Peak Advantage Vista (PPO) Medicare Advantage Plan H8947-001-4 • 2027
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $7500.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Enhanced, $0.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- See List
- Total Enrollment
- 3,672 beneficiaries
Peak Advantage Vista (PPO) Introduction
Peak Advantage Vista is a Medicare Advantage PPO plan offered by Peak Health. It uses a Preferred Provider Organization (PPO) provider network and comes with prescription drug coverage. For the 2027 plan year it has a $0.00 monthly premium, $0.00 medical deductible, and $7500.00 in-network maximum out-of-pocket. CMS Plan ID H8947-001-4 identifies this plan. The 2027 Part D prescription drug deductible is $0.00.
Plan Benefits
Peak Advantage Vista 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 H8947-001-4.
Compare 2027 plan benefits with 2026.
Office Visits
| Covered Service | 2027 | 2026 |
|---|---|---|
| Primary care | In-network: $0 copay Out-of-network: 35% coinsurance |
In-network: $0 copay Out-of-network: 35% coinsurance |
| Specialist | In-network: $25 copay Out-of-network: $35 copay |
In-network: $25 copay Out-of-network: $35 copay |
Preventive and Wellness Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Annual wellness exam | In-network: $0 copay Out-of-network: 35% coinsurance |
In-network: $0 copay |
| Telehealth benefit | In-network: $0 copay | In-network: $0 copay |
| Routine chiropractic | In-network: $25 copay Out-of-network: 35% coinsurance |
In-network: $25 copay Out-of-network: 35% coinsurance |
| Fitness benefits | Coming soon | In-network: $0 copay Out-of-network: $0 copay, 0% coinsurance |
| Health education | In-network: $0 copay Out-of-network: $0 copay, 0% coinsurance |
In-network: $0 copay Out-of-network: $0 copay, 0% coinsurance |
| Counseling services | Not covered | Not covered |
| Over-the-counter drug benefits | In-network: $0 copay Out-of-network: $0 copay, 0% coinsurance |
In-network: $0 copay Out-of-network: $0 copay, 0% coinsurance |
| Health transportation (non-emergency) | Coming soon | In-network: $0 copay Out-of-network: 35% coinsurance |
Diagnostic, Lab, and Imaging Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diagnostic radiology services | In-network: $0-$225 copay Out-of-network: 35% coinsurance |
In-network: $0-$225 copay Out-of-network: 35% coinsurance |
| Lab services | In-network: $0-$25 copay Out-of-network: 35% coinsurance |
In-network: $0-$25 copay Out-of-network: 35% coinsurance |
| Outpatient x-rays | In-network: $0-$25 copay Out-of-network: 35% coinsurance |
In-network: $0-$25 copay Out-of-network: 35% coinsurance |
| Diagnostic tests and procedures | In-network: $0-$25 copay Out-of-network: 35% coinsurance |
In-network: $0-$25 copay Out-of-network: 35% coinsurance |
Emergency and Urgent Care Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Emergency room care | $115 copay | $95 copay |
| Worldwide emergency care | Coming soon | $95 copay |
| Urgent care | $40 copay | $35 copay |
| Inpatient hospital care | In-network: Tier 1 $800 Lifetime Reserve Days for days 1-60 $750 per stay Out-of-network: 35% per stay |
In-network: Tier 1 $800 Lifetime Reserve Days for days 1-60 $615 per stay Out-of-network: 35% per stay |
| Skilled Nursing Facility | In-network: Tier 1 $0 per day for days 1-20 $218 per day for days 21-100 Out-of-network: 35% per stay |
In-network: Tier 1 $0 per day for days 1-20 $218 per day for days 21-100 Out-of-network: 35% per stay |
| Ground ambulance | In-network: $280 copay Out-of-network: 35% coinsurance |
In-network: $280 copay Out-of-network: 35% coinsurance |
Mental Health Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Outpatient individual therapy | In-network: $40 copay Out-of-network: 35% coinsurance |
In-network: $40 copay Out-of-network: 35% coinsurance |
| Outpatient group therapy | In-network: $40 copay Out-of-network: 35% coinsurance |
In-network: $40 copay Out-of-network: 35% coinsurance |
| Inpatient psychiatric hospital care | In-network: Tier 1 $800 Lifetime Reserve Days for days 1-60 $750 per stay Out-of-network: 35% per stay |
In-network: Tier 1 $800 Lifetime Reserve Days for days 1-60 $615 per stay Out-of-network: 35% per stay |
Rehabilitation Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Physical therapy and speech and language therapy | In-network: $20 copay Out-of-network: 35% coinsurance |
In-network: $30 copay Out-of-network: 35% coinsurance |
| Occupational therapy | In-network: $30 copay Out-of-network: 35% coinsurance |
In-network: $30 copay Out-of-network: 35% coinsurance |
Medical Equipment and Supplies
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diabetes supplies | In-network: $0 copay Out-of-network: 35% coinsurance |
In-network: $0 copay Out-of-network: 35% coinsurance |
| Durable medical equipment | In-network: 20% coinsurance Out-of-network: 35% coinsurance |
In-network: 20% coinsurance Out-of-network: 35% coinsurance |
| Prosthetics | In-network: 20% coinsurance Out-of-network: 35% coinsurance |
In-network: 20% coinsurance Out-of-network: 35% coinsurance |
Medicare Part B Drugs
| Covered Service | 2027 | 2026 |
|---|---|---|
| Chemotherapy | In-network: 0%-20% coinsurance Out-of-network: 35% coinsurance |
