HealthSun MediSun Plus (HMO D-SNP)

HealthSun MediSun Plus (HMO D-SNP) is a HMO D-SNP plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Palm Beach. This plan received an overall rating of 4.5 out of 5 stars in 2026.

It's important to know that HealthSun MediSun Plus (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about HealthSun MediSun Plus (HMO D-SNP).

Plan Costs:

The cost of a Medicare Advantage Plan is made up of four main parts.

• First, the monthly premium — the amount you pay every month.
• Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
• Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
• Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.

You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.

Common Services:

Drug Coverage

The HealthSun MediSun Plus (HMO D-SNP) Medicare plan features a $0 drug deductible, meaning your prescription coverage begins immediately with no upfront costs. Under this plan, you will pay no copay for Tier 1 preferred generic drugs, Tier 2 generic drugs, and Tier 6 supplemental drugs when using standard retail pharmacies or standard mail order services. For higher-tier medications, a 1-month supply at standard pharmacies or standard mail order requires a $10 copay for Tier 3 preferred brands and a $50 copay for Tier 4 non-preferred drugs. Tier 5 specialty drugs require a 33% coinsurance for a 1-month supply through standard retail pharmacies and standard mail order.

Additional Benefits

The HealthSun MediSun Plus (HMO D-SNP) offers comprehensive healthcare coverage with no copays, no deductibles, and no coinsurance for the vast majority of its covered services. This includes complete coverage for inpatient and outpatient hospital stays, primary care and specialist visits, emergency care, and diagnostic testing. While most medical services require prior authorization or referrals, members can access essential care like home health, dialysis, and medical equipment at no cost. This plan also features robust supplemental benefits, including dental coverage up to $5,000 annually, a $2,000 hearing aid allowance, and a $400 annual vision allowance with no copays. Additionally, members receive unlimited transportation to plan-approved locations and a $155 monthly allowance for over-the-counter items. Note that while most services are fully covered, certain Medicare Part B drugs may require up to a 20% coinsurance, and Part B insulin may carry a copay of up to $35.