2026 Medicare plan code

H9387-002-000

Wellcare Patriot Giveback Open (PPO) · Wellcare · Select counties in KS

Compact plan code: H9387002000

2026

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

● CMS 2026 plan record

Wellcare Patriot Giveback Open (PPO)

H9387-002-000 Select counties in KS Local PPO
Open in quick lookup
01

In-network

Inpatient hospital

Days 1–6 $425 / day
Days 7–90 $0 / day
Total of listed copays · 6 charged days $2,550
02

Emergency transport

Ambulance

Ground · in-network$290 copay
Air · in-network$290 copay
03

Emergency services

Emergency room

$130 copay

Waived if admitted within 24 hours

04

Medical maximum

Maximum out-of-pocket

In-network$5,400
Combined in + out$10,100
05

Skilled care at home

Home health

In-network$0 copay
Out-of-network45% coinsurance
06

Monthly cost

Premium & giveback

Part C premium$0 / month
Consolidated C + DNot reported

Plan name references a giveback; amount is not available in these CMS exports.

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.

About this code

What H9387-002-000 identifies

H9387-002-000 is a Contract Year 2026 Medicare plan segment code. The compact form H9387002000 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.