PruittHealth Premier D-SNP (HMO D-SNP)
Available to residents of Carroll County, GA for 2027. Contract H3291, plan 002, segment 0.
2027 drug-by-drug coverage is not published by CMS yet. The drug lookup covers 2026, whose formulary is live.
Renewed, service area expanded 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 | $9,850.00 |
| Drug deductible | $700.00Tier 1 and 2 exempt |
| Drug out-of-pocket threshold | $2,400.00 |
| Plan type | HMO D-SNP |
| Special needs plan | Dual-eligible SNP |
| D-SNP integration status | Coordination Only (CO) |
| Zero-dollar cost sharing D-SNP | No |
| Contract / plan | H3291-002-0 |
| Offered by | PruittHealth Premier |
| Parent organization | UNICO Services, Inc. |
| Formulary tiers | 5 |
| Member services | (855)855-0668TTY 711 |
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 H3291 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 · Preferred Generic | $0.00 |
| Tier 2 · Generic | 23% |
| Tier 3 · Preferred Brand | 25% |
| Tier 4 · Non-Preferred Drug | 25% |
| Tier 5 · Specialty Tier | 25% |
Star rating measures
| Measure | 2027 | 2026 |
|---|---|---|
| Staying Healthy: Screenings, Tests and Vaccines | ||
| Breast Cancer Screening · C01 | 1 out of 5 stars for Breast Cancer Screening | 1 out of 5 stars for Breast Cancer Screening |
| Colorectal Cancer Screening · C02 | 3 out of 5 stars for Colorectal Cancer Screening | 5 out of 5 stars for Colorectal Cancer Screening |
| Managing Chronic (Long Term) Conditions | ||
| Special Needs Plan (SNP) Care Management · C07 | 5 out of 5 stars for Special Needs Plan (SNP) Care Management | 5 out of 5 stars for Special Needs Plan (SNP) Care Management |
| Care for Older Adults – Medication Review · C08 | 4 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 | 4 out of 5 stars for Diabetes Care – Eye Exam | 5 out of 5 stars for Diabetes Care – Eye Exam |
| Diabetes Care – Blood Sugar Controlled · C12 | 2 out of 5 stars for Diabetes Care – Blood Sugar Controlled | 3 out of 5 stars for Diabetes Care – Blood Sugar Controlled |
| Kidney Health Evaluation for Patients with Diabetes · C13 | 2 out of 5 stars for Kidney Health Evaluation for Patients with Diabetes | 3 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 | not enough data |
| Plan All-Cause Readmissions · C17 | 3 out of 5 stars for Plan All-Cause Readmissions | 3 out of 5 stars for Plan All-Cause Readmissions |
| Transitions of Care · C19 | 1 out of 5 stars for Transitions of Care | not enough data |
| 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 Complaints and Changes in the Health Plan's Performance | ||
| Complaints about the Health Plan · C27 | 3 out of 5 stars for Complaints about the Health Plan | 5 out of 5 stars for Complaints about the Health Plan |
| Members Choosing to Leave the Plan · C28 | 5 out of 5 stars for Members Choosing to Leave the Plan | 5 out of 5 stars for Members Choosing to Leave the Plan |
| Health Plan Customer Service | ||
| Call Center – Foreign Language Interpreter and TTY Availability · C32 | 4 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability | 4 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 | 4 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability | 4 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability |
| DD2: Member Complaints and Changes in the Drug Plan’s Performance | ||
| Complaints about the Drug Plan · D02 | 3 out of 5 stars for Complaints about the Drug Plan | 5 out of 5 stars for Complaints about the Drug Plan |
| Members Choosing to Leave the Plan · D03 | 5 out of 5 stars for Members Choosing to Leave the Plan | 5 out of 5 stars for Members Choosing to Leave the Plan |
| Drug Plan Quality Improvement · D04 | 2 out of 5 stars for Drug Plan Quality Improvement | 4 out of 5 stars for Drug Plan Quality Improvement |
| DD4: Drug Safety and Accuracy of Drug Pricing | ||
| MPF Price Accuracy · D07 | 3 out of 5 stars for MPF Price Accuracy | 5 out of 5 stars for MPF Price Accuracy |
| Medication Adherence for Diabetes Medications · D08 | 1 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 | 3 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 | 5 out of 5 stars for Medication Adherence for Cholesterol (Statins) | 5 out of 5 stars for Medication Adherence for Cholesterol (Statins) |
| Statin Use in Persons with Diabetes (SUPD) · D11 | 5 out of 5 stars for Statin Use in Persons with Diabetes (SUPD) | 5 out of 5 stars for Statin Use in Persons with Diabetes (SUPD) |
| Concurrent Use of Opioids and Benzodiazepines (COB) · D12 | 2 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 | 2 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 H3291 shares it.
Also available in 117 other GA counties
- Baker
- Baldwin
- Banks
- Barrow
- Bartow
- Ben Hill
- Berrien
- Bibb
- Brooks
- Bryan
- Burke
- Butts
- Camden
- Candler
- Catoosa
- Chatham
- Chattahoochee
- Chattooga
- Cherokee
- Clarke
- Clayton
- Clinch
- Cobb
- Coffee
- Colquitt
- Columbia
- Coweta
- Crawford
- Dawson
- DeKalb
- Dooly
- Dougherty
- Douglas
- Echols
- Effingham
- Elbert
- Emanuel
- Evans
- Fannin
- Fayette
- Floyd
- Forsyth
- Franklin
- Fulton
- Glascock
- Glynn
- Grady
- Greene
- Gwinnett
- Habersham
- Hall
- Hancock
- Haralson
- Harris
- Hart
- Heard
- Henry
- Houston
- Irwin
- Jackson
Plan facts come from the CMS plan Landscape file and the CMS plan benefit package (PBP) files.