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Abilis Health (HMO I-SNP)

Available to residents of Breckinridge County, KY for 2027. Contract H2400, 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, service area expanded for 2027. CMS carries this plan forward from 2026. Every KY plan’s 2026–2027 changes →

Plan details

Monthly premium (Part C + D)$16.20
— medical (Part C) part$0.00
— drug (Part D) part$16.20?
Monthly premium with full Extra Help (LIS)$0.00?
Part B premium reduction (giveback)$15.00 a month?You must continue to pay your Medicare Part B premium.
In-network out-of-pocket maximum$9,850.00?
Drug deductible$700.00
Drug out-of-pocket threshold$2,400.00
Plan typeHMO I-SNP?
Special needs planInstitutional SNP
Contract / planH2400-001-0
Offered byAbilis Health (HMO SNP)
Parent organizationBrightSpring Health Services, Inc.
Pharmacy searchwww.abilishealth.com
Member services(844)214-8633TTY 711

CMS star ratings

Overall
3.5 out of 5 stars for Overall
Health plan (Part C)
4 out of 5 stars for 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 H2400 shares this rating.

Plan health benefits

ServiceIn-network
Doctor visits
Primary care doctor0%–20% coinsurance
Specialist20% coinsurance
Other health care professional0%–20% coinsurance
Additional telehealth services0%–20% coinsurance
Preventive care
Medicare-covered preventive services$0 copay
Annual physical examNot covered
Kidney disease education$0 copay
Glaucoma screening$0 copay
Diabetes self-management training$0 copay
Diagnostic tests, labs and imaging
Diagnostic tests and procedures20% coinsurance(authorization and referral required)
Lab services20% coinsurance(authorization and referral required)
Diagnostic radiology (e.g. MRI, CT)20% coinsurance(authorization required)
Therapeutic radiology20% coinsurance(authorization required)
Outpatient x-rays20% coinsurance(authorization required)
Emergency and urgent care
Emergency room20% coinsurance
Urgent care20% coinsurance
Worldwide emergency coverageNot covered
Worldwide urgent careNot covered
Worldwide emergency transportationNot covered
Hospital care
Inpatient hospital stayOriginal Medicare cost-sharing(authorization required)
Outpatient hospital services20% coinsurance(authorization required)
Outpatient observation20% coinsurance(authorization required)
Ambulatory surgical center20% coinsurance(authorization required)
Outpatient blood services20% coinsurance
Skilled nursing and home health
Skilled nursing facility$0 per day for days 1–100(authorization required)
Home health care$0 copay(authorization required)
Kidney dialysis20% coinsurance
Rehabilitation
Occupational therapy20% coinsurance
Physical therapy and speech-language therapy20% coinsurance
Cardiac rehabilitation20% coinsurance(authorization required)
Pulmonary rehabilitation20% coinsurance(authorization required)
Mental health and substance use
Inpatient psychiatric hospital stayOriginal Medicare cost-sharing(authorization required)
Outpatient mental health, individual session0%–20% coinsurance
Outpatient mental health, group session0%–20% coinsurance
Psychiatrist, individual session0%–20% coinsurance
Psychiatrist, group session0%–20% coinsurance
Partial hospitalization20% coinsurance(authorization required)
Intensive outpatient program20% coinsurance(authorization required)
Outpatient substance use, individual session20% coinsurance
Outpatient substance use, group session20% coinsurance
Opioid treatment program20% coinsurance(authorization required)
Ambulance and transportation
Ground ambulance20% coinsurance(authorization required)
