2027 coverage assessment

Your coverage at a glance

This is an assessment for an entirely synthetic beneficiary with current plan H0028-042-0. The listed medical service scenario can be modeled for all four plans under explicit covered, in-network assumptions. Prescription spending and a complete annual healthcare total remain unresolved.

Devoted's dated public directory lists the selected pharmacy and both physicians at their exact locations for the plan's network. The other plans' network status has not been verified. CMS's latest monthly formulary file in the pinned catalog is for 2026, so no 2027 drug-coverage conclusion is made.

Your healthcare requirements

Fictional assumptions; the real physicians and pharmacy are public examples and have no relationship to a real beneficiary.

Medications

• atorvastatin 20 MG Oral Tablet · 30 tablets per 30 days; 12 expected fills/year. RxCUI 617310; package NDC unselected.
• lisinopril 10 MG Oral Tablet · 30 tablets per 30 days; 12 expected fills/year. RxCUI 314076; package NDC unselected.

Pharmacy

PRUDENT PHARMACY · NPI 1144590704 · 6335 Gulfton St #105, Houston, TX 77081-1112 · mandatory.

Physicians

• Farah Harmouch, MD · NPI 1740849520 · Gastroenterology · 10950 Resource Pkwy Ste A, Houston, TX 77089 · mandatory
• Jacqueline Vo, MD · NPI 1346338001 · Rheumatology · 2204 Austin St Ste 200, Houston, TX 77002 · preferred

Moderate-use scenario: two primary care visits, two general specialist visits and one urgent care center visit. No emergency or inpatient use. Address is unknown; ZIP 77002 is illustrative.

Plans being compared

Doctors and hospitals

The chosen requirements are two physicians; no hospital was specified or checked. A directory listing is dated evidence, not a guarantee of current participation or new-patient acceptance.

Prescriptions and pharmacy

RxNorm matches identify exact generic products. Multiple package NDCs remain possible. Identification does not establish Part D coverage or pricing.

What the modeled medical services could cost

The existing deterministic Phase 2.2 model assumes Medicare-covered, in-network services. These figures are limited to the specified moderate-use scenario and are separate from the plan premium and prescriptions.

A medical out-of-pocket maximum does not cap Part D spending. Neither unknown drug costs nor address eligibility are treated as zero or confirmed.

Prescription costs

No complete pharmacy-specific 2027 drug price, deductible phase, and exact package evidence was obtained. All four prescription-cost calculations remain unresolved. A formulary tier alone cannot supply an insured annual cost.

Alternatives that deserve attention

No plan clears all mandatory requirements on the evidence available today. The findings below show where further investigation would be useful; they are not an enrollment recommendation or a ranking.

• Humana Gold Plus H0028-042 (HMO): requirements unresolved. Needs checking: atorvastatin 20 MG Oral Tablet, lisinopril 10 MG Oral Tablet, PRUDENT PHARMACY, Farah Harmouch, MD, Jacqueline Vo, MD, Exact address.
• HumanaChoice H5216-042 (PPO): requirements unresolved. Needs checking: atorvastatin 20 MG Oral Tablet, lisinopril 10 MG Oral Tablet, PRUDENT PHARMACY, Farah Harmouch, MD, Jacqueline Vo, MD, Exact address.
• KelseyCare Advantage Freedom (HMO-POS): requirements unresolved. Needs checking: atorvastatin 20 MG Oral Tablet, lisinopril 10 MG Oral Tablet, PRUDENT PHARMACY, Farah Harmouch, MD, Jacqueline Vo, MD, Exact address.
• DEVOTED CORE 001 TX (HMO): requirements unresolved. Needs checking: atorvastatin 20 MG Oral Tablet, lisinopril 10 MG Oral Tablet, Exact address.

What must be verified before a decision

• 2027 drug formulary listings, restrictions, exact NDCs, and pharmacy-specific Part D prices.
• Preferred or standard pharmacy status and whether the selected physicians remain in network and accept new patients.
• Exact residential eligibility beyond the county listing and illustrative ZIP.
• Actual care needs, prescription fill dates, deductible and benefit phase, and human reviewer approval.

Sources and audit

Source URLs, retrieval dates, hashes, CMS plan IDs, and calculation inputs are recorded in the machine-readable assessment. The independent audit checks evidence levels and displayed values.