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

2026 Medicare plan code

H8634-030-000

Blue Cross Medicare Advantage Health Choice (PPO) · Blue Cross and Blue Shield of IL, NM, OK, TX · OK Flex Card PPO

Compact plan code: H8634030000

2026

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

● CMS 2026 plan record

Blue Cross Medicare Advantage Health Choice (PPO)

H8634-030-000 OK Flex Card PPO Local PPO
Open in quick lookup
01

In-network

Inpatient hospital

Days 1–7 $380 / day
Days 8–90 $0 / day
Total of listed copays · 7 charged days $2,660
02

Emergency transport

Ambulance

Ground · in-network$250 copay
Air · in-network20% coinsurance
03

Emergency services

Emergency room

$120 copay

Waived if admitted

04

Medical maximum

Maximum out-of-pocket

In-network$6,550
Combined in + out$10,100
05

Skilled care at home

Home health

In-network$0 copay
Out-of-network50% coinsurance
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

H8634-003-000 Blue Cross Medicare Advantage Choice Plus (PPO) Chicago Metro Area Mid PPO · Local PPO H8634-004-000 Blue Cross Medicare Advantage Choice Premier (PPO) Chicago Metro Area High PPO · Local PPO H8634-008-000 Blue Cross Medicare Advantage Classic (PPO) IL $0 Low PPO · Local PPO H8634-009-000 Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) NM PPO DSNP · Local PPO H8634-010-000 Blue Cross Medicare Advantage Classic (PPO) NM $0 Low PPO · Local PPO H8634-012-000 Blue Cross Medicare Advantage Essential (PPO) IL Non-Metro Carve Out PPO · Local PPO H8634-018-000 Blue Cross Medicare Advantage Health Choice (PPO) IL Flexcard PPO · Local PPO H8634-019-000 Blue Cross Medicare Advantage Protect (PPO) IL MA Only Buydown PPO · Local PPO

About this code

What H8634-030-000 identifies

H8634-030-000 is a Contract Year 2026 Medicare plan segment code. The compact form H8634030000 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.