Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) in Adams County, Pennsylvania — 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
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) (H5932-009) is a $18-premium Medicare Advantage HMO D-SNP from Highmark Health available in Adams County, Pennsylvania in 2026, with a 4.0-star overall rating, a $8,000 in-network out-of-pocket maximum, and a $615 annual Part D drug deductible.
Plan facts (CMS CY2026 Landscape file)
| Organization | Highmark Health |
|---|---|
| Plan name | Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) |
| Contract ID | H5932 |
| Plan ID | 009 |
| Segment ID | 0 |
| Contract year | 2026 |
| Contract category | SNP |
| Plan type | HMO D-SNP |
| SNP | Yes — Dual-Eligible |
| Monthly consolidated premium | $17.60 |
| Part C premium | $0.00 |
| Part D basic premium | $17.60 |
| Part D total premium | $17.60 |
| Annual Part D deductible | $615.00 |
| Maximum out-of-pocket (in-network) | $8000.00 |
| Overall star rating | 4.0 |
How this plan is structured
- $18 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 D-SNP 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.
- $8,000 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 = Adams 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 Adams County
The CMS CY2026 Landscape file lists 96 Medicare Advantage plans in Adams County, Pennsylvania, of which 0 carry a 5.0-star overall rating and 44 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $226.00 per month, and in-network out-of-pocket maximums range from $1500.00 to $9250.00.
For the full county plan directory, see all Medicare plans in Adams County, Pennsylvania.
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:
- Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H5932-009.
- Call the plan (Highmark Health) using the member-services number listed on that plan page and ask whether each doctor, hospital, and pharmacy is in-network for 2026.
- Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.
What H5932-009 means
CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H5932-009, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 5932 are the contract number issued to the organization, and the three-digit 009 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 Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) an HMO or PPO?
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) is an HMO D-SNP — a Health Maintenance Organization-style Medicare Advantage plan, meaning in-network care and referral rules generally apply.
Does Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) include prescription drug coverage?
Yes — Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) is a Medicare Advantage plan with prescription drug coverage (MA-PD) and a $615.00 annual Part D drug deductible for 2026.
What is the maximum out-of-pocket cost for Highmark Wholecare Medicare Assured Ruby (HMO D-SNP)?
The 2026 in-network maximum out-of-pocket limit for Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) is $8000.00, per the CMS CY2026 Landscape file.
What counties offer Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) (H5932-009)?
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) (H5932-009) is offered in 57 Pennsylvania counties: Adams County, Allegheny County, Armstrong County, Beaver County, Bedford County, Berks County, Blair County, Bradford County, Butler County, Cambria County, Cameron County, Carbon County, Centre County, Clarion County, Clearfield County, Clinton County, Crawford County, Cumberland County, Dauphin County, Elk County, Erie County, Fayette County, Forest County, Franklin County, Fulton County, Greene County, Huntingdon County, Indiana County, Jefferson County, Juniata County, Lancaster County, Lawrence County, Lebanon County, Lehigh County, Lycoming County, McKean County, Mercer County, Mifflin County, Monroe County, Montour County, Northampton County, Perry County, Potter County, Schuylkill County, Snyder County, Somerset County, Sullivan County, Susquehanna County, Tioga County, Union County, Venango County, Warren County, Washington County, Wayne County, Westmoreland County, Wyoming County, and York County.
Sources
- CMS, Plan Year 2026 Medicare Advantage & Part D Landscape source file (March 2026) — retrieved 2026-07-18. Overall star rating year: 2026.
- Medicare.gov Plan Finder — compare plans and enroll.