Medicare Plans

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Advantage Care by Ultimate (HMO C-SNP) H2962-050 • 2027 • Orange County, FL

CMS Rating: Not yet rated by CMS.
Monthly Premium
$0.00Plus Part B premium.
Medical Deductible
$0.00
Maximum Out-of-Pocket
$1900.00In-network
Part B Giveback
−$202.90 reduction
Prescription Coverage
Enhanced, $0.00 deductible
Additional Benefits
Dental, Vision, Hearing
Service Area
Orange County, FL
Local Enrollment
282 beneficiaries in Orange County
Last update:

Introduction

Advantage Care by Ultimate is a Medicare Advantage Chronic Condition Special Needs Plan (C-SNP) offered by Ultimate Health Plans. The plan uses a Health Maintenance Organization (HMO) provider network and includes Medicare Part D prescription drug coverage. For the 2027 plan year, it has a $0.00 monthly premium, $0.00 medical deductible, and $1900.00 in-network maximum out-of-pocket. CMS Plan ID H2962-050 identifies this plan. The 2027 Part D prescription drug deductible is $0.00.

This plan is available to eligible residents of Orange County, Florida. CMS reports 282 beneficiaries enrolled in this plan in Orange County. For assistance with this plan, new members can call (844)602-2732 (TTY 711).

Eligibility

Advantage Care by Ultimate is a Medicare C-SNP plan for individuals with specific chronic conditions.

Special Needs Plan Type
Chronic Condition Special Needs Plan (C-SNP)
Medicare Requirement
Must have Medicare Part A and Part B
Special Needs Requirement
This plan is for individuals with cardiovascular disorders, chronic heart failure, and/or diabetes mellitus.
Service Area Requirement
Must live in the plan's service area
Prescription Drug Coverage
Medicare Part D prescription drug coverage is included.

Compare Similar Plans in Orange County

Compare this plan with the two most-enrolled HMO C-SNP plans available in Orange County, Florida. Enrollment is based on CMS local enrollment data.

HMO C-SNP plan comparison for Orange County, Florida
Plan Detail Advantage Care by Ultimate Freedom VIP Savings Humana Gold Plus - Diabetes and Heart
CMS Plan ID H2962-050-0 H5427-072-0 H1036-300-0
Local Enrollment 282 7,502 3,589
Monthly Premium $0.00 $0.00 $0.00
Medical Deductible $0.00 $0.00 $0.00
Maximum Out-of-Pocket $1,900.00 $3,400.00 $3,100.00
Part B Giveback −$202.90 reduction −$202.90 reduction −$171.00 reduction
Primary Care $0 copay $0 copay $0 copay
Specialist $5 copay $10 copay $15 copay
Part D Deductible $0.00 $0.00 $700.00
CMS Star Rating Not yet rated Not yet rated Not yet rated
Dental $0 copay $0 copay $0 copay
Vision $0 copay $0 copay $0 copay
Hearing $0 copay $0 copay $0 copay

Plan Benefits

Advantage Care by Ultimate 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 H2962-050.

You can also compare 2027 costs and coverage with last year, side-by-side: Plan H2962-050-0 Cost Compare.

Office Visits

Primary care
In-network: $0 copay
Specialist
In-network: $5 copay

Preventive and Wellness Services

Annual wellness exam
Not covered
Telehealth benefit
Not covered
Routine chiropractic
Not covered
Fitness benefits
Coming soon
Health education
In-network: $0 copay
Counseling services
Not covered
Over-the-counter drug benefits
In-network: $0 copay
Health transportation (non-emergency)
Coming soon

Diagnostic, Lab, and Imaging Services

Diagnostic radiology services
In-network: $25-$195 copay
Lab services
In-network: $0-$195 copay, 0%-20% coinsurance
Outpatient x-rays
In-network: $0-$195 copay
Diagnostic tests and procedures
In-network: $0-$195 copay, 0%-20% coinsurance

Emergency and Urgent Care Services

Emergency room care
$150 copay
Worldwide emergency care
Coming soon
Urgent care
$10 copay
Inpatient hospital care
Tier 1
$175 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: $200 copay

Mental Health Services

Outpatient individual therapy
In-network: $5 copay
Outpatient group therapy
In-network: $5 copay
Inpatient psychiatric hospital care
Tier 1
$175 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: $5 copay
Occupational therapy
In-network: $5 copay

Medical Equipment and Supplies

Diabetes supplies
In-network: $0 copay
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: 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
Not covered
Orthodontics
Not covered
Oral/Maxillofacial surgery
In-network: $0 copay

Vision Services

Routine eye exam
In-network: $0 copay
Contact lenses
In-network: $0 copay
Eyeglass frames only
In-network: $0 copay
Eyeglass lenses only
In-network: $0 copay
Eyeglasses (frames & lenses)
In-network: $0 copay
Upgrades
In-network: $0 copay

Hearing Services

Hearing exam
In-network: $0 copay
Fitting/evaluation
In-network: $0 copay
Prescription hearing aids
In-network: $0 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
In-network: $0 copay

Certain preventive services are covered 100% by Advantage Care by Ultimate as a Part B benefit.

Prescription Drug Coverage

Advantage Care by Ultimate 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.

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.

Advantage Care by Ultimate (H2962-050-0) Prescription Drug Plan Premium Details
Part D Premium Component Amount
Basic Part D Premium:($53.40)
Supplemental Part D Premium:$53.40
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 $0.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Ultimate Health Plans starts contributing towards your prescription costs.

Prescription Drug Plan Out-of-Pocket Costs

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

Advantage Care by Ultimate (H2962-050-0) Pharmacy Out-of-Pocket Costs by Drug Tier
Drug Tier Retail Mail Order
Preferred Generic$0.00 copay$0.00 copay
Generic$0.00 copay$0.00 copay
Preferred Brand$25.00 copay$25.00 copay
Non-Preferred Drug35% coinsurance35% coinsurance
Specialty Tier33% coinsurance33% coinsurance
Select Care Drugs$10.00 copay$10.00 copay
*Deductible does not apply.

CMS 5-Star Performance Ratings (Contract ID: H2962)

CMS star ratings reflect how well a Medicare plan performs across key quality measures, such as managing chronic conditions, member satisfaction, and customer service. Ratings range from 1 to 5 stars and are updated each year by Medicare.

2027 Medicare Star Ratings for Contract H2962
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 Ultimate Health Plans

Website
Ultimate Health Plans Plan Page
Providers
Ultimate Health Plans Providers Page
Formulary
Ultimate Health Plans Formulary Page
Pharmacy
Ultimate Health Plans Pharmacy Page
New Member Health Plan Help
(844)602-2732
New Member Health Plan TTY
711
New Member Part D Help
(844)602-2732
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 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
Ultimate Health Plans (official source) http://www.chooseultimate.com October 4, 2026
CMS.gov Chronic Condition Special Needs Plans (C-SNPs) April 28, 2026
CMS.gov Medicare Advantage Plan Fact Sheet April 28, 2026
AARP.org The Big Choice: Original Medicare vs. Medicare Advantage April 28, 2026

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