Air ambulance20% coinsurance(authorization required)
Transportation to plan-approved locations$0 copay(authorization required)
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 supplies20% coinsurance(authorization required)
Diabetes supplies20% coinsurance(authorization required)
Diabetic therapeutic shoes or inserts20% coinsurance(authorization required)
Chiropractic, acupuncture and foot care
Chiropractic (Medicare-covered)20% coinsurance(authorization required)
Routine chiropractic careNot covered
AcupunctureNot covered
Foot exams and treatment (Medicare-covered)20% coinsurance
Routine foot care$0 copay(limits apply)
Dental?
Medicare-covered dental services20% coinsurance
Oral exams$0 copay(limits apply)
Cleanings$0 copay(limits apply)
Fluoride treatmentNot covered
Dental x-rays$0 copay(limits apply)
Other diagnostic dental servicesNot covered
Other preventive dental servicesNot covered
Comprehensive dental plan limit$2,000 plan limit every year
Restorative services (fillings, crowns)20% coinsurance
Endodontics (root canals)20% coinsurance
Periodontics (gum disease)20% coinsurance
Dentures and other removable prosthodontics20% coinsurance
Maxillofacial prosthetics20% coinsurance
Implants20% coinsurance
Bridges and other fixed prosthodontics20% coinsurance
Oral and maxillofacial surgery20% coinsurance
Orthodontics20% coinsurance
Adjunctive general services20% coinsurance
Vision?
Eye exam (Medicare-covered)20% coinsurance
Routine eye exam$0 copay(limits apply)
Eyewear after cataract surgery (Medicare-covered)20% coinsurance(limits apply)
Eyewear plan limit$275 plan limit every year
Contact lenses$0 copay(limits apply)
Eyeglasses (frames and lenses)$0 copay(limits apply)
Eyeglass lenses$0 copay(limits apply)
Eyeglass frames$0 copay(limits apply)
Eyewear upgrades$0 copay(limits apply)
Hearing?
Hearing exam (Medicare-covered)20% coinsurance
Routine hearing exam$0 copay(limits apply)
Hearing aid fitting and evaluation$0 copay
Hearing aid plan limit$4,000 plan limit every two years
Hearing aids (all types)$0 copay(limits apply)
Hearing aids, inner earNot covered
Hearing aids, outer earNot covered
Hearing aids, over the earNot covered
Medicare Part B drugs
Part B insulin$35 copay(authorization required)
Chemotherapy and radiation drugs0%–20% coinsurance(authorization required)
Other Part B drugs0%–20% coinsurance(authorization required)
Other extra benefits?
Over-the-counter (OTC) allowance$200 allowance every three months
Meals after a hospital stay or for a chronic conditionNot covered
Fitness benefitNot covered
Health educationNot covered
Nutritional / dietary benefitNot covered
Extra smoking and tobacco cessation counselingNot covered
Enhanced disease managementNot covered
TelemonitoringNot covered
Remote access technologies (web/phone, nurse line)$0 copay(authorization required)
Home and bathroom safety devicesNot covered
Counseling servicesNot covered
In-home safety assessmentNot covered
Personal emergency response system (PERS)Not covered
Medical nutrition therapyNot covered
Post-discharge in-home medication reconciliationNot covered
Re-admission preventionNot covered
Wigs for hair loss from chemotherapyNot covered
Weight management programsNot covered
Alternative therapies$0 copay(authorization required)
Therapeutic massageNot covered
Adult day health servicesNot covered
Home-based palliative care$0 copay(authorization required)
In-home support servicesNot covered
Support for caregiversNot covered

In-network cost-sharing as the plan filed it with CMS (CMS plan benefit package (PBP) files, CY2027). 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.

