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

2026 Medicare plan code

H5883-003-004

BCN Advantage Prestige (HMO-POS) · Blue Care Network · Region 4

Compact plan code: H5883003004

2026

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

● CMS 2026 plan record

BCN Advantage Prestige (HMO-POS)

H5883-003-004 Region 4 HMOPOS
Open in quick lookup
01

In-network

Inpatient hospital

Days 1–7 $200 / day
Days 8–90 $0 / day
Total of listed copays · 7 charged days $1,400
02

Emergency transport

Ambulance

Ground · in-network$250 copay
Air · in-network$250 copay

Ground ambulance: In-network: cost sharing varies by a CMS plan-defined group; Air ambulance: In-network: cost sharing varies by a CMS plan-defined group

03

Emergency services

Emergency room

$130 copay

Waived if admitted

04

Medical maximum

Maximum out-of-pocket

In-network$4,000
Combined in + out$4,000
05

Skilled care at home

Home health

In-networkVerify in plan documents
Out-of-networkNot separately reported
06

Monthly cost

Premium & giveback

Part C premium$163.40 / month
Consolidated C + D$225 / 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

H5883-001-001 BCN Advantage Elements (HMO-POS) Region 1 · HMOPOS H5883-001-002 BCN Advantage Elements (HMO-POS) Region 2 · HMOPOS H5883-001-003 BCN Advantage Elements (HMO-POS) Region 3 · HMOPOS H5883-001-004 BCN Advantage Elements (HMO-POS) Region 4 · HMOPOS H5883-001-005 BCN Advantage Elements (HMO-POS) Region 5 · HMOPOS H5883-002-001 BCN Advantage Classic (HMO-POS) Region 1 · HMOPOS H5883-002-002 BCN Advantage Classic (HMO-POS) Region 2 · HMOPOS H5883-002-003 BCN Advantage Classic (HMO-POS) Region 3 · HMOPOS

About this code

What H5883-003-004 identifies

H5883-003-004 is a Contract Year 2026 Medicare plan segment code. The compact form H5883003004 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.