copay
- Occupational therapy
- In-network: $35 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
- 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
- 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
- Not covered
Hearing Services
- Hearing exam
- In-network: $0 copay
- Fitting/evaluation
- In-network: $0 copay
- Prescription hearing aids
- In-network: $599-$899 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
- 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 Trinity Health Plan of Michigan Cash Back as a Part B benefit.
Prescription Drug Coverage
Trinity Health Plan of Michigan Cash Back 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: | ($12.80) |
| Supplemental Part D Premium: | $$12.80 |
| Total Part D Premium: | $0.00 |
| Low-Income Premium Subsidy: | $6.28 |
| Low-Income Premium Subsidy Paid by CMS: | $0.00 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program .
Prescription Drug Plan Deductible
This plan has a $375.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Trinity Health Plan of Michigan starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Trinity Health Plan of Michigan Cash Back 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 | $0.00 copay | Coming soon |
| Preferred Brand | 15% coinsurance | Coming soon |
| Non-Preferred Drug | 25% coinsurance | Coming soon |
| Specialty Tier | 25% coinsurance | Coming soon |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H9179)
Medicare Advantage (Part C) and Part D plans are rated each year by CMS on a 5-star scale. Ratings summarize plan performance across clinical care and member experience measures.
| CMS Measure | Star Rating |
|---|---|
| 2027 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | Plan too new to be measured |
| Managing Chronic (Long Term) Conditions | Plan too new to be measured |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | Plan too new to be measured |
| 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 Trinity Health Plan of Michigan
- Website
- Trinity Health Plan of Michigan Plan Page
- Providers
- Trinity Health Plan of Michigan Providers Page
- Formulary
- Trinity Health Plan of Michigan Formulary Page
- Pharmacy
- Trinity Health Plan of Michigan Pharmacy Page
- New Member Health Plan Help
- (800)964-4525
- New Member Health Plan TTY
- 711
- New Member Part D Help
- (800)964-4525
- 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 | 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 |
|---|---|---|
| Trinity Health Plan of Michigan (official source) | http://www.thpmedicare.org/michigan | October 4, 2026 |
| Medicare.gov | Understanding Medicare Advantage Plans | 25 May, 2025 |
| NCOA.org | 5 Steps to Choosing the Right Medicare Plan for You | 25 May, 2025 |
| Medicare.gov | Explore your Medicare coverage options | 25 May, 2025 |
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