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

2026 Medicare plan code

H5900-004-000

Blue Medicare Advantage Enhanced PPO (PPO) · Wellmark Advantage Health Plan · South Dakota

Compact plan code: H5900004000

2026

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

● CMS 2026 plan record

Blue Medicare Advantage Enhanced PPO (PPO)

H5900-004-000 South Dakota Local PPO
Open in quick lookup
01

In-network

Inpatient hospital

Per admission $460 per stay
Plan-listed inpatient copay $460
02

Emergency transport

Ambulance

Ground · in-network$325 copay
Air · in-network$325 copay
03

Emergency services

Emergency room

$120 copay

Waived if admitted within 24 hours

04

Medical maximum

Maximum out-of-pocket

In-network$4,200
Combined in + out$5,000
05

Skilled care at home

Home health

In-networkNo cost share reported
Out-of-networkNo cost share reported
06

Monthly cost

Premium & giveback

Part C premium$63 / month
Consolidated C + D$80 / 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

H5900-001-000 Blue Medicare Advantage PPO (PPO) Iowa · Local PPO H5900-006-000 Blue Medicare Advantage Valor PPO (PPO) Iowa · Local PPO H5900-007-000 Blue Medicare Advantage Valor PPO (PPO) South Dakota · Local PPO H5900-008-000 Blue Medicare Advantage Classic PPO (PPO) South Dakota · Local PPO H5900-801-000 Blue Medicare Advantage Group PPO (PPO) States of Iowa and South Dakota · Local PPO H5900-802-000 Blue Medicare Advantage Group PPO (PPO) States of Iowa and South Dakota · Local PPO

About this code

What H5900-004-000 identifies

H5900-004-000 is a Contract Year 2026 Medicare plan segment code. The compact form H5900004000 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.