Medicare Plan Lookup Official CMS data · Contract Year 2027
CMS 2027 data

2027 Medicare plan code

H8379-003

Medicare Plan

PriorityMedicare Dual Premier (HMO D-SNP) · Priority Health Medicare · HMO · St. Joseph County

Full CMS plan ID: H8379-003-003

H8379-003-003 is the full CMS identifier for the H8379-003 Medicare plan. Common searches include H8379 003 and H8379003.

2027

Spaces or dashes work: H5216-435-002 · S2135 802

● CMS 2027 plan record

PriorityMedicare Dual Premier (HMO D-SNP)

H8379-003-003 St. Joseph County HMO Dual-Eligible

At-a-glance

Quick view

01

In-network

Inpatient hospital

Per admission $2,000 per stay
Out-of-network

Not separately reported

Point of service

Not separately reported

02

Emergency transport

Ambulance

Ground · in-network35% coinsurance
Air · in-network35% coinsurance
03

Emergency services

Emergency room

$115 copay

Waived if admitted within 24 hours

04

Medical maximum

Maximum out-of-pocket

In-network$9,850
Combined in + outNot reported
05

Skilled care at home

Home health

In-network$0 cost share
Out-of-networkNot separately reported
06

Monthly cost

Premium & giveback

Part C premium$0 / month
Consolidated C + D$6.30 / month

CMS reports no Part B premium reduction for this plan.

Plan details

All plan benefits

Medical care3 benefits

Primary care physician

In-networkPrimary Care Physician Services: $0 cost share
Out-of-networkNot separately reported

Specialist

In-networkPhysician Specialist Services: $0 cost share
Out-of-networkNot separately reported

Preventive care

In-networkAnnual Physical Exam: $0 cost share; Kidney Disease Education Services: $0 cost share; Glaucoma Screening: $0 cost share; Diabetes Self-Management Training: $0 cost share; Digital Rectal Exams: $0 cost share; EKG following Welcome Visit: $0 cost share
Out-of-networkNot separately reported
Diagnostics & imaging4 benefits

Diagnostic procedures & tests

In-networkDiagnostic Procedures/Tests: 35% coinsurance
Out-of-networkNot separately reported

Laboratory services

In-networkLab Services: 35% coinsurance
Out-of-networkNot separately reported

X-rays & standard imaging

In-networkOutpatient X-Ray Services: 35% coinsurance
Out-of-networkNot separately reported

MRI, CT & PET imaging

In-networkDiagnostic Radiological Services: 35% coinsurance
Out-of-networkNot separately reported
Urgent & hospital care6 benefits

Urgent care

In-networkUrgently Needed Services: 30% coinsurance
Out-of-networkNot separately reported

Emergency room

In-network$115 copay
Out-of-networkNot separately reported

Ground ambulance

In-network35% coinsurance
Out-of-networkNot separately reported

Air ambulance

In-network35% coinsurance
Out-of-networkNot separately reported

Outpatient hospital

In-networkOutpatient Hospital Services: 0%–35% coinsurance; Observation Services: 35% coinsurance
Out-of-networkNot separately reported

Outpatient surgery / ASC

In-networkAmbulatory Surgical Center (ASC) Services: 35% coinsurance
Out-of-networkNot separately reported
Recovery & therapy5 benefits

Home health

In-network$0 cost share
Out-of-networkNot separately reported

Skilled nursing facility

In-networkSkilled nursing facility: Tier 1: $0 / day for days 1–20; $218 / day for days 21–100
Out-of-networkNot separately reported

Cardiac & pulmonary rehabilitation

In-networkCardiac Rehabilitation Services: 30% coinsurance; Intensive Cardiac Rehabilitation Services: 30% coinsurance; Pulmonary Rehabilitation Services: 30% coinsurance; SET for PAD Services: 30% coinsurance; 3-1(NMC): Not applicable; 3-2(NMC): Not applicable; 3-3(NMC): Not applicable; 3-4(NMC): Not applicable
Out-of-networkNot separately reported

Occupational therapy

In-networkOccupational Therapy Services: 30% coinsurance
Out-of-networkNot separately reported

Physical & speech therapy

In-networkPhysical Therapy and Speech-Language Pathology Services: 30% coinsurance
Out-of-networkNot separately reported
Behavioral health2 benefits

Mental health services

In-networkPartial Hospitalization Program: 30% coinsurance; Individual Sessions for Mental Health Specialty Services: $0 cost share; Group Sessions for Mental Health Specialty Services: $0 cost share; Individual Sessions for Psychiatric Services: $0 cost share; Group Sessions for Psychiatric Services: $0 cost share; Inpatient psychiatric hospital: Tier 1: $2,000 per stay
Out-of-networkNot separately reported

