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

2026 Medicare plan code

H9047-013-000

Providence Medicare Extra Part B Only + Rx (HMO) · Providence Medicare Advantage Plans · Portland Metro and Lane

Compact plan code: H9047013000

2026

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

● CMS 2026 plan record

Providence Medicare Extra Part B Only + Rx (HMO)

H9047-013-000 Portland Metro and Lane HMO
Open in quick lookup
01

In-network

Inpatient hospital

Part-B-only inpatient structure requires plan documents

02

Emergency transport

Ambulance

Ground · in-network$50–$275 copay
Air · in-network$50–$275 copay
03

Emergency services

Emergency room

$125 copay

Waived if admitted within 24 hours

04

Medical maximum

Maximum out-of-pocket

In-network$4,000
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 premiumNot reported
Consolidated C + DNot reported

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

H9047-033-000 Providence Medicare Focus Medical (HMO) Portland Metro, Lane, Hood River, Clark WA · HMO H9047-035-000 Providence Medicare Reverence (HMO-POS) Portland Metro, SE WA, Clark WA, Hood River, Lane · HMOPOS H9047-037-000 Providence Medicare Prime + Rx (HMO) Portland Metro · HMO H9047-043-000 Providence Medicare Dual Plus (HMO D-SNP) Clackamas, Multnomah, Washington counties · HMO H9047-054-000 Providence Medicare Timber + Rx (HMO) Lane, Hood River, Clark WA counties · HMO H9047-063-000 Providence Medicare Pine + Rx (HMO) SE WA, Spokane and Snohomish counties · HMO H9047-064-000 Providence Medicare Extra + Rx (HMO) Portland Metro, Lane, Hood River, Clark WA · HMO H9047-066-000 Providence Medicare Sycamore + Rx (HMO) Orange County · HMO

About this code

What H9047-013-000 identifies

H9047-013-000 is a Contract Year 2026 Medicare plan segment code. The compact form H9047013000 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.