2027 Medicare Advantage plan
Johns Hopkins Advantage MD BMORE Balanced (HMO D-SNP): 2027 benefits and costs
Johns Hopkins Advantage MD HMO D-SNP Special Needs Plan
CMS plan ID: H1225-006-0 · Plan year: 2027
Johns Hopkins Advantage MD BMORE Balanced (HMO D-SNP) is a 2027 Medicare Advantage plan offered by Johns Hopkins Advantage MD. It is listed in Maryland.
2027 plan costs at a glance
Monthly plan premium$7.90
Drug deductible$700.00
In-network medical out-of-pocket maximum$9,850.00
Costs shown are before Medicaid or Extra Help; your costs depend on your eligibility and assistance.
- Organization
- Johns Hopkins Advantage MD
- Plan organization
- HOPKINS HEALTH ADVANTAGE, INC.
- Parent company
- Johns Hopkins Healthcare LLC
- Plan type
- HMO D-SNP
- Part C premium
- $0.00
- Part D premium
- $7.90
- Prescription drug coverage
- Yes
- Special Needs Plan type
- Dual-Eligible
- 2027 CMS Star Rating
- Standard monthly Medicare Part B premium
- $209.50 (estimated)
You must continue to pay your Medicare Part B premium.
- In-network medical deductible
- Same as Medicare's Part B deductible
Applies to certain in-network Medicare-covered services.
- In-network medical maximum
- $9,850.00
Who can join this Special Needs Plan?
This plan is for people who qualify for both Medicare and Medicaid. The plan must confirm the required Medicaid eligibility level. Your costs can depend on your assistance level.
- Plan eligibility type
- Dual-Eligible
2027 benefit summary
Doctor visits and medical care
Plan-level deductibles may still apply when a service-specific deductible is listed as No.
| Service | In-network | What to know |
|---|---|---|
| Primary care doctor | 20% coinsurance
| |
| Specialist visit | 20% coinsurance
|
|
| Telehealth | $0
|
|
| Emergency care | 20% coinsurance | |
| Urgent care | 20% coinsurance | |
| Home health | $0
|
|
| Dialysis | 20% coinsurance
|
|
| Part B chemotherapy and radiation drugs | 0% to 20% coinsurance
|
|
| Other Part B drugs | 0% to 20% coinsurance
|
|
| Kidney disease education services | 20% coinsurance
|
|
| Medicare-covered chiropractic | 20% coinsurance
|
|
| Medicare-covered foot care | 20% coinsurance
|
|
| Other health professionals | 20% coinsurance
|
|
Hospital, outpatient surgery and observation care
Inpatient stays and skilled nursing care
| Care | Your share of the cost | What to know |
|---|---|---|
| Inpatient hospital stay | Original Medicare cost-sharing rules apply. |
|
| Inpatient mental health care | Original Medicare cost-sharing rules apply. |
|
| Skilled nursing facility | Original Medicare cost-sharing rules apply. |
|
See plan documents for out-of-network hospital and skilled nursing costs.
| Service | In-network | What to know |
|---|---|---|
| Outpatient hospital care | 20% coinsurance
| |
| Hospital observation services | 20% coinsurance
| |
| Ambulatory surgical center | 20% coinsurance
|
|
| Outpatient blood | 20% coinsurance
|
|
Tests, imaging and laboratory services
| Service | In-network | What to know |
|---|---|---|
| Diagnostic procedures and tests | 20% coinsurance
|
|
| Laboratory services | $0
|
|
| Diagnostic radiology (CT, MRI) | 20% coinsurance
|
|
| Therapeutic radiology | 20% coinsurance
|
|
| X-rays | 20% coinsurance
|
|
Mental health and substance use treatment
| Service | In-network | What to know |
|---|---|---|
| Partial hospitalization | 20% coinsurance
|
|
| Intensive outpatient program | 20% coinsurance
|
|
| Substance use treatment, individual sessions | 20% coinsurance
|
|
| Substance use treatment, group sessions | 20% coinsurance
|
|
| Opioid treatment program | 20% coinsurance
|
|
| Mental health, individual sessions | 20% coinsurance
|
|
| Mental health, group sessions | 20% coinsurance
|
|
| Psychiatry, individual sessions | 20% coinsurance
|
|
| Psychiatry, group sessions | 20% coinsurance
|
|
Therapy and rehabilitation
| Service | In-network | What to know |
|---|---|---|
| Occupational therapy | 20% coinsurance
|
|
| Physical and speech therapy | 20% coinsurance
|
|
| Cardiac rehabilitation | 20% coinsurance
|
|
| Intensive cardiac rehabilitation | 20% coinsurance
|
|
| Pulmonary rehabilitation | 20% coinsurance
|
|
| Supervised exercise for peripheral artery disease | 20% coinsurance
|
|
Ambulance, medical equipment and supplies
| Service | In-network | What to know |
|---|---|---|
| Ground ambulance | 20% coinsurance
|
|
| Air ambulance | 20% coinsurance
|
|
| Durable medical equipment | 20% coinsurance
|
