HealthSun MediSun Full Dual Plus (HMO D-SNP)

HealthSun MediSun Full Dual Plus (HMO D-SNP) is a HMO D-SNP plan offered by Elevance Health, Inc. available for enrollment in 2026 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 Full Dual 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 Full Dual 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 Full Dual Plus (HMO D-SNP) offers robust prescription drug coverage with a $0 annual drug deductible. Under this plan, there is no copay for Tier 1 preferred generic, Tier 2 generic, and Tier 6 supplemental drugs filled at standard pharmacies or through mail order. This ensures that essential everyday medications remain highly affordable for enrolled members. For brand-name and specialty medications, the plan features predictable cost-sharing for one-month supplies. Tier 3 preferred brand drugs require a $5 copay, and Tier 4 non-preferred drugs carry a $50 copay. Tier 5 specialty drugs require a 33% coinsurance for a one-month supply at both standard pharmacies and standard mail order.

Additional Benefits

The HealthSun MediSun Full Dual Plus (HMO D-SNP) offers comprehensive medical coverage with no copay and no coinsurance for almost all covered services. This includes inpatient and outpatient hospital stays, primary and specialist care, emergency services, and diagnostic testing. Members also benefit from covered medical equipment, home health services, and skilled nursing facility care at no cost. In addition to core medical care, the plan provides valuable supplemental benefits like a $5,000 annual dental limit, a $2,000 hearing aid allowance, and a $400 eyewear benefit. Eligible members also receive a $155 monthly over-the-counter allowance and unlimited transportation to plan-approved locations. While these benefits offer extensive financial protection, many services do require prior authorization or referrals.