Prominence Meridian (HMO-POS) Medicare Advantage Plan H5945-036 • 2027 • Washoe County, NV
- Monthly Premium
- $159.00Plus Part B premium.
- Medical Deductible
- $500
- Maximum Out-of-Pocket
- $3000.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Enhanced, $350.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Washoe County, NV
- Local Enrollment
- 0 beneficiaries in Washoe County
Prominence Meridian (HMO-POS) Introduction
CMS Plan ID H5945-036 identifies Prominence Meridian, a Medicare Advantage HMO-POS plan offered by Prominence Health Plan. The plan uses a Health Maintenance Organization with a Point of Service (HMO-POS) provider network and comes with prescription drug coverage. Its costs for the 2027 plan year include a $159.00 monthly premium, $500 medical deductible, and $3000.00 in-network maximum out-of-pocket. The 2027 Part D prescription drug deductible is $350.00.
This plan is available to eligible beneficiaries who live in Washoe County, Nevada. CMS reports local enrollment of 0 beneficiaries for this plan in Washoe County. New members can contact the plan at (855)969-5882 (TTY 711) for help and additional plan information.
Compare Similar Plans in Washoe County
Compare this plan with the two most-enrolled HMO-POS plans available in Washoe County, Nevada. Enrollment is based on CMS local enrollment data.
| Plan Detail | Prominence Meridian | AARP Medicare Advantage from UHC NV-0006 | AARP Medicare Advantage from UHC NV-0003 |
|---|---|---|---|
| CMS Plan ID | H5945-036-0 |
H0609-040-0 |
H0609-033-0 |
| Local Enrollment | 0 | 1,141 | 922 |
| Monthly Premium | $159.00 | $0.00 | $35.00 |
| Medical Deductible | $500 | $0.00 | $0.00 |
| Maximum Out-of-Pocket | $3,000.00 | $4,450.00 | $3,500.00 |
| Part B Giveback | Not offered | Not offered | Not offered |
| Primary Care | $0 copay | $0 copay | $0 copay |
| Specialist | $20-$50 copay | $0-$50 copay | $0-$35 copay |
| Part D Deductible | $350.00 | $190.00 | $685.00 |
| CMS Star Rating | 3.5 | 4.0 | 4.0 |
| Dental | Not covered | $0 copay | $0 copay |
| Vision | Not covered | $0 copay | $0 copay |
| Hearing | Not covered | $0 copay | $0 copay |
Want to explore more options? Browse all Medicare Advantage plans in Washoe County, or compare Medicare Advantage plans across Nevada, including premiums, out-of-pocket costs, CMS ratings, and enrollment.
Plan Benefits
Prominence Meridian 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 H5945-036.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H5945-036-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
- Specialist
- In-network: $20-$50 copay
Out-of-network: 20% coinsurance
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
- 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: $15-$50 copay
- Lab services
- In-network: $0 copay
- Outpatient x-rays
- In-network: $0 copay
- Diagnostic tests and procedures
- In-network: $0 copay
Emergency and Urgent Care Services
- Emergency room care
- $150 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $10 copay
- Inpatient hospital care
- In-network:
Tier 1
$75 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Tier 2
$500 per day for days 1-5
$0 per day for days 6-90
$0 per stay - Skilled Nursing Facility
- In-network:
Tier 1
$20 per day for days 1-20
$221 per day for days 21-100 - Ground ambulance
- In-network: $300 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $10 copay
- Outpatient group therapy
- In-network: $10 copay
- Inpatient psychiatric hospital care
- In-network:
Tier 1
$75 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Tier 2
$500 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: $10 copay
- Occupational therapy
- In-network: $5 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
- 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 Prominence Meridian as a Part B benefit.
Prescription Drug Coverage
Prominence Meridian 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: | $15.70 |
| Supplemental Part D Premium: | $$14.30 |
| Total Part D Premium: | $30.00 |
| Low-Income Premium Subsidy: | $7.28 |
| Low-Income Premium Subsidy Paid by CMS: | $7.30 |
| Low-Income Subsidy Premium: | $22.70 |
For more details, visit the Social Security Extra Help program .
Prescription Drug Plan Deductible
This plan has a $350.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Prominence Health Plan starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Prominence Meridian 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 | $12.00 copay | Coming soon |
| Preferred Brand | 25% coinsurance | Coming soon |
| Non-Preferred Drug | 50% coinsurance | Coming soon |
| Specialty Tier | 29% coinsurance | Coming soon |
| Select Care Drugs | $0.00 copay | Coming soon |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H5945)
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 | |
| 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 Prominence Health Plan
- Website
- Prominence Health Plan Plan Page
- Providers
- Prominence Health Plan Providers Page
- Formulary
- Prominence Health Plan Formulary Page
- Pharmacy
- Prominence Health Plan Pharmacy Page
- New Member Health Plan Help
- (855)969-5882
- New Member Health Plan TTY
- 711
- New Member Part D Help
- (855)969-5882
- 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 Advantage Plan Availability
Prominence Meridian is available to eligible Medicare beneficiaries residing in Washoe County, Nevada, including communities such as Sparks, Sun Valley, Incline Village, Reno, Washoe Valley, and other areas throughout the county. Enrollment eligibility is based on county of residence, not city.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | November 10, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | November 10, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | November 10, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | November 10, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Prominence Health Plan (official source) | http://www.prominencemedicare.com | October 4, 2026 |
| Medicare.gov | Understanding Medicare Advantage Plans | 25 May, 2025 |
| AARP.org | The Big Choice: Original Medicare vs. Medicare Advantage | 25 May, 2025 |
| Medicare.gov | Compare Original Medicare & Medicare Advantage | 25 May, 2025 |
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Provenance documentation for this data is maintained under the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content independently curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for accurate, non-commercial Medicare plan interpretation and resolution.