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

2026 Medicare plan code

H5422-011-000

Anthem Medicare Advantage (HMO-POS) · Anthem Blue Cross and Blue Shield · Select Counties in Georgia

Compact plan code: H5422011000

2026

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

● CMS 2026 plan record

Anthem Medicare Advantage (HMO-POS)

H5422-011-000 Select Counties in Georgia HMOPOS
Open in quick lookup
01

In-network

Inpatient hospital

Days 1–5 $450 / day
Days 6–90 $0 / day
Total of listed copays · 5 charged days $2,250
02

Emergency transport

Ambulance

Ground · in-network$280 copay
Air · in-network$280 copay
03

Emergency services

Emergency room

$115 copay

04

Medical maximum

Maximum out-of-pocket

In-network$9,250
Combined in + outNot reported
05

Skilled care at home

Home health

In-network$0 copay
Out-of-networkNot separately reported
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

H5422-013-000 Anthem Extra Help (HMO-POS) Select counties in Georgia · HMOPOS H5422-014-000 Anthem Veteran (HMO-POS) Select Counties in Georgia · HMOPOS H5422-015-000 Anthem Kidney Care (HMO-POS C-SNP) Select Counties in GA · HMOPOS H5422-018-000 Anthem Dual Advantage (HMO D-SNP) Select counties in GA · HMO H5422-019-000 Anthem Full Dual Advantage (HMO D-SNP) Select counties in GA · HMO H5422-803-000 Anthem Senior Advantage (HMO) Georgia Select Counties · HMO H5422-804-000 Anthem Senior Advantage (HMO) Georgia - Select Counties · HMO H5422-806-000 Anthem Senior Advantage (HMO) Georgia - Select counties · HMO

About this code

What H5422-011-000 identifies

H5422-011-000 is a Contract Year 2026 Medicare plan segment code. The compact form H5422011000 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.