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

2026 Medicare plan code

H4213-017-001

BlueMedicare Preferred (PFFS) · Arkansas Blue Medicare · Northern, Western, and South Central AR counties

Compact plan code: H4213017001

2026

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

● CMS 2026 plan record

BlueMedicare Preferred (PFFS)

H4213-017-001 Northern, Western, and South Central AR counties PFFS
Open in quick lookup
01

In-network

Inpatient hospital

Days 1–5 $390 / day
Days 6–90 $0 / day
Total of listed copays · 5 charged days $1,950
02

Emergency transport

Ambulance

Ground · in-network$325 copay
Air · in-network20% coinsurance
03

Emergency services

Emergency room

$115 copay

04

Medical maximum

Maximum out-of-pocket

In-network$7,500
Combined in + out$7,500
05

Skilled care at home

Home health

In-network$0 copay
Out-of-network$0 copay + 40% coinsurance
06

Monthly cost

Premium & giveback

Part C premium$0 / month
Consolidated C + D$58 / 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

H4213-017-005 BlueMedicare Preferred (PFFS) Northwest, Western, and Central AR counties · PFFS H4213-017-006 BlueMedicare Preferred (PFFS) East Central AR counties · PFFS H4213-019-000 BlueMedicare Value (PFFS) Select Counties in Arkansas · PFFS H4213-801-000 BlueMedicare Preferred Group CY (PFFS) Employer Group Plan · PFFS H4213-802-000 BlueMedicare Preferred Group NCY (PFFS) Employer Group Plan · PFFS H4213-803-000 BlueMedicare Value Group CY (PFFS) Employer Group Plan · PFFS H4213-804-000 BlueMedicare Value Group NCY (PFFS) Employer Group Plan · PFFS

About this code

What H4213-017-001 identifies

H4213-017-001 is a Contract Year 2026 Medicare plan segment code. The compact form H4213017001 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.