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

2026 Medicare plan code

H8634-009

Medicare Plan

Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) · Blue Cross and Blue Shield of IL, NM, OK, TX · Local PPO · NM PPO DSNP

Full CMS plan ID: H8634-009-000

H8634-009-000 is the full CMS identifier for the H8634-009 Medicare plan. Common searches include H8634 009 and H8634009.

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

Blue Cross MA Dual Care Plus Preferred (PPO D-SNP)

H8634-009-000 NM PPO DSNP Local PPO Dual-Eligible

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-network20% coinsurance
Air · in-network20% coinsurance
03

Emergency services

Emergency room

20% coinsurance

Waived if admitted

04

Medical maximum

Maximum out-of-pocket

In-network$9,250
Combined in + out$13,900
05

Skilled care at home

Home health

In-network$0 copay
Out-of-network0% coinsurance
06

Monthly cost

Premium & giveback

Part C premium$0 / month
Consolidated C + D$0 / month

Plan details

All plan benefits

Medical care3 benefits

Primary care physician

In-network20% coinsurance
Out-of-network30% coinsurance

Specialist

In-network20% coinsurance
Out-of-network30% coinsurance

Preventive care

In-network$0 copay
Out-of-network40% coinsurance
Diagnostics & imaging4 benefits

Diagnostic procedures & tests

In-network0% coinsurance
Out-of-network40% coinsurance

Laboratory services

In-network0% 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-network20% 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-network20% coinsurance
Out-of-network20% coinsurance

Air ambulance

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

Outpatient hospital

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

Outpatient surgery / ASC

In-network20% coinsurance
Out-of-network40% coinsurance
Recovery & therapy5 benefits

Home health

In-network$0 copay
Out-of-network0% coinsurance

Skilled nursing facility

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

Cardiac & pulmonary rehabilitation

In-network20% coinsurance
Out-of-network30% coinsurance

Occupational therapy

In-network20% coinsurance
Out-of-network30% coinsurance

Physical & speech therapy

In-network20% coinsurance
Out-of-network30% coinsurance
Behavioral health2 benefits

Mental health services

In-network20% coinsurance
Out-of-network30% coinsurance

Substance use treatment

In-network20% coinsurance
Out-of-network30% coinsurance
Specialty care2 benefits

Podiatry

In-network20% coinsurance
Out-of-network30% coinsurance

Chiropractic

In-network20% coinsurance
Out-of-network30% coinsurance
Supplemental benefits7 benefits

Dental

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

Vision

In-network$0 copay
Out-of-network$0 copay

Hearing

In-network$0 copay
Out-of-network$0 copay

Transportation

In-network$0 copay
Out-of-network$0 copay

Fitness & wellness

In-network$0 copay
Out-of-network$0 copay

Over-the-counter allowance

In-network$0 copay
Out-of-network$0 copay

Meals

In-network$0 copay
Out-of-network$0 copay
Plan costs & rulesCoverage overview

Premium & Part B giveback

$0 Part C premium / month · Part B giveback not separately reported

Maximum out-of-pocket (MOOP)

In-network$9,250
Combined in + out$13,900

Medical deductibles

In-networkNot reported
Out-of-networkNot reported

Network & referrals

Local PPO · Referrals: Required for some services · Out-of-network coverage: Yes

Prescription drugs0 tiers

Part D deductible

Not reported

Using this plan

Understand H8634-009-000

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

Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) is a 2026 Local PPO offered by Blue Cross and Blue Shield of IL, NM, OK, TX in NM PPO DSNP. The CMS record indicates out-of-network coverage, although member costs may differ from in-network care. Referrals are required for some services.

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
0% coinsurance

Separate visits or services; costs are not added together.

Tests & outpatient care

Diagnostic procedures & tests
0% 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
NM PPO DSNP (NM)
Plan type
Local PPO
Special Needs Plan
Dual-Eligible
Contract / plan
H8634-009
Coverage year
2026

This is a Dual-Eligible; enrollment requires the plan's specific eligibility criteria as well as residence in its 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.

Dental20% coinsurance
Vision$0 copay
Hearing$0 copay
Over-the-counter allowance$0 copay
Fitness & wellness$0 copay
Transportation$0 copay
Meals$0 copay

Plan-specific answers

Frequently asked questions

Where is H8634-009-000 available?

Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) is listed for NM PPO DSNP (NM). This is a Dual-Eligible; enrollment requires the plan's specific eligibility criteria as well as residence in its service area.

What is the in-network maximum out-of-pocket limit for H8634-009-000?

The 2026 CMS record lists an in-network medical maximum out-of-pocket limit of $9,250. Prescription drug spending generally does not count toward this medical limit.

What is the monthly plan premium for H8634-009-000?

The listed consolidated Part C and Part D premium is $0 per month. This does not replace the standard Medicare Part B premium.

What does an emergency room visit cost on H8634-009-000?

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

Does H8634-009-000 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 H8634-009-000 fits

Full CMS plan ID
H8634-009-000
Contract
H8634
Base plan code
H8634-009
Segment
000
Carrier
Blue Cross and Blue Shield of IL, NM, OK, TX
Plan type
Local PPO
Service area
NM PPO DSNP (NM)

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.

  • Bernalillo, NM
  • Catron, NM
  • Chaves, NM
  • Cibola, NM
  • Curry, NM
  • Dona Ana, NM
  • Eddy, NM
  • Grant, NM
  • Guadalupe, NM
  • Harding, NM
  • Lincoln, NM
  • Los Alamos, NM

15 additional service-area entries are retained in the data record.

Same CMS contract

H8634-010-000 Blue Cross Medicare Advantage Classic (PPO) NM $0 Low PPO · Local PPO H8634-801-000 Blue Cross Group Medicare Advantage Plan (PPO) Nationwide · Local PPO H8634-803-000 Blue Cross Group Medicare Advantage Plan (PPO) Nationwide · Local PPO H8634-805-000 Blue Cross Group Medicare Advantage Plan (PPO) Nationwide · Local PPO H8634-807-000 Blue Cross Group Medicare Advantage Plan (PPO) Nationwide · Local PPO H8634-809-000 Blue Cross Group Medicare Advantage Plan (PPO) Nationwide · Local PPO H8634-811-000 Blue Cross Group Medicare Advantage Plan (PPO) Nationwide · Local PPO H8634-813-000 Blue Cross Group Medicare Advantage Plan (PPO) Nationwide · Local PPO

About this code

What H8634-009-000 identifies

H8634-009-000 is a Contract Year 2026 Medicare plan segment code. Searches written as H8634-009, H8634 009, or the compact full CMS ID H8634009000 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.