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

2026 Medicare plan code

H1914-001-000

Wellcare Simple Open (PPO) · Wellcare · All counties in CT

Compact plan code: H1914001000

2026

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

● CMS 2026 plan record

Wellcare Simple Open (PPO)

H1914-001-000 All counties in CT Local PPO
Open in quick lookup
01

In-network

Inpatient hospital

Days 1–3 $650 / day
Days 4–90 $0 / day
Total of listed copays · 3 charged days $1,950
02

Emergency transport

Ambulance

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

Emergency services

Emergency room

$115 copay

Waived if admitted within 24 hours

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-network40% coinsurance
06

Monthly cost

Premium & giveback

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

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. Quick-reference values should be confirmed in current official plan documents.

PBP benefits ↗ Landscape data ↗

Same CMS contract

H1914-002-000 Wellcare Giveback Open (PPO) All counties in CT · Local PPO H1914-007-000 Wellcare Simple Open (PPO) Select counties in NC · Local PPO H1914-008-000 Wellcare Dual Liberty Open (PPO D-SNP) Select counties in NC · Local PPO H1914-009-000 Wellcare Assist Open (PPO) Select counties in NC · Local PPO H1914-010-000 Wellcare Giveback Open (PPO) Select counties in NC · Local PPO H1914-011-000 Wellcare Patriot Giveback Open (PPO) Select counties in NC · Local PPO

About this code

What H1914-001-000 identifies

H1914-001-000 is a Contract Year 2026 Medicare plan segment code. The compact form H1914001000 refers to the same normalized contract, plan, and segment shown on this page.

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.