Substance use treatment

In-networkIntensive Outpatient Program Services: 30% coinsurance; Individual Sessions for Outpatient Substance Abuse: $0 cost share; Group Sessions for Outpatient Substance Abuse: $0 cost share
Out-of-networkNot separately reported
Specialty care2 benefits

Podiatry

In-networkPodiatry Services: $0 cost share; 7f(NMC): $0 cost share
Out-of-networkNot separately reported

Chiropractic

In-networkChiropractic Services: $0 cost share
Out-of-networkNot separately reported
Supplemental benefits7 benefits

Dental

In-networkMedicare Dental Services: 0%–35% coinsurance
Out-of-networkNot separately reported

Vision

In-networkEye Exams: $0 cost share; Routine Eye Exams: Not applicable; Other Eye Exam Services: Not applicable; Eyewear: $0 cost share; Contact Lenses: Not applicable; Eyeglasses (lenses and frames): Not applicable; Eyeglass lenses: Not applicable; Eyeglass frames: Not applicable; Upgrades: Not applicable
Out-of-networkNot separately reported

Hearing

In-networkHearing Exams: $0 cost share; Routine Hearing Exams: $0 cost share; Fitting/Evaluation for Hearing Aid: $0 cost share; Prescription Hearing Aids (all types): $0 cost share; Prescription Hearing Aids - Inner Ear: Not applicable; Prescription Hearing Aids - Outer Ear: Not applicable; Prescription Hearing Aids - Over the Ear: Not applicable
Out-of-networkNot separately reported

Transportation

Not applicable
In-network10b(NMC): Not applicable
Out-of-networkNot separately reported

Fitness & wellness

In-networkFitness Benefit: $0 cost share
Out-of-networkNot separately reported

Over-the-counter allowance

In-networkOver-the-Counter (OTC) Items: $0 cost share
Out-of-networkNot separately reported

Meals

Not applicable
In-networkMeal Benefit: Not applicable
Out-of-networkNot separately reported
Plan costs & rulesCoverage overview

Premium & Part B giveback

$0 Part C premium / month · CMS reports no Part B premium reduction for this plan.

Maximum out-of-pocket (MOOP)

In-network$9,850
Combined in + outNot reported

Medical deductibles

In-network$480
Out-of-networkNot reported

Annual health deductible

Not separately reported

Combined network deductible

Not separately reported

Part D premium

$6.30 / month

Network & referrals

HMO · Referrals: Required for some services · Out-of-network coverage: Not reported

Prescription drugs5 tiers

Part D deductible

$700 / year

Drug tier 1

Standard retail: $0 copay · Preferred retail: $0 copay · 30-day supply

Drug tier 2

Standard retail: $0 copay · Preferred retail: $0 copay · 30-day supply

Drug tier 3

Standard retail: 25% coinsurance · Preferred retail: 25% coinsurance · 30-day supply

Drug tier 4

Standard retail: 25% coinsurance · Preferred retail: 25% coinsurance · 30-day supply

Drug tier 5

Standard retail: 25% coinsurance · Preferred retail: 25% coinsurance · 30-day supply

Using this plan

Understand H8379-003-003

Plain-language context built from this plan’s 2027 CMS record. It is a guide to the reported benefits, not a personalized cost estimate.

Plan at a glance

A quick read on this plan

PriorityMedicare Dual Premier (HMO D-SNP) is a 2027 HMO offered by Priority Health Medicare in St. Joseph County. Referrals are required for some services.

Common benefit costs

What you may pay

These are individual in-network benefit amounts. A real visit may involve more than one separately billed service.

Routine care

Primary care physician
Primary Care Physician Services: $0 cost share
Specialist
Physician Specialist Services: $0 cost share
Laboratory services
Lab Services: 35% coinsurance

Separate visits or services; costs are not added together.

Tests & outpatient care

Diagnostic procedures & tests
Diagnostic Procedures/Tests: 35% coinsurance
MRI, CT & PET imaging
Diagnostic Radiological Services: 35% coinsurance
Outpatient hospital
Outpatient Hospital Services: 0%–35% coinsurance; Observation Services: 35% coinsurance

The service setting and billing details can change what you pay.

Emergency & hospital care

Emergency room
$115 copay

Actual costs depend on the care received and plan rules.

Helpful context

Terms worth knowing

Maximum out-of-pocket (MOOP)

This is the most you generally pay during the plan year for covered Part A and Part B medical services under the applicable network limit. Premiums and prescription drug costs generally do not count toward it.

Part B premium reduction (“giveback”)

A giveback may reduce the amount you pay toward Medicare Part B; it is not usually paid to you as cash. The CMS record notes: CMS reports no Part B premium reduction for this plan.

