name = "Atlas Commons research objects — Medicare plans in Sussex, Delaware (CY2026)"
description = "CMS CY2026 Medicare Advantage and Part D plans available in Sussex, Delaware: plan count (AGGREGATED), premium range (RECORDED from CMS Landscape Files), CMS star ratings (DETERMINATION — CMS-issued institutional quality rating), and epistemic boundary (INTERPRETATION). Premiums are base plan premiums; actual cost depends on Part B premium, IRMAA, and LIS. Star ratings are CMS quality scores. This surface informs; it does not rank or advise. Use medicare.gov/plan-compare to enroll. CC0."
license = "CC0-1.0"
jsonld = "https://coverage-atlas.ryanjhunter.workers.dev/coverage/medicare-plans/de/sussex.jsonld"

[[claims]]
id = "https://coverage-atlas.ryanjhunter.workers.dev/coverage/medicare-plans/de/sussex/plan-count"
warrant = "DERIVED"
name = "32 Medicare plans are available in Sussex, Delaware for contract year 2026"
text = "The CMS CY2026 Medicare Landscape Files record 32 Medicare Advantage and Part D plans available in Sussex, Delaware. Atlas Commons counted the rows; CMS published the underlying plan×county records, not this county-level total."
source = "CMS CY2026 Medicare Landscape Files"
sourceUrl = "https://www.cms.gov/medicare/health-drug-plans/medicare-advantage/plan-information/plan-information"
falsifier = "occurred=TRUE: a faithful COUNT/SUM/total over the named record set that introduces NO modeling choice — it IS the case in the record. adjudged=FALSE: Atlas Commons computed the aggregate; CMS CY2026 Medicare Landscape Files published the underlying records, NOT this figure. Re-count it from the named source to verify. Distinct from a median/ratio/index (which picks a population, weighting, denominator, or threshold — a constructed statistic → 'derived', occurred=FALSE) and from an authority-published total (→ 'recorded', adjudged=TRUE)."

[[claims]]
id = "https://coverage-atlas.ryanjhunter.workers.dev/coverage/medicare-plans/de/sussex/premium-range"
warrant = "RECORDED"
name = "Monthly premiums for Medicare plans in Sussex, Delaware range from $0.00/mo to $134.00/mo (CY2026)"
text = "The CMS CY2026 Medicare Landscape Files publish per-plan monthly consolidated premiums for Sussex, Delaware. Across the 32 plans with a published premium, the range is $0.00/mo to $134.00/mo. These are the plan's base monthly premium — your actual cost depends on income-related adjustments (IRMAA), any applicable Low Income Subsidy (LIS/Extra Help), and your Part B premium. A $0 plan premium does not mean $0 total cost."
source = "CMS CY2026 Medicare Landscape Files"
sourceUrl = "https://www.cms.gov/medicare/health-drug-plans/medicare-advantage/plan-information/plan-information"
falsifier = "Verify in the CMS CY2026 Medicare Landscape Files for Sussex, Delaware. Falsified if the CMS-published per-plan premium figures differ."

[[claims]]
id = "https://coverage-atlas.ryanjhunter.workers.dev/coverage/medicare-plans/de/sussex/star-ratings"
warrant = "PROJECTED"
name = "CMS assigned star ratings to 25 of 32 Medicare plans in Sussex, Delaware (CY2026); average overall: 3.8 stars"
text = "CMS issued Overall star ratings (1–5 stars) to 25 of 32 Medicare plans in Sussex, Delaware for CY2026. The unweighted average overall star rating across rated plans is 3.8. Star ratings are CMS quality scores — an institutional determination, not a measured event. A higher rating reflects better performance across CMS quality measures. Ratings cover the contract's overall performance, not this county specifically; a plan may be available in your county with a rating earned across its full service area."
source = "CMS CY2026 Medicare Landscape Files"
sourceUrl = "https://www.cms.gov/medicare/health-drug-plans/medicare-advantage/plan-information/plan-information"
falsifier = "Verify CMS star ratings for these contract IDs at the CMS Medicare Plan Finder or the CMS star ratings dataset. Falsified if the CMS-published ratings for these contracts differ. Note: PDP-only plans and newly contracted plans may not have an overall star rating — the 7 unrated plans in this county are not rated, not unqualified."

