Elite Core HMO (HMO) Medicare Advantage Plan H6368-002 • 2027
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $2400.00In-network
- Part B Giveback
- −$154.00 reduction
- Prescription Coverage
- Enhanced, $150.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- See List
- Total Enrollment
- 0 beneficiaries
Elite Core HMO (HMO) Introduction
This Medicare Advantage HMO plan, Elite Core HMO, is offered by Elite Health Plan, Inc. 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 $2400.00. The plan is identified by CMS Plan ID H6368-002. The 2027 Part D prescription drug deductible is $150.00.
Plan Benefits
Elite Core HMO includes cost-sharing, which refers to out-of-pocket expenses for covered healthcare services. The tables below outline the most common in-network out-of-pocket costs associated with plan H6368-002.
Compare 2027 plan benefits with 2026.
Office Visits
| Covered Service | 2027 | 2026 |
|---|---|---|
| Primary care | In-network: $0 copay | In-network: $0 copay |
| Specialist | In-network: $0 copay | In-network: $0 copay |
Preventive and Wellness Services
| 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 | In-network: $0 copay | In-network: $0 copay |
| Fitness benefits | Coming soon | In-network: $0 copay |
| Health education | In-network: $0 copay | In-network: $0 copay |
| 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 | Not covered |
Diagnostic, Lab, and Imaging Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diagnostic radiology services | In-network: $75 copay | In-network: 20% coinsurance |
| Lab services | In-network: $0 copay | In-network: $0 copay |
| Outpatient x-rays | In-network: $0 copay | In-network: $50 copay |
| Diagnostic tests and procedures | In-network: $0 copay | In-network: $0 copay |
Emergency and Urgent Care Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Emergency room care | $150 copay | $150 copay |
| Worldwide emergency care | Coming soon | $150 copay |
| Urgent care | $0 copay | $0 copay |
| Inpatient hospital care | Tier 1 $0 per day for days 1-3 $150 per day for days 4-15 $0 per day for days 16-90 $0 Lifetime Reserve Days for days 1-3 $150 Lifetime Reserve Days for days 4-15 $0 Lifetime Reserve Days for days 16-60 $0 per stay |
Tier 1 $100 per day for days 1-5 $0 per day for days 6-90 $100 Lifetime Reserve Days for days 1-5 $0 Lifetime Reserve Days for days 6-60 $0 per stay |
| Skilled Nursing Facility | Tier 1 $0 per day for days 1-20 $125 per day for days 21-100 |
Tier 1 $0 per day for days 1-20 $100 per day for days 21-100 |
| Ground ambulance | In-network: $325 copay | In-network: $225 copay |
Mental Health Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Outpatient individual therapy | In-network: $25 copay | In-network: $25 copay |
| Outpatient group therapy | In-network: $0 copay | In-network: $0 copay |
| Inpatient psychiatric hospital care | Tier 1 $0 per day for days 1-3 $150 per day for days 4-15 $0 per day for days 16-90 $0 Lifetime Reserve Days for days 1-3 $150 Lifetime Reserve Days for days 4-15 $0 Lifetime Reserve Days for days 16-60 $0 per stay |
Tier 1 $100 per day for days 1-5 $0 per day for days 6-90 $100 Lifetime Reserve Days for days 1-5 $0 Lifetime Reserve Days for days 6-60 $0 per stay |
Rehabilitation Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Physical therapy and speech and language therapy | In-network: $0 copay | In-network: $0 copay |
| Occupational therapy | In-network: $0 copay | In-network: $0 copay |
Medical Equipment and Supplies
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diabetes supplies | In-network: 0%-20% coinsurance | In-network: 0%-20% coinsurance |
| Durable medical equipment | In-network: 0%-20% coinsurance | In-network: 0%-20% coinsurance |
| Prosthetics | In-network: 20% coinsurance | In-network: 20% coinsurance |
Medicare Part B Drugs
| 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
| Covered Service | 2027 | 2026 |
|---|---|---|
| Oral exam | In-network: $0 copay | In-network: $0 copay |
| Dental x-rays | In-network: $0 copay | In-network: $0 copay |
| Cleaning | In-network: $0 copay | In-network: $0 copay |
| Periodontics | In-network: $0 copay | In-network: $0-$30 copay |
| Endodontics | In-network: $0 copay | Not covered |
| Restorative services | In-network: $0 copay | In-network: $19-$44 copay |
| Implant services | Not covered | Not covered |
| Orthodontics | Not covered | Not covered |
| Oral/Maxillofacial surgery | In-network: $0 copay | In-network: $20-$98 copay |
Vision Services
| 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 | In-network: $0 copay | In-network: $0 copay |
Hearing Services
| 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 | In-network: $399-$949 copay |
| OTC hearing aids | In-network: $0 copay | Not covered |
Additional and Special Needs Services
| 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 | Not covered |
| 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 | In-network: $0 copay | In-network: $0 copay |
| Home/bathroom safety devices | Not covered | Not covered |
Certain preventive services are covered 100% by Elite Core HMO as a Part B benefit.