Availability

Who can enroll

Service area
St. Joseph County (MI)
Plan type
HMO
Special Needs Plan
Dual-Eligible
Contract / plan
H8379-003
Coverage year
2027

This is a Dual-Eligible; enrollment requires the plan's specific eligibility criteria as well as residence in its service area. Confirm eligibility and the exact service area with the plan before enrolling.

Supplemental coverage

Extra benefits reported

Availability is summarized here; allowances, frequency limits, networks, and prior-authorization rules may apply.

DentalMedicare Dental Services: 0%–35% coinsurance
VisionEye Exams: $0 cost share; Routine Eye Exams: Not applicable; Other Eye Exam Services: Not applicable; Eyewear: $0 cost share; Contact Lenses: Not applicable; Eyeglasses (lenses and frames): Not applicable; Eyeglass lenses: Not applicable; Eyeglass frames: Not applicable; Upgrades: Not applicable
HearingHearing Exams: $0 cost share; Routine Hearing Exams: $0 cost share; Fitting/Evaluation for Hearing Aid: $0 cost share; Prescription Hearing Aids (all types): $0 cost share; Prescription Hearing Aids - Inner Ear: Not applicable; Prescription Hearing Aids - Outer Ear: Not applicable; Prescription Hearing Aids - Over the Ear: Not applicable
Over-the-counter allowanceOver-the-Counter (OTC) Items: $0 cost share
Fitness & wellnessFitness Benefit: $0 cost share

Plan-specific answers

Frequently asked questions

Where is H8379-003-003 available?

PriorityMedicare Dual Premier (HMO D-SNP) is listed for St. Joseph County (MI). This is a Dual-Eligible; enrollment requires the plan's specific eligibility criteria as well as residence in its service area.

What is the in-network maximum out-of-pocket limit for H8379-003-003?

The 2027 CMS record lists an in-network medical maximum out-of-pocket limit of $9,850. Prescription drug spending generally does not count toward this medical limit.

What is the monthly plan premium for H8379-003-003?

The listed consolidated Part C and Part D premium is $6.30 per month. This does not replace the standard Medicare Part B premium.

What does an emergency room visit cost on H8379-003-003?

The plan record lists $115 copay, waived when an admission meets the plan's stated timing rule.

Does H8379-003-003 report extra benefits?

Yes. CMS reports dental, vision, hearing, over-the-counter allowance, fitness & wellness. See the detailed benefit rows and official plan documents for limits and conditions.

Source trail

Official CMS, Contract Year 2027

Plan identity and benefits come from CMS PBP data. Benefits and drug cost sharing come from the approved annual PBP tabular extract and its CMS dictionary. Premiums and drug deductibles are cross-checked with the annual Landscape. Geography comes from annual PlanArea and PlanRegionArea records, including exact segments and partial-county or employer/group qualifiers. Quick-reference values should be confirmed in current official plan documents.

PBP benefits ↗ Landscape data ↗ County service area ↗

Plan context

Where H8379-003-003 fits

Full CMS plan ID
H8379-003-003
Contract
H8379
Base plan code
H8379-003
Segment
003
Carrier
Priority Health Medicare
Plan type
HMO
Service area
St. Joseph County (MI)

County/service-area foundation

CMS service-area entries

Service areas come from the annual CMS PlanArea and PlanRegionArea tables for this exact contract, plan, and segment. Partial-county and employer/group qualifiers remain part of the coverage area. Regional PPO county entries use the matching annual Landscape expansion of the CMS region.

  • St. Joseph, MI

Exact county navigation

These links are limited to named counties tied to this exact medical plan segment. Partial-county entries remain labeled for verification.

Show 1 county link

Same CMS contract

H8379-003-001 PriorityMedicare Dual Premier (HMO D-SNP) Barry County · HMO H8379-003-002 PriorityMedicare Dual Premier (HMO D-SNP) Berrien, Calhoun, Cass, Kalamazoo, Van Buren · HMO H8379-003-004 PriorityMedicare Dual Premier (HMO D-SNP) Wayne, Macomb and Branch · HMO H8379-001-000 PriorityMedicare D-SNP (HMO D-SNP) lower peninsula MI counties · HMO

About this code

What H8379-003-003 identifies

H8379-003-003 is a Contract Year 2027 Medicare plan segment code. Searches written as H8379-003, H8379 003, or the compact full CMS ID H8379003003 refer to this plan or its base plan code.

Medicare Plan Lookup uses official CMS data as a quick reference. Benefit details, eligibility, service-area rules, and cost sharing should be confirmed in the current Summary of Benefits or Evidence of Coverage.