|
| Prosthetic devices | 20% coinsurance
|
|
| Medical supplies | 20% coinsurance
|
|
| Diabetic supplies | 20% coinsurance
|
|
| Diabetic shoes and inserts | 20% coinsurance
|
|
| Diabetic monitors | 20% coinsurance
|
|
Dental benefits
| Service | In-network | What to know |
|---|---|---|
| Medicare-covered dental | $0 | |
| Oral examsAdditional plan benefit | $0 | |
| Dental X-raysAdditional plan benefit | $0 | |
| Dental cleaningAdditional plan benefit | $0 | |
| FluorideAdditional plan benefit | $0 | |
| Restorative dental careAdditional plan benefit | $0 | |
| Root canal treatment (endodontics)Additional plan benefit | $0 | |
| Gum treatment (periodontics)Additional plan benefit | $0 | |
| Removable dentures (prosthodontics)Additional plan benefit | $0 | |
| Dental implantsAdditional plan benefit | $0 | |
| Fixed dental restorations (prosthodontics)Additional plan benefit | $0 | |
| Oral surgeryAdditional plan benefit | $0 | |
| Other dental servicesAdditional plan benefit | $0 |
Vision benefits
| Service | In-network | What to know |
|---|---|---|
| Medicare-covered eye exams | $0
|
|
| Routine eye examsAdditional plan benefit | $0 |
|
| Medicare-covered eyewear | $0
|
|
| Contact lensesAdditional plan benefit | $0 |
|
| Eyeglasses, lenses and framesAdditional plan benefit | $0 |
|
| Eyeglass lensesAdditional plan benefit | $0 |
|
| Eyeglass framesAdditional plan benefit | $0 |
|
Hearing benefits
| Service | In-network | What to know |
|---|---|---|
| Medicare-covered hearing exams | $0
|
|
| Routine hearing examsAdditional plan benefit | $0 |
|
| Hearing aid fitting and evaluationAdditional plan benefit | $0 |
|
| Prescription hearing aids (all types)Additional plan benefit | $0
|
|
Extra benefits
| Service | In-network | What to know |
|---|---|---|
| Over-the-counter health itemsAdditional plan benefit | $0
| |
| Limited-duration mealsAdditional plan benefit | $0
|
|
| Annual physical examAdditional plan benefit | $0
|
|
| Fitness benefitAdditional plan benefit | $0
|
|
Allowances and optional benefits
OTC and/or Healthy Food
One shared limit covers the listed services, not a separate allowance for each service.
- Services sharing this allowance
- Over-the-counter health items; Additional Benefits for SSBCI
- Service categories that apply to the combined supplemental benefits group for Special Supplemental Benefits for Chronically Ill (SSBCI) package(s)
- Food and produce (SSBCI: Healthy Food)
- How benefits are provided
- Catalogue Purchase; Debit Card
- Advance choice of benefits required
- No
- Shared benefit limit
- $90.00
- How often this limit applies
- Every one month
- Are the benefits combined such that a single benefit maximum available to all enrollees in the benefit details section is extended to an SSBCI or MA UF benefit for eligible enrollees?
- Yes
- Shared limit on visits or trips
- No
Benefits for qualifying members
Healthy Food
The plan must confirm eligibility, including any qualifying condition.
- Qualifying conditions
- Chronic alcohol use disorder and other substance use disorders (SUDs); Autoimmune disorders; Cancer; Cardiovascular disorders; Chronic heart failure; Dementia; Diabetes mellitus; Overweight, obesity, and metabolic syndrome; Chronic gastrointestinal disease; Chronic kidney disease (CKD); Severe hematologic disorders; HIV/AIDS; Chronic lung disorders; Chronic and disabling mental health conditions; Neurologic disorders; Stroke; Post-organ transplantation; Immunodeficiency and Immunosuppressive disorders; Conditions associated with cognitive impairment; Conditions with functional challenges; Chronic conditions that impair vision, hearing (deafness), taste, touch, and smell; Conditions that require continued therapy services in order for individuals to maintain or retain functioning
- Included services
- Food and produce
- Some package benefits are exempt from the deductible
- No
Prescription drug coverage
Costs shown are for initial coverage.
This plan uses a non-tiered standard drug benefit; individual drug prices are not listed here.
| Pharmacy | Supply |
|---|---|
| Standard retail | 30 days |
| Standard retail | 60 days |
| Standard retail | 100 days |
| Standard mail order | 30 days |
| Standard mail order | 60 days |
| Standard mail order | 100 days |
| Out-of-network pharmacy | 30 days |
| Long-term care pharmacy | 31 days |
Where this plan is offered
CMS lists this plan in 1 state or territory. Availability can vary by county and ZIP code.