Medicare Plan Lookup Official CMS data · Contract Year 2026
CMS 2026 data

2026 Medicare plan code

H3957-044

Medicare Plan

Security Blue HMO-POS ValueRx (HMO-POS) · Highmark Blue Cross Blue Shield or Highmark Blue Shield · HMOPOS · West Central PA

Full CMS plan ID: H3957-044-001

H3957-044-001 is the full CMS identifier for the H3957-044 Medicare plan. Common searches include H3957 044 and H3957044.

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

Security Blue HMO-POS ValueRx (HMO-POS)

H3957-044-001 West Central PA HMOPOS

At-a-glance

Quick view

01

In-network

Inpatient hospital

Days 1–5 $220 / day
Days 6–90 $0 / day
Total of listed copays · 5 charged days $1,100
02

Emergency transport

Ambulance

Ground · in-network$340 copay
Air · in-network$340 copay
03

Emergency services

Emergency room

$130 copay

Waived if admitted

04

Medical maximum

Maximum out-of-pocket

In-network$5,500
Combined in + out$8,950
05

Skilled care at home

Home health

In-networkCost share not reported
Out-of-networkNot separately reported
06

Monthly cost

Premium & giveback

Part C premium$36 / month
Consolidated C + D$36 / month

Plan details

All plan benefits

Medical care3 benefits

Primary care physician

Verify in plan documents
In-networkVerify in plan documents
Out-of-networkNot separately reported

Specialist

Verify in plan documents
In-network$35 copay
Out-of-networkNot separately reported

Preventive care

Verify in plan documents
In-networkCost share not reported
Out-of-networkNot separately reported
Diagnostics & imaging4 benefits

Diagnostic procedures & tests

Verify in plan documents
In-network$0–$5 copay
Out-of-networkNot separately reported

Laboratory services

Verify in plan documents
In-network$0–$5 copay
Out-of-networkNot separately reported

X-rays & standard imaging

Verify in plan documents
In-network$175 copay
Out-of-networkNot separately reported

MRI, CT & PET imaging

Verify in plan documents
In-network$60 copay
Out-of-networkNot separately reported
Urgent & hospital care6 benefits

Urgent care

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

Emergency room

In-network$130 copay
Out-of-networkNot separately reported

Ground ambulance

In-network$340 copay
Out-of-networkNot separately reported

Air ambulance

In-network$340 copay
Out-of-networkNot separately reported

Outpatient hospital

Verify in plan documents
In-network$200 copay
Out-of-networkNot separately reported

Outpatient surgery / ASC

Verify in plan documents
In-network$175 copay
Out-of-networkNot separately reported
Recovery & therapy5 benefits

Home health

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

Skilled nursing facility

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

Cardiac & pulmonary rehabilitation

Verify in plan documents
In-networkCost share not reported
Out-of-networkNot separately reported

Occupational therapy

Verify in plan documents
In-network$10 copay
Out-of-networkNot separately reported

Physical & speech therapy

Verify in plan documents
In-network$10 copay
Out-of-networkNot separately reported
Behavioral health2 benefits

Mental health services

Verify in plan documents
In-networkCost share not reported
Out-of-networkNot separately reported

Substance use treatment

Verify in plan documents
In-network$40 copay
Out-of-networkNot separately reported
Specialty care2 benefits

Podiatry

In-network$35 copay
Out-of-networkNot separately reported

Chiropractic

In-network$15 copay
Out-of-networkNot separately reported
Supplemental benefits7 benefits

Dental

In-network$35 copay
Out-of-networkNot separately reported

Vision

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

Hearing

In-network$599–$899 copay
Out-of-networkNot separately reported

Transportation

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

Fitness & wellness

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

Over-the-counter allowance

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

Meals

Not reported in this CMS export

Not reported in this CMS export

Plan costs & rulesCoverage overview

Premium & Part B giveback

$36 Part C premium / month · Part B giveback not separately reported

Maximum out-of-pocket (MOOP)

In-network$5,500
Combined in + out$8,950

Medical deductibles

In-networkNot reported
Out-of-networkNot reported

Network & referrals

HMOPOS · Referrals: Not required · Out-of-network coverage: Not reported

Prescription drugs5 tiers

Part D deductible

Not reported

Drug tier 1

$5 retail copay · 31-day supply

Drug tier 2

$19 retail copay · 31-day supply

Drug tier 3

$47 retail copay · 31-day supply

Drug tier 4

35% retail coinsurance · 31-day supply

Drug tier 5

33% retail coinsurance · 31-day supply

Using this plan

Understand H3957-044-001

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

Security Blue HMO-POS ValueRx (HMO-POS) is a 2026 HMOPOS offered by Highmark Blue Cross Blue Shield or Highmark Blue Shield in West Central PA. The plan record does not require referrals. Its listed inpatient copay stages total $1,100 across 5 charged days.