[[claims]]
id = "https://coverage-atlas.ryanjhunter.workers.dev/coverage/medicare-plans/de/sussex/boundary"
warrant = "INTERPRETATION"
name = "What these Medicare plan figures are — and are NOT — for Sussex, Delaware (the epistemic boundary)"
text = "This page lists Medicare Advantage (MA) and Part D Prescription Drug Plan (PDP) plans available in Sussex, Delaware for CY2026, with their CMS-published base premiums and CMS star ratings. The premiums shown are the PLAN's base monthly premium — your actual monthly cost depends on the Part B premium (deducted from Social Security for most enrollees), income-related premium adjustments (IRMAA), and any Low Income Subsidy (Extra Help). A star rating is CMS's quality score for the plan's overall performance — a higher rating is generally better, but the \"best\" plan depends on your specific prescriptions, preferred doctors, and budget. This surface informs and compares; it does NOT rank plans, recommend a \"best\" plan, or account for your individual situation. To compare plans with your specific drugs and providers and to enroll, use the official Medicare Plan Finder at medicare.gov/plan-compare. For free, unbiased help, contact your State Health Insurance Assistance Program (SHIP) or call 1-800-MEDICARE (1-800-633-4227)."
source = "Coverage Atlas framing (over the CMS facts above)"
sourceUrl = "https://coverage-atlas.ryanjhunter.workers.dev/coverage/medicare-plans/de/sussex"
falsifier = "occurred=FALSE (a framing) and adjudged=FALSE (the atlas's reading, not a CMS verdict) — the LOWEST-warrant claim here."

[[medicarePlans]]
contract_plan_id = "H0710_017"
plan_name = "UHC Nursing Home Plan EX-F002 (PPO I-SNP)"
category = "SNP"
plan_type = "PPO I-SNP"
organization = "UnitedHealthcare"
monthly_premium_usd = 32.6
overall_stars = 4.5
moop_in_network_usd = 9250
snp = "No"

[[medicarePlans]]
contract_plan_id = "H0738_001"
plan_name = "AmeriHealth Caritas VIP Care (HMO D-SNP)"
category = "SNP"
plan_type = "HMO D-SNP"
organization = "AmeriHealth Caritas VIP Care (HMO-D-SNP)"
monthly_premium_usd = 31.2
overall_stars = "Not rated"
moop_in_network_usd = 9250
snp = "No"

[[medicarePlans]]
contract_plan_id = "H0738_002"
plan_name = "AmeriHealth Caritas VIP Care Choice (HMO D-SNP)"
category = "SNP"
plan_type = "HMO D-SNP"
organization = "AmeriHealth Caritas VIP Care (HMO-D-SNP)"
monthly_premium_usd = 31.2
overall_stars = "Not rated"
moop_in_network_usd = 7550
snp = "No"

[[medicarePlans]]
contract_plan_id = "H2108_029"
plan_name = "HealthSpring Achieve (HMO C-SNP)"
category = "SNP"
plan_type = "HMO C-SNP"
organization = "HealthSpring"
monthly_premium_usd = 28
overall_stars = 3
moop_in_network_usd = 5500
snp = "No"

[[medicarePlans]]
contract_plan_id = "H2108_042"
plan_name = "HealthSpring Preferred (HMO)"
category = "MA-PD"
plan_type = "HMO"
organization = "HealthSpring"
monthly_premium_usd = 0
overall_stars = 3
moop_in_network_usd = 7500
snp = "No"

[[medicarePlans]]
contract_plan_id = "H2406_075"
plan_name = "AARP Medicare Advantage from UHC DE-0001 (PPO)"
category = "MA-PD"
plan_type = "PPO"
organization = "UnitedHealthcare"
monthly_premium_usd = 0
overall_stars = 4
moop_in_network_usd = 6700
snp = "No"

[[medicarePlans]]
contract_plan_id = "H2406_100"
plan_name = "AARP Medicare Advantage from UHC DE-0002 (PPO)"
category = "MA-PD"
plan_type = "PPO"
organization = "UnitedHealthcare"
monthly_premium_usd = 52
overall_stars = 4
moop_in_network_usd = 6300
snp = "No"

[[medicarePlans]]
contract_plan_id = "H3931_102"
plan_name = "Aetna Medicare Enhanced (HMO)"
category = "MA-PD"
plan_type = "HMO"
organization = "Aetna Medicare"
monthly_premium_usd = 46
overall_stars = 3
moop_in_network_usd = 6750
snp = "No"

