CDPHP $0 Medicare Rx (HMO) Medicare Advantage Plan H3388-014 • 2027 • Rensselaer County, NY
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $9850.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Basic, $700.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Rensselaer County, NY
- Local Enrollment
- 3,630 beneficiaries in Rensselaer County
CDPHP $0 Medicare Rx (HMO) Introduction
This Medicare Advantage HMO plan, CDPHP $0 Medicare Rx, is offered by CDPHP Medicare Advantage and uses a Health Maintenance Organization (HMO) provider network. It comes with 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 $9850.00. The plan is identified by CMS Plan ID H3388-014. The 2027 Part D prescription drug deductible is $700.00.
Enrollment in this plan requires residence in Rensselaer County, New York. CMS enrollment data reports 3,630 plan members in Rensselaer County. New members can call the plan directly at (888)519-4455 (TTY 711) for assistance.
Compare Similar Plans in Rensselaer County
Compare this plan with the two most-enrolled HMO plans available in Rensselaer County, New York. Enrollment is based on CMS local enrollment data.
| Plan Detail | CDPHP $0 Medicare Rx | CDPHP Choice Rx | CDPHP Clear Rx |
|---|---|---|---|
| CMS Plan ID | H3388-014-0 |
H3388-002-0 |
H3388-020-0 |
| Local Enrollment | 3,630 | 2,715 | 571 |
| Monthly Premium | $0.00 | $139.00 | $100.00 |
| Medical Deductible | $0.00 | $0.00 | $0.00 |
| Maximum Out-of-Pocket | $9,850.00 | $6,400.00 | $6,750.00 |
| Part B Giveback | Not offered | Not offered | Not offered |
| Primary Care | $0 copay | $0 copay | $0 copay |
| Specialist | $0-$50 copay | $0-$35 copay | $0-$40 copay |
| Part D Deductible | $700.00 | $250.00 | $500.00 |
| CMS Star Rating | 3.5 | 3.5 | 3.5 |
| Dental | $0 copay | $0 copay | $0 copay |
| Vision | $50 copay | $35 copay | $40 copay |
| Hearing | $0 copay | $0 copay | $0 copay |
Want to explore more options? Browse all Medicare Advantage plans in Rensselaer County, or compare Medicare Advantage plans across New York, including premiums, out-of-pocket costs, CMS ratings, and enrollment.
Plan Benefits
Cost-sharing for CDPHP $0 Medicare Rx 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 H3388-014.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H3388-014-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
- Specialist
- In-network: $0-$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
- Not covered
- Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: $260 copay
- Lab services
- In-network: $0-$10 copay
- Outpatient x-rays
- In-network: $10 copay
- Diagnostic tests and procedures
- In-network: 0%-20% coinsurance
Emergency and Urgent Care Services
- Emergency room care
- $115 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $40 copay
- Inpatient hospital care
- Tier 1
$460 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 21-100 - Ground ambulance
- In-network: $265 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $35 copay
- Outpatient group therapy
- In-network: $35 copay
- Inpatient psychiatric hospital care
- Tier 1
$460 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: $30 copay
- Occupational therapy
- In-network: $30 copay
Medical Equipment and Supplies
- Diabetes supplies
- In-network: $5 copay, 20% coinsurance
- 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: $35 copay, 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: $50 copay
- 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
- In-network: $0 copay
- Fitting/evaluation
- In-network: $0 copay
- Prescription hearing aids
- In-network: $299-$799 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 CDPHP $0 Medicare Rx as a Part B benefit.
Prescription Drug Coverage
CDPHP $0 Medicare Rx 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 a basic benefit Medicare Part D plan (PDP), meeting the minimum coverage requirements defined by CMS.
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: | $0.00 |
| Supplemental Part D Premium: | $$0.00 |
| Total Part D Premium: | $0.00 |
| Low-Income Premium Subsidy: | $40.45 |
| 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 $700.00 annual Part D deductible. You'll pay this deductible at the pharmacy before CDPHP Medicare Advantage starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, CDPHP $0 Medicare Rx may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $5.00 copay | Coming soon |
| Generic | $11.00 copay | Coming soon |
| Preferred Brand | 22% coinsurance | Coming soon |
| Non-Preferred Drug | 29% coinsurance | Coming soon |
| Specialty Tier | 25% coinsurance | Coming soon |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H3388)
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 CDPHP Medicare Advantage
- Website
- CDPHP Medicare Advantage Plan Page
- Providers
- CDPHP Medicare Advantage Providers Page
- Formulary
- CDPHP Medicare Advantage Formulary Page
- Pharmacy
- CDPHP Medicare Advantage Pharmacy Page
- New Member Health Plan Help
- (888)519-4455
- New Member Health Plan TTY
- 711
- New Member Part D Help
- (888)519-4455
- 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
CDPHP $0 Medicare Rx is available to eligible Medicare beneficiaries residing in Rensselaer County, New York, including communities such as Averill Park, Castleton On Hudson, Cropseyville, Eagle Bridge, East Greenbush, East Nassau, Hoosick Falls, Johnsonville, Melrose, Nassau, Petersburg, Poestenkill, Rensselaer, Schaghticoke, Stephentown, Troy, Valley Falls, West Sand Lake, Wynantskill, 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 | 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 |
|---|---|---|
| CDPHP Medicare Advantage (official source) | https://www.cdphp.com/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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