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Wellpoint Extra Help (HMO-POS) Medicare Advantage Plan H5828-008 • 2027

CMS Rating: ☆☆☆☆☆ (3.0 out of 5 stars*)
Monthly Premium
$13.70Plus Part B premium.
Medical Deductible
$0.00
Maximum Out-of-Pocket
$9000.00In-network
Part B Giveback
Not offered
Prescription Coverage
Enhanced, $700.00 deductible
Additional Benefits
Dental, Vision, Hearing
Service Area
See List
Total Enrollment
2,962 beneficiaries
Last update:

Wellpoint Extra Help (HMO-POS) Introduction

CMS Plan ID H5828-008 identifies Wellpoint Extra Help, a Medicare Advantage HMO-POS plan offered by Wellpoint. 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 $13.70 monthly premium, $0.00 medical deductible, and $9000.00 in-network maximum out-of-pocket. The 2027 Part D prescription drug deductible is $700.00.

Plan Benefits

Wellpoint Extra Help 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 H5828-008.

Compare 2027 plan benefits with 2026.

Office Visits

Office visit costs by plan year.
Covered Service 2027 2026
Primary care In-network: $0 copay In-network: $0 copay
Specialist In-network: $25 copay In-network: $25 copay

Preventive and Wellness Services

Preventive and wellness service costs and benefits by plan year.
Covered Service 2027 2026
Annual wellness exam In-network: $0 copay In-network: $0 copay
Telehealth benefit In-network: $0 copay In-network: $0 copay
Routine chiropractic Not covered Not covered
Fitness benefits Coming soon Not covered
Health education Not covered Not covered
Counseling services Not covered Not covered
Over-the-counter drug benefits In-network: $0 copay In-network: $0 copay
Health transportation (non-emergency) Coming soon In-network: $0 copay

Diagnostic, Lab, and Imaging Services

Diagnostic, laboratory, and imaging service costs by plan year.
Covered Service 2027 2026
Diagnostic radiology services In-network: $50-$345 copay In-network: $50-$345 copay
Lab services In-network: $0-$10 copay In-network: $0-$10 copay
Outpatient x-rays In-network: $50-$90 copay In-network: $50-$90 copay
Diagnostic tests and procedures In-network: $0-$90 copay In-network: $0-$90 copay

Emergency and Urgent Care Services

Emergency, urgent care, hospital, ambulance, and skilled nursing costs by plan year.
Covered Service 2027 2026
Emergency room care $115 copay $115 copay
Worldwide emergency care Coming soon $115 copay
Urgent care $40 copay $40 copay
Inpatient hospital care In-network:
Tier 1
$345 per day for days 1-7
$0 per day for days 8-90
$0 per stay		 In-network:
Tier 1
$345 per day for days 1-7
$0 per day for days 8-90
$0 per stay
Skilled Nursing Facility In-network:
Tier 1
$0 per day for days 1-20
$221 per day for days 21-100		 In-network:
Tier 1
$0 per day for days 1-20
$218 per day for days 21-100
Ground ambulance In-network: $325 copay In-network: $325 copay

Mental Health Services

Mental health therapy and inpatient psychiatric care costs by plan year.
Covered Service 2027 2026
Outpatient individual therapy In-network: $25 copay In-network: $25 copay
Outpatient group therapy In-network: $25 copay In-network: $25 copay
Inpatient psychiatric hospital care In-network:
Tier 1
$345 per day for days 1-7
$0 per day for days 8-90
$0 per stay		 In-network:
Tier 1
$345 per day for days 1-7
$0 per day for days 8-90
$0 per stay

Rehabilitation Services

Physical, speech, and occupational therapy costs by plan year.
Covered Service 2027 2026
Physical therapy and speech and language therapy In-network: $25 copay In-network: $25 copay
Occupational therapy In-network: $25 copay In-network: $25 copay

Medical Equipment and Supplies

Diabetes supplies, durable medical equipment, and prosthetic costs by plan year.
Covered Service 2027 2026
Diabetes supplies In-network: $0 copay In-network: $0 copay
Durable medical equipment In-network: 20% coinsurance In-network: 0%-20% coinsurance
Prosthetics In-network: 20% coinsurance In-network: 20% coinsurance

Medicare Part B Drugs

Chemotherapy and other Medicare Part B-covered drug costs by plan year.
Covered Service 2027 2026
Chemotherapy In-network: 0%-20% coinsurance In-network: 0%-20% coinsurance
Other Part B drugs (Medicare-covered) In-network: 0%-20% coinsurance In-network: 0%-20% coinsurance

