2026 Medicare plan code

H0342-802

Medicare Plan

CarePartners Access Rx (PPO) · CarePartners of Connecticut · Local PPO · All Counties Except Fairfield County

Full CMS plan ID: H0342-802-000

H0342-802-000 is the full CMS identifier for the H0342-802 Medicare plan. Common searches include H0342 802 and H0342802.

Historical 2026 record. Benefits and service areas shown apply to that year.

2026

Spaces or dashes work: H5216-435-002 · S2135 802

● CMS 2026 plan record

CarePartners Access Rx (PPO)

H0342-802-000 All Counties Except Fairfield County Local PPO Employer-only

At-a-glance

Quick view

01

In-network

Inpatient hospital

inpatient copayment is selected but its amount is missing

02

Emergency transport

Ambulance

Ground · in-network$325 copay
Air · in-network$325 copay
03

Emergency services

Emergency room

20% coinsurance

Waived if admitted

04

Medical maximum

Maximum out-of-pocket

In-network$6,350
Combined in + out$9,550
05

Skilled care at home

Home health

In-networkCost share not reported
Out-of-network40% coinsurance
06

Monthly cost

Premium & giveback

Part C premiumNot reported
Consolidated C + DNot reported

Plan details

All plan benefits

Medical care3 benefits

Primary care physician

In-network20% coinsurance
Out-of-network$80 copay

Specialist

In-network20% coinsurance
Out-of-network$80 copay

Preventive care

In-network20% coinsurance
Out-of-network0%–40% coinsurance
Diagnostics & imaging4 benefits

Diagnostic procedures & tests

In-network20% coinsurance
Out-of-network40% coinsurance

Laboratory services

In-network20% coinsurance
Out-of-network40% coinsurance

X-rays & standard imaging

In-network20% coinsurance
Out-of-network40% coinsurance

MRI, CT & PET imaging

In-network20% coinsurance
Out-of-network40% coinsurance
Urgent & hospital care6 benefits

Urgent care

In-networkCost share not reported
Out-of-networkNot separately reported

Emergency room

In-network20% coinsurance
Out-of-networkNot separately reported

Ground ambulance

In-network$325 copay
Out-of-network$325 copay

Air ambulance

In-network$325 copay
Out-of-network$325 copay

Outpatient hospital

In-network20% coinsurance
Out-of-network50% coinsurance

Outpatient surgery / ASC

In-network20% coinsurance
Out-of-network50% coinsurance
Recovery & therapy5 benefits

Home health

In-networkCost share not reported
Out-of-network40% coinsurance

Skilled nursing facility

In-networkCost share not reported
Out-of-networkNot separately reported

Cardiac & pulmonary rehabilitation

In-network20% coinsurance
Out-of-network40% coinsurance

Occupational therapy

In-network20% coinsurance
Out-of-network40% coinsurance

Physical & speech therapy

In-network20% coinsurance
Out-of-network40% coinsurance
Behavioral health2 benefits

Mental health services

In-network20% coinsurance
Out-of-network40% coinsurance

Substance use treatment

In-network20% coinsurance
Out-of-network40% coinsurance
Specialty care2 benefits

Podiatry

In-network20% coinsurance
Out-of-network$65 copay

Chiropractic

In-network20% coinsurance
Out-of-network$80 copay
Supplemental benefits7 benefits

Dental

In-network20% coinsurance
Out-of-network$65 copay

Vision

In-network20% coinsurance
Out-of-network$65 copay

Hearing

In-network20% coinsurance
Out-of-network$65 copay

Transportation

Not reported in this CMS export

Not reported in this CMS export

Fitness & wellness

Not reported in this CMS export

Not reported in this CMS export

Over-the-counter allowance

Not reported in this CMS export

Not reported in this CMS export

Meals

Not reported in this CMS export

Not reported in this CMS export

Plan costs & rulesCoverage overview

Premium & Part B giveback

Part C premium not reported · Part B giveback not separately reported

Maximum out-of-pocket (MOOP)

In-network$6,350
Combined in + out$9,550

Medical deductibles

In-networkNot reported
Out-of-networkNot reported

Network & referrals

Local PPO · Referrals: Not required · Out-of-network coverage: Yes

Prescription drugs0 tiers

Part D deductible

This plan is not present in the public CMS Landscape release

Using this plan

Understand H0342-802-000

Plain-language context built from this plan’s 2026 CMS record. It is a guide to the reported benefits, not a personalized cost estimate.

