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

2026 Medicare plan code

H5496-012-000

Imperial Dynamic Plan (HMO) · Imperial Health Plan of California, Inc. · Northern, Central, Southern California

Compact plan code: H5496012000

2026

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

● CMS 2026 plan record

Imperial Dynamic Plan (HMO)

H5496-012-000 Northern, Central, Southern California HMO
Open in quick lookup
01

In-network

Inpatient hospital

Days 1–90 $0 / day
Plan-listed inpatient copay $0
02

Emergency transport

Ambulance

Ground · in-network$150 copay
Air · in-network20% coinsurance
03

Emergency services

Emergency room

$125 copay

Waived if admitted within 48 hours

04

Medical maximum

Maximum out-of-pocket

In-network$296
Combined in + outNot reported
05

Skilled care at home

Home health

In-networkNo cost share reported
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

H5496-005-000 Imperial Senior Value (HMO C-SNP) Northern, Central and Southern California · HMO H5496-016-000 Imperial Courage Plan (HMO) Northern, Central, Southern California · HMO

About this code

What H5496-012-000 identifies

H5496-012-000 is a Contract Year 2026 Medicare plan segment code. The compact form H5496012000 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.