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

2026 Medicare plan code

H5106-030-002

Complete Blue PPO Signature (PPO) · Highmark Blue Cross Blue Shield · Kanawha, Lincoln, Putnam

Compact plan code: H5106030002

2026

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

● CMS 2026 plan record

Complete Blue PPO Signature (PPO)

H5106-030-002 Kanawha, Lincoln, Putnam Local PPO
Open in quick lookup
01

In-network

Inpatient hospital

Days 1–5 $275 / day
Days 6–90 $0 / day
Total of listed copays · 5 charged days $1,375
02

Emergency transport

Ambulance

Ground · in-network$200 copay
Air · in-network$200 copay
03

Emergency services

Emergency room

$115 copay

Waived if admitted

04

Medical maximum

Maximum out-of-pocket

In-network$7,550
Combined in + out$10,000
05

Skilled care at home

Home health

In-networkNo cost share reported
Out-of-network30% 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

H5106-029-001 Complete Blue PPO Distinct (PPO) BER, CAB, CLA, FAY, MAR, OHI, WAY · Local PPO H5106-029-002 Complete Blue PPO Distinct (PPO) Kanawha, Lincoln, Putnam · Local PPO H5106-029-003 Complete Blue PPO Distinct (PPO) North and South WV 16 Counties · Local PPO H5106-030-001 Complete Blue PPO Signature (PPO) BER, CAB, CLA, FAY, MAR, OHI, WAY · Local PPO H5106-030-003 Complete Blue PPO Signature (PPO) North and South WV 16 Counties · Local PPO H5106-034-001 Freedom Blue PPO Standard (PPO) North and South WV 26 Counties · Local PPO H5106-034-002 Freedom Blue PPO Standard (PPO) North and South 29 Counties · Local PPO H5106-035-000 Complete Blue PPO Signature (PPO) North and South WV 15 Counties · Local PPO

About this code

What H5106-030-002 identifies

H5106-030-002 is a Contract Year 2026 Medicare plan segment code. The compact form H5106030002 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.