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
Verify in plan documents
Specialist
$35 copay
Laboratory services
$0–$5 copay

Separate visits or services; costs are not added together.

Tests & outpatient care

Diagnostic procedures & tests
$0–$5 copay
MRI, CT & PET imaging
$60 copay
Outpatient hospital
$200 copay

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

Emergency & hospital care

Emergency room
$130 copay
Listed inpatient stages
$1,100 total

5 charged inpatient days are included in the calculated total. 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
West Central PA (PA)
Plan type
HMOPOS
Contract / plan
H3957-044
Coverage year
2026

Enrollment generally requires Medicare eligibility and residence in the plan's service area. 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.

Dental$35 copay
VisionCost share not reported
Hearing$599–$899 copay
Over-the-counter allowanceCost share not reported
Fitness & wellnessCost share not reported
TransportationCost share not reported

Plan-specific answers

Frequently asked questions

Where is H3957-044-001 available?

Security Blue HMO-POS ValueRx (HMO-POS) is listed for West Central PA (PA). Enrollment generally requires Medicare eligibility and residence in the plan's service area.

What is the in-network maximum out-of-pocket limit for H3957-044-001?

The 2026 CMS record lists an in-network medical maximum out-of-pocket limit of $5,500. Prescription drug spending generally does not count toward this medical limit.

What is the monthly plan premium for H3957-044-001?

The listed consolidated Part C and Part D premium is $36 per month. This does not replace the standard Medicare Part B premium.

What does an emergency room visit cost on H3957-044-001?

The plan record lists $130 copay, waived when an admission meets the plan's stated timing rule.

Does H3957-044-001 report extra benefits?

Yes. CMS reports dental, vision, hearing, over-the-counter allowance, fitness & wellness, and other supplemental benefits. 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.

PBP benefits ↗ Landscape data ↗ County service area ↗

Plan context

Where H3957-044-001 fits

Full CMS plan ID
H3957-044-001
Contract
H3957
Base plan code
H3957-044
Segment
001
Carrier
Highmark Blue Cross Blue Shield or Highmark Blue Shield
Plan type
HMOPOS
Service area
West Central PA (PA)

County/service-area foundation

CMS service-area entries

Named county entries are tied to this exact contract, plan, and segment in CMS Landscape data. County codes are enriched from the aligned CMS contract service-area release where a match exists.

  • Bedford, PA
  • Blair, PA
  • Cameron, PA
  • Clarion, PA
  • Clearfield, PA
  • Elk, PA
  • Huntingdon, PA
  • Jefferson, PA
  • Somerset, PA

Same CMS contract

H3957-044-004 Security Blue HMO-POS ValueRx (HMO-POS) North West PA · HMOPOS H3957-031-000 Security Blue HMO-POS ValueRx (HMO-POS) Southwestern PA · HMOPOS H3957-043-001 Security Blue HMO-POS Basic (HMO-POS) Southwest PA · HMOPOS H3957-043-002 Security Blue HMO-POS Basic (HMO-POS) West Central PA · HMOPOS H3957-045-001 Security Blue HMO-POS Standard (HMO-POS) Southwest PA · HMOPOS H3957-045-002 Security Blue HMO-POS Standard (HMO-POS) West Central PA · HMOPOS H3957-046-001 Security Blue HMO-POS Deluxe (HMO-POS) Southwest PA · HMOPOS H3957-046-002 Security Blue HMO-POS Deluxe (HMO-POS) West Central PA · HMOPOS

About this code

What H3957-044-001 identifies

H3957-044-001 is a Contract Year 2026 Medicare plan segment code. Searches written as H3957-044, H3957 044, or the compact full CMS ID H3957044001 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.