UCLA Health Medicare Advantage Principal Plan (HMO)
Available to residents of Los Angeles County, CA for 2026. Contract H4647, plan 001, segment 0.
Plan details
| Monthly drug premium | $0.00 |
|---|---|
| Drug deductible | $250.00Tier 1 and 2 exempt |
| Plan type | Medicare Advantage |
| Contract / plan | H4647-001-0 |
| Offered by | UCLA Health Medicare Advantage Plan |
| Parent organization | The Regents of the University of California |
| Formulary drugs | 3,250 |
CMS star ratings
- Overall
- —
- Health plan (Part C)
- —
- Drug plan (Part D)
- —
Published per contract — every plan under contract H4647 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $0.00 |
| Tier 2 | $0.00 |
| Tier 3 | $47.00 |
| Tier 4 | 45% |
| Tier 5 | 30% |
Plan facts come from the CMS quarterly prescription drug plan public use files.