Prescription Drug Coverage
Elite Core HMO 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: | $0.00 |
| Supplemental Part D Premium: | $$0.00 |
| Total Part D Premium: | $0.00 |
| Low-Income Premium Subsidy: | $7.28 |
| 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 $150.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Elite Health Plan, Inc. starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Elite Core HMO 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 | $10.00 copay | Coming soon |
| Preferred Brand | $47.00 copay | Coming soon |
| Non-Preferred Drug | 25% coinsurance | Coming soon |
| Specialty Tier | 31% coinsurance | Coming soon |
| Select Care Drugs | $0.00 copay | Coming soon |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H6368)
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 | Plan too new to be measured |
| Managing Chronic (Long Term) Conditions | Plan too new to be measured |
| Member Experience with Health Plan | Plan too new to be measured |
| Complaints and Changes in Plans Performance | Plan too new to be measured |
| Health Plan Customer Service | Plan too new to be measured |
| Drug Plan Customer Service | Plan too new to be measured |
| Complaints and Changes in the Drug Plan | Plan too new to be measured |
| Member Experience with the Drug Plan | Plan too new to be measured |
| Drug Safety and Accuracy of Drug Pricing | Plan too new to be measured |
Contact Information for Elite Health Plan, Inc.
- Website
- Elite Health Plan, Inc. Plan Page
- Providers
- Elite Health Plan, Inc. Providers Page
- Formulary
- Elite Health Plan, Inc. Formulary Page
- Pharmacy
- Elite Health Plan, Inc. Pharmacy Page
- New Member Health Plan Help
- (800)958-1129
- New Member Health Plan TTY
- 711
- New Member Part D Help
- (800)958-1129
- 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.
Plan Availability
Elite Core HMO (H6368-002-0) is available in the following locations:
California Counties Served
Frequently Asked Questions
Here are some of the most frequently asked questions about this plan (click to open).
Frequently Asked Questions About Elite Core HMO (HMO)
What is the monthly premium for Elite Core HMO (HMO)?
The 2027 monthly premium is $0.00. The Medicare Part B premium is paid separately.
What is the in-network MOOP for plan H6368-002?
For 2027, the in-network maximum out-of-pocket is $2400.00. The plan pays 100% of covered in-network services beyond this amount.
What is the star rating for plan H6368-002 in 2027?
For 2027, plan H6368-002 has a CMS star rating of ★0.0 out of 5 stars.
What is the total enrollment for plan H6368-002?
Total enrollment is 0 beneficiaries based on the latest CMS data.
Is there a Part D deductible for this plan?
The Part D deductible is $150.00.
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 |
|---|---|---|
| Elite Health Plan, Inc. (official source) | https://www.elitehealthplan.com/ | October 4, 2026 |
| CMS.gov | Medicare Advantage Plan Fact Sheet | 25 May, 2025 |
| Medicare.gov | Joining a plan | 25 May, 2025 |
| Medicare.gov | Your coverage options | 25 May, 2025 |
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