PHP (HMO C-SNP)
Available to residents of Los Angeles County, CA for 2027. Contract H5852, plan 001, segment 0.
2027 drug-by-drug coverage is not published by CMS yet. The drug lookup covers 2026, whose formulary is live.
Renewed for 2027. CMS carries this plan forward from 2026.
Plan details
| Monthly premium (Part C + D) | $0.00 |
|---|---|
| — medical (Part C) part | $0.00 |
| — drug (Part D) part | $0.00 |
| In-network out-of-pocket maximum | $5,000.00 |
| Drug deductible | $700.00Tier 5 exempt |
| Drug out-of-pocket threshold | $2,400.00 |
| Plan type | HMO C-SNP |
| Special needs plan | Chronic-condition SNP |
| Qualifying condition | HIV_AIDS |
| Contract / plan | H5852-001-0 |
| Offered by | AHF |
| Parent organization | AIDS Healthcare Foundation |
| Formulary tiers | 5 |
| Member services | (800)263-0067TTY 711 |
CMS star ratings
- Overall
- —
- Health plan (Part C)
- —
- Drug plan (Part D)
- 4 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H5852 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 · Generic | 15% |
| Tier 2 · Preferred Brand | 25% |
| Tier 3 · Non-Preferred Brand | 25% |
| Tier 4 · Specialty Tier | 25% |
| Tier 5 · Select Care Drugs | $0.00 |
Star rating measures
| Measure | 2027 | 2026 |
|---|---|---|
| Staying Healthy: Screenings, Tests and Vaccines | ||
| Colorectal Cancer Screening · C02 | 4 out of 5 stars for Colorectal Cancer Screening | 4 out of 5 stars for Colorectal Cancer Screening |
| Annual Flu Vaccine · C03 | 5 out of 5 stars for Annual Flu Vaccine | 5 out of 5 stars for Annual Flu Vaccine |
| Managing Chronic (Long Term) Conditions | ||
| Special Needs Plan (SNP) Care Management · C07 | 3 out of 5 stars for Special Needs Plan (SNP) Care Management | 3 out of 5 stars for Special Needs Plan (SNP) Care Management |
| Care for Older Adults – Medication Review · C08 | 5 out of 5 stars for Care for Older Adults – Medication Review | 4 out of 5 stars for Care for Older Adults – Medication Review |
| Care for Older Adults - Functional Status Assessment · C09 | 5 out of 5 stars for Care for Older Adults - Functional Status Assessment | new measure |
| Diabetes Care – Eye Exam · C11 | 2 out of 5 stars for Diabetes Care – Eye Exam | 2 out of 5 stars for Diabetes Care – Eye Exam |
| Diabetes Care – Blood Sugar Controlled · C12 | 4 out of 5 stars for Diabetes Care – Blood Sugar Controlled | 4 out of 5 stars for Diabetes Care – Blood Sugar Controlled |
| Kidney Health Evaluation for Patients with Diabetes · C13 | 5 out of 5 stars for Kidney Health Evaluation for Patients with Diabetes | 5 out of 5 stars for Kidney Health Evaluation for Patients with Diabetes |
| Controlling High Blood Pressure · C14 | 3 out of 5 stars for Controlling High Blood Pressure | 3 out of 5 stars for Controlling High Blood Pressure |
| Transitions of Care · C19 | 5 out of 5 stars for Transitions of Care | 4 out of 5 stars for Transitions of Care |
| Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions · C20 | 2 out of 5 stars for Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions | 1 out of 5 stars for Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions |
| Member Experience with Health Plan | ||
| Getting Needed Care · C21 | 4 out of 5 stars for Getting Needed Care | 4 out of 5 stars for Getting Needed Care |
| Customer Service · C23 | 4 out of 5 stars for Customer Service | 3 out of 5 stars for Customer Service |
| Rating of Health Care Quality · C24 | not enough data | 4 out of 5 stars for Rating of Health Care Quality |
| Rating of Health Plan · C25 | 5 out of 5 stars for Rating of Health Plan | 5 out of 5 stars for Rating of Health Plan |
| Care Coordination · C26 | not enough data | 3 out of 5 stars for Care Coordination |
| Member Complaints and Changes in the Health Plan's Performance | ||
| Health Plan Quality Improvement · C29 | not enough data | 5 out of 5 stars for Health Plan Quality Improvement |
| Health Plan Customer Service | ||
| Call Center – Foreign Language Interpreter and TTY Availability · C32 | 3 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability | 3 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability |
| DD1: Drug Plan Customer Service | ||
| Call Center – Foreign Language Interpreter and TTY Availability · D01 | 3 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability | 3 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability |
| DD2: Member Complaints and Changes in the Drug Plan’s Performance | ||
| Drug Plan Quality Improvement · D04 | 3 out of 5 stars for Drug Plan Quality Improvement | 3 out of 5 stars for Drug Plan Quality Improvement |
| DD3: Member Experience with the Drug Plan | ||
| Rating of Drug Plan · D05 | 5 out of 5 stars for Rating of Drug Plan | 5 out of 5 stars for Rating of Drug Plan |
| DD4: Drug Safety and Accuracy of Drug Pricing | ||
| MPF Price Accuracy · D07 | 5 out of 5 stars for MPF Price Accuracy | 4 out of 5 stars for MPF Price Accuracy |
| Medication Adherence for Diabetes Medications · D08 | 4 out of 5 stars for Medication Adherence for Diabetes Medications | 4 out of 5 stars for Medication Adherence for Diabetes Medications |
| Medication Adherence for Hypertension (RAS antagonists) · D09 | 4 out of 5 stars for Medication Adherence for Hypertension (RAS antagonists) | 4 out of 5 stars for Medication Adherence for Hypertension (RAS antagonists) |
| Medication Adherence for Cholesterol (Statins) · D10 | 4 out of 5 stars for Medication Adherence for Cholesterol (Statins) | 4 out of 5 stars for Medication Adherence for Cholesterol (Statins) |
| Statin Use in Persons with Diabetes (SUPD) · D11 | 4 out of 5 stars for Statin Use in Persons with Diabetes (SUPD) | 4 out of 5 stars for Statin Use in Persons with Diabetes (SUPD) |
| Concurrent Use of Opioids and Benzodiazepines (COB) · D12 | 1 out of 5 stars for Concurrent Use of Opioids and Benzodiazepines (COB) | new measure |
| Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH) · D13 | 5 out of 5 stars for Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH) | new measure |
Measures are paired between the two years by name, not by the C/D number: CMS reuses those numbers, and in 2027 nineteen of them refer to a different measure than they did in 2026. A measure introduced for 2027 has no 2026 score to show. Published per contract — every plan under H5852 shares it.
Also available in 1 other CA county
Plan facts come from the CMS plan Landscape file and the CMS plan benefit package (PBP) files.