Healthy Mississippi Premier Advantage (HMO-POS)
Available to residents of Simpson County, MS for 2026. Contract H8879, plan 001, segment 0.
- ✉ Email a copy of the plan benefit details
- Plan health benefits
- Benefits in plain text
- Rx cost-sharing for all pharmacies and tiers
- Other plans in Simpson County
- Plan website
- Browse the Healthy Mississippi Premier Advantage (HMO-POS) formulary
Renewed, service area expanded for 2026. CMS carries this plan forward from 2025.
Plan details
| Monthly premium (Part C + D) | $0.00 |
|---|---|
| — medical (Part C) part | $0.00 |
| — drug (Part D) part | $0.00? |
| Monthly premium with full Extra Help (LIS) | $0.00? |
| Part B premium reduction (giveback) | None |
| Health plan deductible (in-network) | None |
| In-network out-of-pocket maximum | $3,850.00? |
| Drug deductible | $0.00 |
| Drug out-of-pocket threshold | $2,100.00 |
| Plan type | HMO-POS? |
| Contract / plan | H8879-001-0 |
| Offered by | Healthy Mississippi, Inc. |
| Parent organization | Singh Holdings LLC |
| Formulary drugs | 3,859 |
| Formulary exception tier | 4? |
| Pharmacy search | healthy-ms.com |
| Member services | (833)201-6413TTY (800)582-2233 |
CMS star ratings
- Overall
- —
- Health plan (Part C)
- —
- Drug plan (Part D)
- —
Published per contract — every plan under contract H8879 shares this rating.
Plan health benefits
| Service | In-network |
|---|---|
| Doctor visits | |
| Primary care doctor | $0 copay |
| Specialist | $0–$30 copay(authorization required) |
| Other health care professional | $0–$30 copay(authorization required) |
| Additional telehealth services | $0–$40 copay(authorization required) |
| Preventive care | |
| Medicare-covered preventive services | $0 copay(authorization required) |
| Annual physical exam | $0 copay(authorization required) |
| Kidney disease education | $0 copay(authorization required) |
| Glaucoma screening | $0 copay(authorization required) |
| Diabetes self-management training | $0 copay(authorization required) |
| Diagnostic tests, labs and imaging | |
| Diagnostic tests and procedures | $0–$50 copay(authorization required) |
| Lab services | $0 copay(authorization required) |
| Diagnostic radiology (e.g. MRI, CT) | $0–$140 copay(authorization required) |
| Therapeutic radiology | $0–$50 copay(authorization required) |
| Outpatient x-rays | $0–$15 copay(authorization required) |
| Emergency and urgent care | |
| Emergency room | $110 copay |
| Urgent care | $0–$40 copay |
| Worldwide emergency coverage | $110 copay · $10,000 plan limit |
| Worldwide urgent care | $40 copay · $10,000 plan limit |
| Worldwide emergency transportation | $295 copay |
| Hospital care | |
| Inpatient hospital stay | $0 per day for days 1–90; $0 per day for days 91–999 (additional days); varies by hospital tier(authorization required) |
| Outpatient hospital services | $0–$225 copay(authorization required) |
| Outpatient observation | $0–$225 copay(authorization required) |
| Ambulatory surgical center | $0–$225 copay(authorization required) |
| Outpatient blood services | $0 copay(authorization required) |
| Skilled nursing and home health | |
| Skilled nursing facility | $0 per day for days 1–100; varies by hospital tier(authorization required) |
| Home health care | $0 copay(authorization required) |
| Kidney dialysis | 20% coinsurance(authorization required) |
| Rehabilitation | |
| Occupational therapy | $0–$20 copay(authorization required) |
| Physical therapy and speech-language therapy | $0–$20 copay(authorization required) |
| Cardiac rehabilitation | $0–$25 copay(authorization required) |
| Pulmonary rehabilitation | $15 copay(authorization required) |
| Mental health and substance use | |
| Inpatient psychiatric hospital stay | $0 per day for days 1–90; varies by hospital tier(authorization required) |
| Outpatient mental health, individual session | $0–$25 copay(authorization required) |
| Outpatient mental health, group session | $0–$25 copay(authorization required) |
| Psychiatrist, individual session | $0–$25 copay(authorization required) |
| Psychiatrist, group session | $0–$25 copay(authorization required) |