[[medicarePlans]]
contract_plan_id = "H3959_055"
plan_name = "Aetna Medicare Advantra Signature (HMO)"
category = "MA-PD"
plan_type = "HMO"
organization = "Aetna Medicare"
monthly_premium_usd = 0
overall_stars = 4
moop_in_network_usd = 6500
snp = "No"

[[medicarePlans]]
contract_plan_id = "H3959_056"
plan_name = "Aetna Medicare Advantra Eagle Plus (HMO)"
category = "MA"
plan_type = "HMO"
organization = "Aetna Medicare"
monthly_premium_usd = "N/A"
overall_stars = 4
moop_in_network_usd = 6750
snp = "No"

[[medicarePlans]]
contract_plan_id = "H3959_083"
plan_name = "Aetna Medicare Chronic Care Total (HMO C-SNP)"
category = "SNP"
plan_type = "HMO C-SNP"
organization = "Aetna Medicare"
monthly_premium_usd = 7.4
overall_stars = 4
moop_in_network_usd = 9250
snp = "No"

[[medicarePlans]]
contract_plan_id = "H3959_084"
plan_name = "Aetna Medicare Chronic Care (HMO C-SNP)"
category = "SNP"
plan_type = "HMO C-SNP"
organization = "Aetna Medicare"
monthly_premium_usd = 0
overall_stars = 4
moop_in_network_usd = 6750
snp = "No"

[[medicarePlans]]
contract_plan_id = "H4661_001"
plan_name = "Wellcare Simple (HMO-POS)"
category = "MA-PD"
plan_type = "HMO-POS"
organization = "Wellcare"
monthly_premium_usd = 0
overall_stars = "Not rated"
moop_in_network_usd = 6000
snp = "No"

[[medicarePlans]]
contract_plan_id = "H4661_003"
plan_name = "Wellcare Delaware First Health Dual Align (HMO-POS D-SNP)"
category = "SNP"
plan_type = "HMO-POS D-SNP"
organization = "Wellcare"
monthly_premium_usd = 31.2
overall_stars = "Not rated"
moop_in_network_usd = 9250
snp = "No"

[[medicarePlans]]
contract_plan_id = "H4661_005"
plan_name = "Wellcare Dual Select (HMO-POS D-SNP)"
category = "SNP"
plan_type = "HMO-POS D-SNP"
organization = "Wellcare"
monthly_premium_usd = 18.1
overall_stars = "Not rated"
moop_in_network_usd = 3850
snp = "No"

[[medicarePlans]]
contract_plan_id = "H5216_308"
plan_name = "Humana Essentials Plus Giveback H5216-308 (PPO)"
category = "MA-PD"
plan_type = "PPO"
organization = "Humana"
monthly_premium_usd = 0
overall_stars = 3.5
moop_in_network_usd = 9250
snp = "No"

[[medicarePlans]]
contract_plan_id = "H5216_381"
plan_name = "Humana USAA Honor Giveback (PPO)"
category = "MA"
plan_type = "PPO"
organization = "Humana"
monthly_premium_usd = "N/A"
overall_stars = 3.5
moop_in_network_usd = 6750
snp = "No"

[[medicarePlans]]
contract_plan_id = "H5216_386"
plan_name = "Humana USAA Honor Giveback (PPO)"
category = "MA"
plan_type = "PPO"
organization = "Humana"
monthly_premium_usd = "N/A"
overall_stars = 3.5
moop_in_network_usd = 6750
snp = "No"

[[medicarePlans]]
contract_plan_id = "H5216_387"
plan_name = "HumanaChoice H5216-387 (PPO)"
category = "MA-PD"
plan_type = "PPO"
organization = "Humana"
monthly_premium_usd = 25
overall_stars = 3.5
moop_in_network_usd = 8950
snp = "No"

[[medicarePlans]]
contract_plan_id = "H5216_390"
plan_name = "HumanaChoice H5216-390 (PPO)"
category = "MA-PD"
plan_type = "PPO"
organization = "Humana"
monthly_premium_usd = 19.7
overall_stars = 3.5
moop_in_network_usd = 5900
snp = "No"