Dental Services

Preventive and comprehensive dental service costs by plan year.
Covered Service 2027 2026
Oral exam In-network: $0 copay
Out-of-network: 20%-50% coinsurance		 In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Dental x-rays In-network: $0 copay
Out-of-network: 20%-50% coinsurance		 In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Cleaning In-network: $0 copay
Out-of-network: 20%-50% coinsurance		 In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Periodontics In-network: 25% coinsurance
Out-of-network: 20%-50% coinsurance		 In-network: 25% coinsurance
Out-of-network: 20%-50% coinsurance
Endodontics In-network: 25% coinsurance
Out-of-network: 20%-50% coinsurance		 In-network: 25% coinsurance
Out-of-network: 20%-50% coinsurance
Restorative services In-network: 25% coinsurance
Out-of-network: 20%-50% coinsurance		 In-network: 25% coinsurance
Out-of-network: 20%-50% coinsurance
Implant services Not covered Not covered
Orthodontics Not covered Not covered
Oral/Maxillofacial surgery In-network: 25% coinsurance
Out-of-network: 20%-50% coinsurance		 In-network: 25% coinsurance
Out-of-network: 20%-50% coinsurance

Vision Services

Routine eye exams, contact lenses, and eyewear costs by plan year.
Covered Service 2027 2026
Routine eye exam In-network: $0 copay In-network: $0 copay
Contact lenses In-network: $0 copay In-network: $0 copay
Eyeglass frames only In-network: $0 copay In-network: $0 copay
Eyeglass lenses only In-network: $0 copay In-network: $0 copay
Eyeglasses (frames & lenses) In-network: $0 copay In-network: $0 copay
Upgrades Not covered Not covered

Hearing Services

Hearing exams, fittings, and hearing aid costs by plan year.
Covered Service 2027 2026
Hearing exam In-network: $0 copay In-network: $0 copay
Fitting/evaluation In-network: $0 copay In-network: $0 copay
Prescription hearing aids In-network: $0 copay
You can choose for this plan to cover
either
your prescription or over-the-counter hearing aids each year, but
not
both.		 In-network: $0 copay
OTC hearing aids In-network: $0 copay
You can choose for this plan to cover
either
your prescription or over-the-counter hearing aids each year, but
not
both.		 In-network: $0 copay

Additional and Special Needs Services

Additional and special needs service costs and benefits by plan year.
Covered Service 2027 2026
Adult day health services Not covered Not covered
Home-based palliative care Not covered Not covered
Personal emergency response system Coming soon In-network: $0 copay
Weight management programs Not covered Not covered
Wigs for chemotherapy-related hair loss Coming soon Not covered
Alternative therapies Not covered Not covered
Massage therapy Not covered Not covered
Home/bathroom safety devices Not covered Not covered

Certain preventive services are covered 100% by Wellpoint Extra Help as a Part B benefit.

Prescription Drug Coverage

Wellpoint Extra Help 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.

Wellpoint Extra Help (H5828-008-0) Prescription Drug Plan Premium Details
Part D Premium Component Amount
Basic Part D Premium:$13.70
Supplemental Part D Premium:$$0.00
Total Part D Premium:$13.70
Low-Income Premium Subsidy:$13.65
Low-Income Premium Subsidy Paid by CMS:$13.70
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 Wellpoint starts contributing towards your prescription costs.

Prescription Drug Plan Out-of-Pocket Costs

Beyond premiums and deductibles, Wellpoint Extra Help may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.

Wellpoint Extra Help (H5828-008-0) Pharmacy Out-of-Pocket Costs by Drug Tier
Drug Tier Retail Mail Order
Preferred Generic$0.00 copayComing soon
Generic25% coinsuranceComing soon
Preferred Brand25% coinsuranceComing soon
Non-Preferred Drug25% coinsuranceComing soon
Specialty Tier25% coinsuranceComing soon
*Deductible does not apply.

CMS 5-Star Performance Ratings (Contract ID: H5828)

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 H5828
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 ☆☆☆☆☆

Plan Availability

Wellpoint Extra Help (H5828-008-0) is available in the following locations:

Tennessee Counties Served

Frequently Asked Questions

Here are some of the most frequently asked questions about this plan (click to open).

Frequently Asked Questions About Wellpoint Extra Help (HMO-POS)

How much does plan H5828-008 cost per month?

The 2027 monthly premium is $13.70. The Medicare Part B premium is paid separately.

What is the annual out-of-pocket maximum (MOOP) for this plan?

The 2027 in-network MOOP is $9000.00. Once this limit is reached, covered in-network costs are fully covered.

What is the star rating for plan H5828-008 in 2027?

The 2027 CMS star rating for Wellpoint Extra Help is ★3.0 out of 5.

What is the total enrollment for plan H5828-008?

Total enrollment is 2,962 beneficiaries based on the latest CMS data.

What is the prescription drug deductible for 2027?

The plan’s Part D deductible is $700.00, applied to covered prescription drug costs.

Medicare Plan Data Sources and Methodology
Primary CMS datasets used for this Medicare Advantage Plan resource.
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.

Official plan information and secondary Medicare references.
Publisher Reference Last Accessed
Wellpoint (official source) https://shop.wellpoint.com/medicare October 4, 2026
Medicare.gov Understanding Medicare Advantage Plans 25 May, 2025
Medicare.gov Joining a plan 25 May, 2025
Medicare.gov Explore your Medicare coverage options 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.