Essence Advantage (HMO) in Fayette County, Kentucky — 2026 plan details

Last updated Jul 18, 2026

Reviewed by Jason Burns, Editorial Steward

Published by Senior Direct Answers · Licensed under Citation License 1.0

Essence Advantage (HMO) (H2610-021) is a $0-premium Medicare Advantage HMO from Lumeris Group Holdings Corporation available in Fayette County, Kentucky in 2026, with a 4.5-star overall rating, a $3,350 in-network out-of-pocket maximum, and a $340 annual Part D drug deductible.

Plan facts (CMS CY2026 Landscape file)

OrganizationLumeris Group Holdings Corporation
Plan nameEssence Advantage (HMO)
Contract IDH2610
Plan ID021
Segment ID0
Contract year2026
Contract categoryMA-PD
Plan typeHMO
SNPNo
Monthly consolidated premium$0.00
Part C premium$0.00
Part D basic premium$5.20
Part D total premium$0.00
Annual Part D deductible$340.00
Maximum out-of-pocket (in-network)$3350.00
Overall star rating4.5

How this plan is structured

  • $0 consolidated premium. A $0 or near-$0 consolidated premium does not remove the Part B premium — the standard 2026 Part B premium is $202.90 per month and still applies. See the 2026 Medicare Part B premium.
  • HMO plan type. In an HMO-style Medicare Advantage plan, in-network care and primary-care referral rules generally apply. See how Medicare Advantage HMO and PPO plans differ.
  • $3,350 in-network out-of-pocket maximum. The MOOP is the annual cap on what a member pays in-network for covered Part A and Part B services. See how the Medicare Advantage MOOP works.
  • Service area = Fayette County. Medicare Advantage plans are sold by service area; moving out of the plan's service area triggers a Special Enrollment Period to switch plans. See how moving changes your Medicare options.

How it compares in Fayette County

The CMS CY2026 Landscape file lists 65 Medicare Advantage plans in Fayette County, Kentucky, of which 0 carry a 5.0-star overall rating and 33 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $138.00 per month, and in-network out-of-pocket maximums range from $3350.00 to $9250.00.

For the full county plan directory, see all Medicare plans in Fayette County, Kentucky.

How to verify your doctors take this plan

Network participation changes throughout the year; we hold no provider-network data, so verify directly with these three sources before you decide:

  1. Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H2610-021.
  2. Call the plan (Lumeris Group Holdings Corporation) using the member-services number listed on that plan page and ask whether each doctor, hospital, and pharmacy is in-network for 2026.
  3. Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.

What H2610-021 means

CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H2610-021, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 2610 are the contract number issued to the organization, and the three-digit 021 is the plan benefit package under that contract. The segment ID 0 identifies the service-area segment within the plan (0 = the default single segment).

Frequently asked questions

Is Essence Advantage (HMO) an HMO or PPO?

Essence Advantage (HMO) is an HMO — a Health Maintenance Organization-style Medicare Advantage plan, meaning in-network care and referral rules generally apply.

Does Essence Advantage (HMO) include prescription drug coverage?

Yes — Essence Advantage (HMO) is a Medicare Advantage plan with prescription drug coverage (MA-PD) and a $340.00 annual Part D drug deductible for 2026.

What is the maximum out-of-pocket cost for Essence Advantage (HMO)?

The 2026 in-network maximum out-of-pocket limit for Essence Advantage (HMO) is $3350.00, per the CMS CY2026 Landscape file.

What counties offer Essence Advantage (HMO) (H2610-021)?

Essence Advantage (HMO) (H2610-021) is offered in 21 Kentucky counties: Anderson County, Bourbon County, Bullitt County, Carroll County, Clark County, Fayette County, Harrison County, Henry County, Jefferson County, Larue County, Meade County, Mercer County, Nelson County, Oldham County, Owen County, Robertson County, Shelby County, Spencer County, Trimble County, Washington County, and Woodford County.

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