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

2026 Medicare plan code

H5774-022-000

Contigo Plus (HMO C-SNP) · Triple S Advantage · Puerto Rico

Compact plan code: H5774022000

2026

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

● CMS 2026 plan record

Contigo Plus (HMO C-SNP)

H5774-022-000 Puerto Rico HMO Chronic or Disabling Condition
Open in quick lookup
01

In-network

Inpatient hospital

Cost-sharing tier 1

Per admission $0 per stay
Plan-listed inpatient copay $0

Cost-sharing tier 2

Per admission $50 per stay
Plan-listed inpatient copay $50

inpatient cost sharing varies by a CMS plan-defined group

02

Emergency transport

Ambulance

Ground · in-networkNo cost share reported
Air · in-networkNo cost share reported
03

Emergency services

Emergency room

$50 copay

Waived if admitted within 24 hours

04

Medical maximum

Maximum out-of-pocket

In-network$4,200
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

H5774-028-000 Platino Blindao (HMO D-SNP) Puerto Rico · HMO H5774-031-000 Brillante (HMO-POS) Puerto Rico · HMOPOS H5774-035-000 Platino Enlace (HMO D-SNP) Puerto Rico · HMO H5774-038-000 Enlace Plus (HMO) Puerto Rico · HMO H5774-041-001 PLATINO ADVANCE (HMO D-SNP) Oeste · HMO H5774-041-002 PLATINO ADVANCE (HMO D-SNP) Norte · HMO H5774-041-003 PLATINO ADVANCE (HMO D-SNP) Suroeste · HMO H5774-041-004 PLATINO ADVANCE (HMO D-SNP) Metro · HMO

About this code

What H5774-022-000 identifies

H5774-022-000 is a Contract Year 2026 Medicare plan segment code. The compact form H5774022000 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.