HealthSun MediSun Extra (HMO D-SNP)

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

It's important to know that HealthSun MediSun Extra (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 Extra (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 Extra (HMO D-SNP) offers comprehensive prescription drug coverage with a $0 drug deductible, meaning your benefits begin immediately. Under this plan, you will pay no copay for Tier 1 preferred generic, Tier 2 generic, and Tier 6 supplemental drugs filled at standard pharmacies or through standard mail order. This cost-effective structure ensures that essential, everyday medications remain highly affordable for members. For other prescription tiers, a one-month supply of Tier 3 preferred brand drugs carries a $10 copay, while Tier 4 non-preferred drugs require a $50 copay. Tier 5 specialty drugs are subject to a 33% coinsurance at both standard retail pharmacies and standard mail order locations. These straightforward copayments and coinsurance rates help you easily plan your healthcare budget.

Additional Benefits

The HealthSun MediSun Extra (HMO D-SNP) plan offers comprehensive coverage with no copay and no coinsurance for almost all essential medical services. Members can access inpatient and outpatient hospital care, primary and specialist doctor visits, emergency services, and medical equipment with zero out-of-pocket costs. Additionally, the plan covers routine dental care up to a $5,000 annual maximum, vision exams with a $400 eyewear allowance, and hearing aids up to $2,000, all with no copays or coinsurance. While most medical services are covered at no cost, many benefits require prior authorization and doctor referrals before you can receive care. For prescription-related medical needs, Medicare Part B insulin carries a $0 to $35 copay, while chemotherapy and other Part B drugs may require a 0% to 20% coinsurance. The plan also includes valuable extra benefits like unlimited transportation to plan-approved health locations and a $128 monthly allowance for over-the-counter items.