In-network: 0%-20% coinsurance Out-of-network: 35% coinsurance |
| Other Part B drugs (Medicare-covered) | In-network: 0%-20% coinsurance Out-of-network: 35% coinsurance |
In-network: 0%-20% coinsurance Out-of-network: 35% coinsurance |
Dental Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Oral exam | In-network: $0 copay Out-of-network: $0 copay, 0% coinsurance |
In-network: $0 copay Out-of-network: $0 copay, 0% coinsurance |
| Dental x-rays | In-network: $0 copay Out-of-network: $0 copay, 0% coinsurance |
In-network: $0 copay Out-of-network: $0 copay, 0% coinsurance |
| Cleaning | In-network: $0 copay Out-of-network: $0 copay, 0% coinsurance |
In-network: $0 copay Out-of-network: $0 copay, 0% coinsurance |
| Periodontics | In-network: 50% coinsurance Out-of-network: 50% coinsurance |
In-network: 50% coinsurance Out-of-network: 50% coinsurance |
| Endodontics | In-network: 50% coinsurance Out-of-network: 50% coinsurance |
In-network: 50% coinsurance Out-of-network: 50% coinsurance |
| Restorative services | In-network: 50% coinsurance Out-of-network: 50% coinsurance |
In-network: 50% coinsurance Out-of-network: 50% coinsurance |
| Implant services | Not covered | Not covered |
| Orthodontics | Not covered | Not covered |
| Oral/Maxillofacial surgery | In-network: 50% coinsurance Out-of-network: 50% coinsurance |
In-network: 50% coinsurance Out-of-network: 50% coinsurance |
Vision Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Routine eye exam | In-network: $0 copay Out-of-network: 35% coinsurance |
In-network: $0 copay Out-of-network: 35% coinsurance |
| Contact lenses | In-network: $0 copay Out-of-network: 35% coinsurance |
In-network: $0 copay Out-of-network: 35% coinsurance |
| Eyeglass frames only | In-network: $0 copay Out-of-network: 35% coinsurance |
In-network: $0 copay Out-of-network: 35% coinsurance |
| Eyeglass lenses only | In-network: $0 copay Out-of-network: 35% coinsurance |
In-network: $0 copay Out-of-network: 35% coinsurance |
| Eyeglasses (frames & lenses) | In-network: $0 copay Out-of-network: 35% coinsurance |
In-network: $0 copay Out-of-network: 35% coinsurance |
| Upgrades | In-network: $0 copay Out-of-network: 35% coinsurance |
In-network: $0 copay Out-of-network: 35% coinsurance |
Hearing Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Hearing exam | In-network: $0 copay Out-of-network: 35% coinsurance |
In-network: $0 copay Out-of-network: 35% coinsurance |
| Fitting/evaluation | In-network: $0 copay Out-of-network: 35% coinsurance |
In-network: $0 copay Out-of-network: 35% coinsurance |
| Prescription hearing aids | In-network: $399-$899 copay Out-of-network: 35% coinsurance |
In-network: $399-$899 copay Out-of-network: 35% coinsurance |
| OTC hearing aids | Not covered | 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 | Not covered | Not covered |
| Home/bathroom safety devices | Not covered | Not covered |
Certain preventive services are covered 100% by Peak Advantage Vista as a Part B benefit.
Prescription Drug Coverage
Peak Advantage Vista 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: | $12.80 |
| 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 $0.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Peak Health starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Peak Advantage Vista 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 | $4.00 copay | Coming soon |
| Preferred Brand | 25% coinsurance | Coming soon |
| Non-Preferred Drug | 25% coinsurance | Coming soon |
| Specialty Tier | 33% coinsurance | Coming soon |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H8947)
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.
| 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 | |
| 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 Peak Health
- Website
- Peak Health Plan Page
- Providers
- Peak Health Providers Page
- Formulary
- Peak Health Formulary Page
- Pharmacy
- Peak Health Pharmacy Page
- New Member Health Plan Help
- (855)962-7325
- New Member Health Plan TTY
- 711
- New Member Part D Help
- (855)847-1026
- 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
Peak Advantage Vista (H8947-001-4) is available in the following locations:
Frequently Asked Questions
Here are some of the most frequently asked questions about this plan (click to open).
Frequently Asked Questions About Peak Advantage Vista (PPO)
How much does plan H8947-001-4 cost per month?
For 2027, the monthly premium is $0.00. Medicare Part B premiums apply in addition to this amount.
What is the in-network MOOP for plan H8947-001-4?
The annual in-network MOOP is $7500.00 for 2027. After this limit is reached, covered in-network services are fully paid.
What is the CMS star rating for this plan?
For 2027, plan H8947-001-4 has a CMS star rating of ★0.0 out of 5 stars.
How many beneficiaries are enrolled in this plan?
The plan has 3,672 enrolled beneficiaries according to CMS.
What is the Part D deductible for plan H8947-001-4?
For 2027, the prescription drug deductible is $0.00.
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 |
|---|---|---|
| Peak Health (official source) | http://medicare.peakhealth.or | 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.
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.