[[medicarePlans]]
contract_plan_id = "H5253_142"
plan_name = "AARP Medicare Advantage Essentials from UHC DE-3 (HMO-POS)"
category = "MA-PD"
plan_type = "HMO-POS"
organization = "UnitedHealthcare"
monthly_premium_usd = 0
overall_stars = 4
moop_in_network_usd = 5900
snp = "No"

[[medicarePlans]]
contract_plan_id = "H5253_143"
plan_name = "AARP Medicare Advantage Patriot No Rx DE-MA01 (HMO-POS)"
category = "MA"
plan_type = "HMO-POS"
organization = "UnitedHealthcare"
monthly_premium_usd = "N/A"
overall_stars = 4
moop_in_network_usd = 6700
snp = "No"

[[medicarePlans]]
contract_plan_id = "H5253_179"
plan_name = "UHC Complete Care DE-4 (HMO-POS C-SNP)"
category = "SNP"
plan_type = "HMO-POS C-SNP"
organization = "UnitedHealthcare"
monthly_premium_usd = 0
overall_stars = 4
moop_in_network_usd = 5900
snp = "No"

[[medicarePlans]]
contract_plan_id = "H5253_200"
plan_name = "UHC Complete Care Support DE-5A (HMO-POS C-SNP)"
category = "SNP"
plan_type = "HMO-POS C-SNP"
organization = "UnitedHealthcare"
monthly_premium_usd = 31.2
overall_stars = 4
moop_in_network_usd = 9250
snp = "No"

[[medicarePlans]]
contract_plan_id = "H5253_206"
plan_name = "AARP Medicare Advantage Extras from UHC DE-6 (HMO-POS)"
category = "MA-PD"
plan_type = "HMO-POS"
organization = "UnitedHealthcare"
monthly_premium_usd = 0
overall_stars = 4
moop_in_network_usd = 6700
snp = "No"

[[medicarePlans]]
contract_plan_id = "H5521_095"
plan_name = "Aetna Medicare Premier (PPO)"
category = "MA-PD"
plan_type = "PPO"
organization = "Aetna Medicare"
monthly_premium_usd = 87
overall_stars = 4.5
moop_in_network_usd = 7500
snp = "No"

[[medicarePlans]]
contract_plan_id = "H7617_100"
plan_name = "Humana Essentials Plus Giveback H7617-100 (PPO)"
category = "MA-PD"
plan_type = "PPO"
organization = "Humana"
monthly_premium_usd = 0
overall_stars = 4.5
moop_in_network_usd = 9250
snp = "No"

[[medicarePlans]]
contract_plan_id = "H7710_001"
plan_name = "Highmark Health Options Duals (HMO D-SNP)"
category = "SNP"
plan_type = "HMO D-SNP"
organization = "Highmark Blue Cross Blue Shield"
monthly_premium_usd = 31.2
overall_stars = "Not rated"
moop_in_network_usd = 9250
snp = "No"

[[medicarePlans]]
contract_plan_id = "H7710_002"
plan_name = "Highmark Health Options Duals Select (HMO D-SNP)"
category = "SNP"
plan_type = "HMO D-SNP"
organization = "Highmark Blue Cross Blue Shield"
monthly_premium_usd = 31.2
overall_stars = "Not rated"
moop_in_network_usd = 9250
snp = "No"

[[medicarePlans]]
contract_plan_id = "H7849_146"
plan_name = "HealthSpring True Choice (PPO)"
category = "MA-PD"
plan_type = "PPO"
organization = "HealthSpring"
monthly_premium_usd = 0
overall_stars = 3
moop_in_network_usd = 6800
snp = "No"

[[medicarePlans]]
contract_plan_id = "H8166_003"
plan_name = "Freedom Blue PPO Valor (PPO)"
category = "MA"
plan_type = "PPO"
organization = "Highmark Blue Cross Blue Shield"
monthly_premium_usd = "N/A"
overall_stars = 4
moop_in_network_usd = 6000
snp = "No"

[[medicarePlans]]
contract_plan_id = "H8166_007"
plan_name = "Complete Blue PPO Distinct (PPO)"
category = "MA-PD"
plan_type = "PPO"
organization = "Highmark Blue Cross Blue Shield"
monthly_premium_usd = 134
overall_stars = 4
moop_in_network_usd = 6500
snp = "No"
