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Health New England Medicare Premium No Rx (HMO) Medicare Advantage Plan H8578-003 • 2027

CMS Rating: Not yet rated by CMS.
Monthly Premium
$0.00Plus Part B premium.
Medical Deductible
$0.00
Maximum Out-of-Pocket
$4500.00In-network
Part B Giveback
Not offered
Prescription Coverage
Not Included
Additional Benefits
Dental, Vision, Hearing
Service Area
See List
Total Enrollment
82 beneficiaries
Last update:

Health New England Medicare Premium No Rx (HMO) Introduction

CMS Plan ID H8578-003 identifies Health New England Medicare Premium No Rx, a Medicare Advantage HMO plan offered by Health New England Medicare Advantage Plans. The plan uses a Health Maintenance Organization (HMO) provider network and comes without prescription drug coverage. Its costs for the 2027 plan year include a $0.00 monthly premium, $0.00 medical deductible, and $4500.00 in-network maximum out-of-pocket.

Plan Benefits

Health New England Medicare Premium No Rx 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 H8578-003.

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: $20 copay In-network: $20 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-$20 copay In-network: $0 copay
Routine chiropractic Not covered Not covered
Fitness benefits Coming soon In-network: $0 copay
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: $0-$175 copay In-network: $0-$175 copay
Lab services In-network: $0 copay In-network: $0 copay
Outpatient x-rays In-network: $20 copay In-network: $20 copay
Diagnostic tests and procedures In-network: $0 copay In-network: $0 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 $130 copay $130 copay
Worldwide emergency care Coming soon $130 copay
Urgent care $50 copay $50 copay
Inpatient hospital care Tier 1
$150 per day for days 1-6
$0 per day for days 7-90
$0 per stay		 Tier 1
$150 per day for days 1-6
$0 per day for days 7-90
$0 per stay
Skilled Nursing Facility Tier 1
$0 per day for days 1-20
$150 per day for days 21-50
$0 per day for days 51-100		 Tier 1
$0 per day for days 1-20
$150 per day for days 21-50
$0 per day for days 51-100
Ground ambulance In-network: $340 copay In-network: $350 copay

Mental Health Services

Mental health therapy and inpatient psychiatric care costs by plan year.
Covered Service 2027 2026
Outpatient individual therapy In-network: $20 copay In-network: $20 copay
Outpatient group therapy In-network: $20 copay In-network: $20 copay
Inpatient psychiatric hospital care Tier 1
$150 per day for days 1-6
$0 per day for days 7-90
$0 per stay		 Tier 1
$150 per day for days 1-6
$0 per day for days 7-90
$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: $20 copay In-network: $20 copay
Occupational therapy In-network: $20 copay In-network: $20 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: 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 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 copay
Endodontics In-network: $0 copay In-network: $0 copay
Restorative services In-network: $0 copay In-network: $0 copay
Implant services In-network: $0 copay In-network: $0 copay
Orthodontics In-network: $0 copay In-network: $0 copay
Oral/Maxillofacial surgery In-network: $0 copay In-network: $0 copay

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 In-network: $0 copay In-network: $0 copay

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: $499-$999 copay In-network: $499-$999 copay
OTC hearing aids Not covered Not covered

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 Not covered
Weight management programs In-network: $0 copay In-network: $0 copay
Wigs for chemotherapy-related hair loss Coming soon In-network: $0 copay
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 Health New England Medicare Premium No Rx as a Part B benefit.

Prescription Drug Coverage

This plan does not include a Medicare Part D plan for prescriptions.

CMS 5-Star Performance Ratings (Contract ID: H8578)

The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage (Part C) and Part D prescription drug plans each year using a 5-star system. These ratings measure plan performance in areas such as preventive care, management of chronic conditions, and member experience.

2027 Medicare Star Ratings for Contract H8578
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 Health New England Medicare Advantage Plans

Website
Health New England Medicare Advantage Plans Plan Page
Providers
Health New England Medicare Advantage Plans Providers Page
Formulary
Health New England Medicare Advantage Plans Formulary Page
Pharmacy
Health New England Medicare Advantage Plans Pharmacy Page
New Member Health Plan Help
(877)443-3314
New Member Health Plan TTY
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

Health New England Medicare Premium No Rx (H8578-003-0) is available in the following locations:

Massachusetts Counties Served

Frequently Asked Questions

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

Frequently Asked Questions About Health New England Medicare Premium No Rx (HMO)

How much does plan H8578-003 cost per month?

The plan’s monthly premium is $0.00 for 2027. The Part B premium is not included.

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

The annual in-network MOOP is $4500.00 for 2027. After this limit is reached, covered in-network services are fully paid.

What is the current enrollment for Health New England Medicare Premium No Rx?

The plan has 82 enrolled beneficiaries according to CMS.

What is the prescription drug deductible for 2027?

For 2027, the prescription drug deductible is $0.00.

Medicare Plan Data Sources and Methodology
Primary CMS datasets used for this Medicare Advantage Plan resource.
Data Source Publisher CMS Version
Landscape Source Files Centers for Medicare & Medicaid Services CY2027 Landscape (202609.1)
Medicare Part C & D Performance Centers for Medicare & Medicaid Services 2027 Star Ratings Data Tables
Plan Benefits Package Centers for Medicare & Medicaid Services PBP Benefits-2027
Monthly Enrollment by Contract/Plan/State/County Centers for Medicare & Medicaid Services 2026-09

Data sources and methodology documentation.

Official plan information and secondary Medicare references.
Publisher Reference Last Accessed
Health New England Medicare Advantage Plans (official source) http://www.healthnewengland.org/medic October 4, 2026
Medicare.gov Compare types of Medicare Advantage Plans 25 May, 2025
NCOA.org 5 Steps to Choosing the Right Medicare Plan for You 25 May, 2025
Medicare.gov Compare Original Medicare & Medicare Advantage 25 May, 2025

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Data provenance is documented in accordance with the U.S. Core Data for Interoperability (USCDI) Provenance standard.