Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
Blue Medicare PPO Enhanced, 2027
H3404Contract003Plan
PPO · 82 counties in North Carolina
Run by Blue Cross and Blue Shield of North Carolina (contract H3404), sold as Blue Cross and Blue Shield of North Carolina, owned by CuraCor Solutions Corp.
Blue Medicare PPO Enhanced (H3404-003) costs $45 to $70 a month in 2027, up $10 from 2026, with an in-network out-of-pocket limit of $6,900 ($6,300 in 2026).
What changes from 2026 to 2027?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| Monthly premium | $35 to $53 | $45 to $70 | ▲up $10 |
| In-network out-of-pocket limit | $6,300 | $6,900 | ▲up $600 |
| Drug deductible | $100 | $700 | ▲up $600 |
| Medical deductible, in network (best in its area) | none | $170 | ▲added |
| Hospital stay, in network (best in its area) | $350 a day for days 1–6, then $0 a day for days 7–90 | $399 a day for days 1–6, then $0 a day for days 7–90 | ▲up $245for a 5-day stay |
| Skilled nursing facility, in network (best in its area) | $0 a day for days 1–20, then $218 a day for days 21–100 | $10 a day for days 1–20, then $221 a day for days 21–100 | ▲up $230for a 30-day stay |
| Over-the-counter items, yearly (best in its area) | $160 a year | $136 a year | ▼down $24 |
| Drug tier 3, preferred brand | 25% of the cost | 21% of the cost | ▼down 4 points |
| Drug tier 4, non-preferred drug | 31% of the cost | 26% of the cost | ▼down 5 points |
| Drug tier 5, specialty tier | 31% of the cost | 25% of the cost | ▼down 6 points |
| Drug tier 6, select care drugs | $1 | $3 | ▲up $2 |
| 11 lines do not change | |||
| Part B premium reduction, monthly (best in its area) | none | none | no change |
| Primary care visit (best in its area) | $0 copay | $0 copay | no change |
| Specialist visit (best in its area) | $20 copay | $20 copay | no change |
| Emergency room (best in its area) | $130 copay | $130 copay | no change |
| Ground ambulance, in network (best in its area) | $250 copay | $250 copay | no change |
| Comprehensive dental, yearly limit (best in its area) | not offered | not offered | no change |
| Eyewear, yearly limit (best in its area) | not offered | not offered | no change |
| Hearing aids, yearly limit for both ears (best in its area) | not offered | not offered | no change |
| Counties served | 82 | 82 | no change |
| Drug tier 1, preferred generic | $15 | $15 | no change |
| Drug tier 2, generic | $20 | $20 | no change |
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026; CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026). Plan details can change during the year; confirm on Medicare Plan Finder.
What will prescriptions cost?
| Tier | What the tier holds | 2026, standard pharmacy | 2027, standard pharmacy | 2027, preferred pharmacy |
|---|---|---|---|---|
| Tier 1 | Preferred Generic | $15 | $15 | $0 |
| Tier 2 | Generic | $20 | $20 | $4 |
| Tier 3 | Preferred Brand | 25% of the cost | 21% of the cost | 21% of the cost |
| Tier 4 | Non-Preferred Drug | 31% of the cost | 26% of the cost | 26% of the cost |
| Tier 5 | Specialty Tier | 31% of the cost | 25% of the cost | 25% of the cost |
| Tier 6 | Select Care Drugs | $1 | $3 | $0 |
Source: CMS plan benefit package files, 2027 and 2026. Insulin is capped at $35 a month by law. A drug's tier is set by the plan's formulary.
How does it compare with plans sold where it is?
In the counties it serves, 106 plans open to everyone are sold for 2027, this one included. Against the others, 49 plans have a lower out-of-pocket limit, 2 the same, 54 a higher one. On the premium, 97 plans have a lower premium, 8 a higher one.
Out-of-pocket limits of the 106 plans open to everyone
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
Where is it sold, and what does it cost there?
| Monthly premium | Out-of-pocket limit | Where |
|---|---|---|
| $45 | $6,900 | Alamance (NC), Buncombe (NC), Burke (NC), Catawba (NC), Chatham (NC), Davidson (NC), Davie (NC), Forsyth (NC), Gaston (NC), Guilford (NC), Harnett (NC), Haywood (NC), Iredell (NC), Mecklenburg (NC), New Hanover (NC), Person (NC), Randolph (NC), Rockingham (NC), Stokes (NC), Wilkes (NC), Yadkin (NC) |
| $70 | $6,900 | Alexander (NC), Anson (NC), Avery (NC), Beaufort (NC), Bertie (NC), Bladen (NC), Brunswick (NC), Cabarrus (NC), Caldwell (NC), Caswell (NC), Chowan (NC), Cleveland (NC), Columbus (NC), Cumberland (NC), Currituck (NC), Duplin (NC), Durham (NC), Edgecombe (NC), Franklin (NC), Gates (NC), Granville (NC), Halifax (NC), Henderson (NC), Hertford (NC), Hoke (NC), Johnston (NC), Jones (NC), Lee (NC), Lenoir (NC), Lincoln (NC), Madison (NC), Martin (NC), McDowell (NC), Mitchell (NC), Montgomery (NC), Moore (NC), Nash (NC), Northampton (NC), Orange (NC), Pender (NC), Pitt (NC), Polk (NC), Richmond (NC), Robeson (NC), Rowan (NC), Rutherford (NC), Sampson (NC), Scotland (NC), Stanly (NC), Surry (NC), Swain (NC), Transylvania (NC), Union (NC), Vance (NC), Wake (NC), Warren (NC), Washington (NC), Watauga (NC), Wayne (NC), Wilson (NC), Yancey (NC) |
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
Who runs this plan?
- Plan ID
- H3404-003
- Legal name of the contract
- Blue Cross and Blue Shield of North Carolina
- Sold as
- Blue Cross and Blue Shield of North Carolina
- Parent company
- CuraCor Solutions Corp.
- Plan type
- PPO
- 2026 star rating of the contract
- 4.5 of 5 overall; health plan 4.5 of 5, drug plan 4 of 5
- Members, September 2026
- 33,215
- Plan website, as filed with CMS
- https://www.bluecrossnc.com/members/medicare
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS 2026 Star Ratings (October 2025); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11). CMS publishes the 2027 Star Ratings in October 2026.
What else should you check?
- Other 2027 plans in Wake, NCWhere most of its members live; premiums and limits side by side
- Every Blue Cross and Blue Shield of North Carolina plan for 2027Its contracts, counties and plans that end
- The other 1 plan of contract H3404Same company, same contract
- Is your prescription covered?Coverage share and tier for 2,259 drugs
Data, not advice. These are the plan's filed amounts, not a quote for you; confirm on Medicare Plan Finder or call the plan before you enroll.