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

2026 Medicare plan code

H3404-003-001

Blue Medicare PPO Enhanced (PPO) · Blue Cross and Blue Shield of North Carolina · PPO Region 1

Compact plan code: H3404003001

2026

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

● CMS 2026 plan record

Blue Medicare PPO Enhanced (PPO)

H3404-003-001 PPO Region 1 Local PPO
Open in quick lookup
01

In-network

Inpatient hospital

Days 1–6 $350 / day
Days 7–90 $0 / day
Total of listed copays · 6 charged days $2,100
02

Emergency transport

Ambulance

Ground · in-network$250 copay
Air · in-network$250 copay
03

Emergency services

Emergency room

$130 copay

Waived if admitted within 48 hours

04

Medical maximum

Maximum out-of-pocket

In-network$6,300
Combined in + out$6,300
05

Skilled care at home

Home health

In-network$0 copay
Out-of-network40% coinsurance
06

Monthly cost

Premium & giveback

Part C premium$6 / month
Consolidated C + D$35 / 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

H3404-003-002 Blue Medicare PPO Enhanced (PPO) PPO Region 2 · Local PPO H3404-004-000 Blue Medicare Freedom+ (PPO) Select North Carolina Counties · Local PPO H3404-801-000 Blue Medicare PPO EGWP Medical Only (PPO) North Carolina Employer Groups · Local PPO H3404-810-000 Blue Medicare PPO EGWP Complete (PPO) NC Employer Groups · Local PPO H3404-811-000 Blue Medicare PPO EGWP Classic (PPO) NC Employer Groups · Local PPO

About this code

What H3404-003-001 identifies

H3404-003-001 is a Contract Year 2026 Medicare plan segment code. The compact form H3404003001 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.