Trinity Health Plan New York Cash Back (HMO)
Available to residents of Madison County, NY for 2026. Contract H9827, plan 004, segment 0.
Plan details
| Monthly drug premium | $0.00 |
|---|---|
| Drug deductible | $275.00Tier 1 and 2 exempt |
| Plan type | Medicare Advantage |
| Contract / plan | H9827-004-0 |
| Offered by | Trinity Health Plan New York |
| Parent organization | Trinity Health Corporation |
| Formulary drugs | 3,507 |
CMS star ratings
- Overall
- —
- Health plan (Part C)
- —
- Drug plan (Part D)
- 3 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H9827 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $0.00 |
| Tier 2 | $5.00 |
| Tier 3 | 25% |
| Tier 4 | 35% |
| Tier 5 | 29% |
Also available in 7 other NY counties
Plan facts come from the CMS quarterly prescription drug plan public use files.