name: Troy Medicare Plans & Pricing
generated: '2026-08-30'
method: searched
source: https://troymedicare.com/summary-of-benefits
description: >-
  Troy Medicare publishes NO API access plans, tiers, quotas or developer pricing of any kind — it
  has no developer program. plan_count is therefore 0. What the company does publish is consumer
  pricing for its two Medicare Advantage insurance products, captured below under product_pricing
  so the research is not lost; those are health-plan premiums, not API tiers, and are deliberately
  kept out of plans[].
applies_to: api-access
plan_count: 0
plans: []
note: >-
  No developer portal, no API pricing page, no self-serve API sign-up, and no "contact sales for API
  access" path was found across troymedicare.com (sitemap.xml enumerates 55 URLs, none developer-facing,
  probed 2026-08-30).
product_pricing:
  kind: medicare-advantage-insurance-products
  contract: H4676
  plan_year: 2026
  currency: USD
  source_documents:
  - name: 2026 Troy Medicare (HMO) Summary of Benefits
    url: https://cdn.prod.website-files.com/5d8c963eace5c7685e78fa4c/68d42692846c00cb6a08bfb5_2026%20Troy%20HMO%20SB%20Final%2008152025.pdf
    status: 200
    cms_id: H4676_001SB2026_M
  - name: 2026 Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) Summary of Benefits
    url: https://cdn.prod.website-files.com/5d8c963eace5c7685e78fa4c/68d42ab5599bfede59044aa9_e0da13ddcfe57d2c380dc14ed97290d3_2026%20Troy%20DSNP%20SB%20Final%2008152025.pdf
    status: 200
    cms_id: H4676_002SB2026_M
  products:
  - name: Troy Medicare (HMO)
    cms_plan_id: H4676-001
    type: Medicare Advantage HMO (Part C + Part D)
    monthly_premium: '$0'
    premium_note: There is no plan premium; the member continues to pay the Medicare Part B premium and any late-enrollment penalty.
    deductible: '$0'
    maximum_out_of_pocket: '$3,950'
    pcp_copay: '$0'
    specialist_copay: '$0'
    outpatient_hospital_copay: '$350 per visit'
    extra_benefits:
    - Hearing exams and hearing aids up to $825 (Hearing Care Solutions)
    - Over-the-counter allowance up to $20/month (Solutran)
    - Preventive dental (Liberty Dental)
    service_area: 35 North Carolina counties
  - name: Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
    cms_plan_id: H4676-002
    type: Dual Eligible Special Needs Plan (HMO D-SNP)
    monthly_premium: '$0 with full Extra Help'
    deductible: '$0'
    maximum_out_of_pocket: '$0'
    eligibility: Medicare Part A and B plus NC Medicaid assistance at FBDE, SLMB+, QMB+ or QMB level
    extra_benefits:
    - Over-the-counter allowance up to $115/month (Solutran)
    - Hearing benefits
    service_area: 35 North Carolina counties
evidence:
- url: https://troymedicare.com/summary-of-benefits
  status: 200
- url: https://troymedicare.com/troy-medicare-hmo
  status: 200
- url: https://troymedicare.com/troy-medicare-dsnp
  status: 200