Plan at a glance

A quick read on this plan

CarePartners Access Rx (PPO) is a 2026 Local PPO offered by CarePartners of Connecticut in All Counties Except Fairfield County. The CMS record indicates out-of-network coverage, although member costs may differ from in-network care. The plan record does not require referrals.

Common benefit costs

What you may pay

These are individual in-network benefit amounts. A real visit may involve more than one separately billed service.

Routine care

Primary care physician
20% coinsurance
Specialist
20% coinsurance
Laboratory services
20% coinsurance

Separate visits or services; costs are not added together.

Tests & outpatient care

Diagnostic procedures & tests
20% coinsurance
MRI, CT & PET imaging
20% coinsurance
Outpatient hospital
20% coinsurance

The service setting and billing details can change what you pay.

Emergency & hospital care

Emergency room
20% coinsurance

Actual costs depend on the care received and plan rules.

Helpful context

Terms worth knowing

Maximum out-of-pocket (MOOP)

This is the most you generally pay during the plan year for covered Part A and Part B medical services under the applicable network limit. Premiums and prescription drug costs generally do not count toward it.

Availability

Who can enroll

Service area
All Counties Except Fairfield County (CT)
Plan type
Local PPO
Contract / plan
H0342-802
Coverage year
2026

Enrollment is limited to people eligible through the sponsoring employer or group. Confirm eligibility and the exact service area with the plan before enrolling.

Supplemental coverage

Extra benefits reported

Availability is summarized here; allowances, frequency limits, networks, and prior-authorization rules may apply.

Dental20% coinsurance
Vision20% coinsurance
Hearing20% coinsurance

Plan-specific answers

Frequently asked questions

Where is H0342-802-000 available?

CarePartners Access Rx (PPO) is listed for All Counties Except Fairfield County (CT). Enrollment is limited to people eligible through the sponsoring employer or group.

What is the in-network maximum out-of-pocket limit for H0342-802-000?

The 2026 CMS record lists an in-network medical maximum out-of-pocket limit of $6,350. Prescription drug spending generally does not count toward this medical limit.

What does an emergency room visit cost on H0342-802-000?

The plan record lists 20% coinsurance, waived when an admission meets the plan's stated timing rule.

Does H0342-802-000 report extra benefits?

Yes. CMS reports dental, vision, hearing. See the detailed benefit rows and official plan documents for limits and conditions.

Source trail

Official CMS, Contract Year 2026

Plan identity and benefits come from CMS PBP data. Premium and MOOP figures are cross-checked against the August 2026 Landscape release; county identity is sourced from segment-level Landscape rows and stable codes are enriched from the aligned MA contract service-area release where matched. Quick-reference values should be confirmed in 2026 official plan documents.

Plan context

Where H0342-802-000 fits

Full CMS plan ID
H0342-802-000
Contract
H0342
Base plan code
H0342-802
Segment
000
Carrier
CarePartners of Connecticut
Plan type
Local PPO
Service area
All Counties Except Fairfield County (CT)

County/service-area foundation

CMS service-area entries

These named entries come from a CMS contract-level service-area file. They describe the contract's published geography and must not be treated as proof that every segment has identical county-level rules.

  • Hartford, CT
  • Litchfield, CT
  • Middlesex, CT
  • New Haven, CT
  • New London, CT
  • Tolland, CT
  • Windham, CT

About this code

What H0342-802-000 identifies

H0342-802-000 is a Contract Year 2026 Medicare plan segment code. Searches written as H0342-802, H0342 802, or the compact full CMS ID H0342802000 refer to this plan or its base plan code.

Medicare Plan Lookup uses official CMS data as a quick reference. Benefit details, eligibility, service-area rules, and cost sharing should be confirmed in the current Summary of Benefits or Evidence of Coverage.

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