Star rating measures

Each CMS star measure for contract H2400, 2027 against 2026
Measure20272026
Staying Healthy: Screenings, Tests and Vaccines
Colorectal Cancer Screening · C021 out of 5 stars for Colorectal Cancer Screening1 out of 5 stars for Colorectal Cancer Screening
Managing Chronic (Long Term) Conditions
Special Needs Plan (SNP) Care Management · C075 out of 5 stars for Special Needs Plan (SNP) Care Management5 out of 5 stars for Special Needs Plan (SNP) Care Management
Care for Older Adults – Medication Review · C085 out of 5 stars for Care for Older Adults – Medication Review5 out of 5 stars for Care for Older Adults – Medication Review
Care for Older Adults - Functional Status Assessment · C095 out of 5 stars for Care for Older Adults - Functional Status Assessmentnew measure
Diabetes Care – Eye Exam · C11no data2 out of 5 stars for Diabetes Care – Eye Exam
Diabetes Care – Blood Sugar Controlled · C125 out of 5 stars for Diabetes Care – Blood Sugar Controlled3 out of 5 stars for Diabetes Care – Blood Sugar Controlled
Kidney Health Evaluation for Patients with Diabetes · C131 out of 5 stars for Kidney Health Evaluation for Patients with Diabetes1 out of 5 stars for Kidney Health Evaluation for Patients with Diabetes
Controlling High Blood Pressure · C14not enough data5 out of 5 stars for Controlling High Blood Pressure
Plan All-Cause Readmissions · C17no data2 out of 5 stars for Plan All-Cause Readmissions
Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions · C201 out of 5 stars for Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions1 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 · C275 out of 5 stars for Complaints about the Health Plan5 out of 5 stars for Complaints about the Health Plan
Members Choosing to Leave the Plan · C285 out of 5 stars for Members Choosing to Leave the Plan5 out of 5 stars for Members Choosing to Leave the Plan
Health Plan Quality Improvement · C294 out of 5 stars for Health Plan Quality Improvement3 out of 5 stars for Health Plan Quality Improvement
Health Plan Customer Service
Plan Makes Timely Decisions about Appeals · C301 out of 5 stars for Plan Makes Timely Decisions about Appeals1 out of 5 stars for Plan Makes Timely Decisions about Appeals
Reviewing Appeals Decisions · C315 out of 5 stars for Reviewing Appeals Decisions4 out of 5 stars for Reviewing Appeals Decisions
Call Center – Foreign Language Interpreter and TTY Availability · C323 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability3 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 · D013 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability4 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 · D025 out of 5 stars for Complaints about the Drug Plan5 out of 5 stars for Complaints about the Drug Plan
Members Choosing to Leave the Plan · D035 out of 5 stars for Members Choosing to Leave the Plan5 out of 5 stars for Members Choosing to Leave the Plan
Drug Plan Quality Improvement · D043 out of 5 stars for Drug Plan Quality Improvement2 out of 5 stars for Drug Plan Quality Improvement
DD4: Drug Safety and Accuracy of Drug Pricing
MPF Price Accuracy · D073 out of 5 stars for MPF Price Accuracy5 out of 5 stars for MPF Price Accuracy
Medication Adherence for Diabetes Medications · D081 out of 5 stars for Medication Adherence for Diabetes Medications2 out of 5 stars for Medication Adherence for Diabetes Medications
Medication Adherence for Hypertension (RAS antagonists) · D092 out of 5 stars for Medication Adherence for Hypertension (RAS antagonists)2 out of 5 stars for Medication Adherence for Hypertension (RAS antagonists)
Medication Adherence for Cholesterol (Statins) · D104 out of 5 stars for Medication Adherence for Cholesterol (Statins)3 out of 5 stars for Medication Adherence for Cholesterol (Statins)
Statin Use in Persons with Diabetes (SUPD) · D111 out of 5 stars for Statin Use in Persons with Diabetes (SUPD)2 out of 5 stars for Statin Use in Persons with Diabetes (SUPD)
Concurrent Use of Opioids and Benzodiazepines (COB) · D121 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) · D133 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 H2400 shares it.

Also available in 102 other KY counties

Benefits in plain text

Abilis Health (HMO I-SNP) (H2400-001-0) is a 2027 HMO I-SNP Medicare Advantage plan offered by Abilis Health (HMO SNP), available to residents of Breckinridge County, KY.

The monthly premium is $16.20.

The plan reduces the member's Medicare Part B premium by $15.00 a month (a "giveback"); the Part B premium itself must still be paid.

With full Extra Help (the Low-Income Subsidy), the total monthly premium is $0.00.

Its in-network out-of-pocket maximum is $9,850.00.

The drug deductible is $700.00.

It is a special needs plan (Institutional SNP).

CMS gives the plan's contract (H2400) an overall rating of 3.5 out of 5 stars.

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Plan facts come from the CMS plan Landscape file and the CMS plan benefit package (PBP) files.