| Outpatient substance use, individual session | $0–$25 copay(authorization required) |
| Outpatient substance use, group session | $0–$25 copay(authorization required) |
| Opioid treatment program | $0 copay(authorization required) |
| Ambulance and transportation | |
| Ground ambulance | $295 copay(authorization required) |
| Air ambulance | $295 copay(authorization required) |
| Transportation to plan-approved locations | $0 copay(authorization required, limits apply) |
| Medical equipment and supplies | |
| Durable medical equipment (e.g. wheelchairs, oxygen) | 20% coinsurance(authorization required) |
| Prosthetics (e.g. braces, artificial limbs) | 20% coinsurance(authorization required) |
| Medical supplies | 20% coinsurance(authorization required) |
| Diabetes supplies | $0 copay(authorization required) |
| Diabetic therapeutic shoes or inserts | 20% coinsurance(authorization required) |
| Chiropractic, acupuncture and foot care | |
| Chiropractic (Medicare-covered) | $15 copay(authorization required) |
| Routine chiropractic care | Not covered |
| Acupuncture | Not covered |
| Foot exams and treatment (Medicare-covered) | $30 copay(authorization required) |
| Routine foot care | $30 copay(authorization required, limits apply) |
| Dental? | |
| Preventive dental plan limit | $3,000 plan limit every year |
| Oral exams | $0 copay(authorization required, limits apply) |
| Cleanings | $0 copay(authorization required, limits apply) |
| Fluoride treatment | $0 copay(authorization required, limits apply) |
| Dental x-rays | $0 copay(authorization required, limits apply) |
| Other diagnostic dental services | $0 copay(authorization required) |
| Other preventive dental services | $0 copay(authorization required) |
| Restorative services (fillings, crowns) | $0 copay(authorization required) |
| Endodontics (root canals) | $0 copay(authorization required) |
| Periodontics (gum disease) | $0 copay(authorization required) |
| Dentures and other removable prosthodontics | $0 copay(authorization required) |
| Maxillofacial prosthetics | $0 copay(authorization required) |
| Implants | $0 copay(authorization required) |
| Bridges and other fixed prosthodontics | $0 copay(authorization required) |
| Oral and maxillofacial surgery | $0 copay(authorization required) |
| Orthodontics | Not covered |
| Adjunctive general services | $0 copay(authorization required) |
| Vision? | |
| Eye exam (Medicare-covered) | $0–$30 copay(authorization required) |
| Routine eye exam | $0 copay(authorization required, limits apply) |
| Eyewear after cataract surgery (Medicare-covered) | $0 copay(authorization required, limits apply) |
| Eyewear plan limit | $300 plan limit every year |
| Contact lenses | $0 copay(authorization required, limits apply) |
| Eyeglasses (frames and lenses) | $0 copay(authorization required, limits apply) |
| Eyeglass lenses | $0 copay(authorization required, limits apply) |
| Eyeglass frames | $0 copay(authorization required, limits apply) |
| Eyewear upgrades | $0 copay(authorization required, limits apply) |
| Hearing? | |
| Hearing exam (Medicare-covered) | $0–$30 copay(authorization required) |
| Routine hearing exam | $0 copay(authorization required, limits apply) |
| Hearing aid fitting and evaluation | $0 copay(authorization required, limits apply) |
| Hearing aid plan limit | $1,950 plan limit every year |
| Hearing aids (all types) | $0 copay(authorization required, limits apply) |
| Hearing aids, inner ear | Not covered |
| Hearing aids, outer ear | Not covered |
| Hearing aids, over the ear | Not covered |
| Medicare Part B drugs | |
| Part B insulin | 0%–20% coinsurance(authorization required, step therapy may apply) |
| Chemotherapy and radiation drugs | 0%–20% coinsurance(authorization required, step therapy may apply) |
| Other Part B drugs | 0%–20% coinsurance(authorization required, step therapy may apply) |
| Other extra benefits? | |
| Over-the-counter (OTC) allowance | $115 allowance every three months |
| Meals after a hospital stay or for a chronic condition | $0 copay(authorization required) |
| Fitness benefit | $0 copay(authorization required, limits apply) |
| Health education | $0 copay(authorization required, limits apply) |
| Nutritional / dietary benefit | Not covered |
| Extra smoking and tobacco cessation counseling | Not covered |
| Enhanced disease management | Not covered |
| Telemonitoring | $0 copay(authorization required, limits apply) |
| Remote access technologies (web/phone, nurse line) | Not covered |
| Home and bathroom safety devices | $0 copay(authorization required, limits apply) |
| Counseling services | Not covered |
| In-home safety assessment | Not covered |
| Personal emergency response system (PERS) | Not covered |
| Medical nutrition therapy | Not covered |
| Post-discharge in-home medication reconciliation | Not covered |
| Re-admission prevention | Not covered |
| Wigs for hair loss from chemotherapy | Not covered |
| Weight management programs | $0 copay(authorization required, limits apply) |
| Alternative therapies | Not covered |
| Therapeutic massage | Not covered |
| Adult day health services | Not covered |
| Home-based palliative care | Not covered |
| In-home support services | $0 copay(authorization required, limits apply) |
| Support for caregivers | Not covered |
In-network cost-sharing as the plan filed it with CMS (CMS plan benefit package (PBP) files, CY2026). A range means the cost depends on the service or setting. Rows the filing does not state are left out rather than guessed. Contact the plan for the full Evidence of Coverage.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $0.00 |
| Tier 2 | $0.00 |
| Tier 3 | $0.00 |
| Tier 4 | $0.00 |
| Tier 5 | 33% |
Rx cost-sharing by coverage phase
| Tier | 30-day supply | 90-day supply | ||||
|---|---|---|---|---|---|---|
| Preferred | Standard | Mail Order | Preferred | Standard | Mail Order | |
| Initial coverage phase | ||||||
| Tier 1: Preferred Generic | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 2: Generic | $0.00 | $10.00 | $0.00 | $0.00 | $30.00 | $0.00 |
| Tier 3: Preferred Brand | $0.00 | $47.00 | $0.00 | $0.00 | $141.00 | $0.00 |
| Tier 4: Non-Preferred Drug | $0.00 | $100.00 | $0.00 | $0.00 | $300.00 | $0.00 |
| Tier 5: Specialty Tier | 33% | 33% | 33% | n/a | n/a | n/a |
| Catastrophic coverage phase | ||||||
| Tier 1: Preferred Generic | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 2: Generic | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 3: Preferred Brand | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 4: Non-Preferred Drug | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 5: Specialty Tier | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Also available in 70 other MS counties
- Alcorn
- Amite
- Attala
- Benton
- Calhoun
- Chickasaw
- Choctaw
- Claiborne
- Clarke
- Clay
- Copiah
- Covington
- DeSoto
- Forrest
- Franklin
- George
- Greene
- Grenada
- Hancock
- Harrison
- Hinds
- Holmes
- Issaquena
- Itawamba
- Jasper
- Jefferson
- Jefferson Davis
- Jones
- Kemper
- Lafayette
- Lamar
- Lauderdale
- Lawrence
- Leake
- Leflore
- Lincoln
- Lowndes
- Madison
- Marion
- Marshall
- Monroe
- Neshoba
- Newton
- Noxubee
- Oktibbeha
- Panola
- Pearl River
- Perry
- Pike
- Pontotoc
- Prentiss
- Quitman
- Rankin
- Scott
- Sharkey
- Smith
- Stone
- Tallahatchie
- Tate
- Tippah
Benefits in plain text
Healthy Mississippi Premier Advantage (HMO-POS) (H8879-001-0) is a 2026 HMO-POS Medicare Advantage plan offered by Healthy Mississippi, Inc., available to residents of Simpson County, MS.
The monthly premium is $0.00 (Part C and Part D together).
With full Extra Help (the Low-Income Subsidy), the total monthly premium is $0.00.
There is no in-network deductible for health services.
Its in-network out-of-pocket maximum is $3,850.00.
The drug deductible is $0.00.
The plan's formulary lists 3,859 drugs.
At a preferred pharmacy in the initial coverage phase, a 30-day supply costs tier 1: $0.00; tier 2: $0.00; tier 3: $0.00; tier 4: $0.00; tier 5: 33%.
Email a copy of the plan benefit details
Plan facts come from the CMS quarterly prescription drug plan public use files; the premium split, Extra Help premium, MOOP and plan type from the CMS Landscape file; the Part B giveback and health benefits from the CMS plan benefit package (PBP) files.