Plan year 2026 · coverage ends Dec. 31, 2026CMS crosswalk of Oct. 1, 2026
Complete Blue PPO Merit is not offered under this ID in 2027
H3916Contract066Plan
PPO · served 25 counties in Pennsylvania in 2026
Run by Highmark Senior Health Company (contract H3916), sold as Highmark Blue Cross Blue Shield or Highmark Blue Shield, owned by Highmark Health
CMS crosswalk: renews as H3916-069
Complete Blue PPO Merit (H3916-066) is not offered under this ID in 2027: the CMS plan crosswalk of October 1, 2026 moves its members into Complete Blue PPO Merit (H3916-069) (the plan renews under a new ID), which is sold in every county it served. 5,692 people were enrolled in it in September 2026; they can also choose another plan during open enrollment, October 15 to December 7, 2026.
What changes for its members in Complete Blue PPO Merit?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| Drug deductible | $615 | $700 | ▲up $85 |
| Part B premium reduction, monthly (best in its area) | $91 | $77 | ▼down $14 |
| Skilled nursing facility, in network (best in its area) | $0 a day for days 1–20, then $218 a day for days 21–100 | $0 a day for days 1–20, then $221 a day for days 21–100 | ▲up $30for a 30-day stay |
| Eyewear, yearly limit (best in its area) | $400 a year | not offered | ▼dropped |
| 17 lines do not change | |||
| Monthly premium | $0 | $0 | no change |
| In-network out-of-pocket limit | $8,300 | $8,300 | no change |
| Primary care visit (best in its area) | $0 copay | $0 copay | no change |
| Specialist visit (best in its area) | $40 copay | $40 copay | no change |
| Emergency room (best in its area) | $115 copay | $115 copay | no change |
| Medical deductible, in network (best in its area) | $200 | $200 | no change |
| Hospital stay, in network (best in its area) | $400 a day for days 1–5, then $0 a day for days 6–90 | $400 a day for days 1–5, then $0 a day for days 6–90 | no change |
| Ground ambulance, in network (best in its area) | $320 copay | $320 copay | no change |
| Comprehensive dental, yearly limit (best in its area) | not offered | not offered | no change |
| Hearing aids, yearly limit for both ears (best in its area) | $500 a year | $500 a year | no change |
| Over-the-counter items, yearly (best in its area) | not offered | not offered | no change |
| Counties served | 25 | 25 | no change |
| Drug tier 1, preferred generic | $7 | $7 | no change |
| Drug tier 2, generic | $15 | $15 | no change |
| Drug tier 3, preferred brand | 23% of the cost | 23% of the cost | no change |
| Drug tier 4, non-preferred drug | 25% of the cost | 25% of the cost | no change |
| Drug tier 5, specialty tier | 25% of the cost | 25% of the cost | no change |
Source: CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026); 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. Your plan's Annual Notice of Change is the letter that confirms your 2027 plan; confirm on Medicare Plan Finder.
What can members do, and by when?
- If you do nothing
- You are moved into Complete Blue PPO Merit on January 1, 2027.
- October 15 to December 7, 2026
- Open enrollment: choose another Medicare Advantage plan, or Original Medicare with a drug plan, instead.
- January 1 to March 31, 2027
- Medicare Advantage open enrollment: switch once to another Medicare Advantage plan or to Original Medicare.
Source: Medicare.gov, “Special enrollment periods” and “Joining a plan” (read Oct. 7, 2026).
Where did its members live?
Where its members lived in September 2026; each county and state page lists the 2027 plans sold there.
| County | Members, Sept. 2026 | For 2027 |
|---|---|---|
| Northampton, PA | 1,252 | moves into H3916-069 |
| York, PA | 685 | moves into H3916-069 |
| Adams, PA | 676 | moves into H3916-069 |
| Carbon, PA | 447 | moves into H3916-069 |
| Lehigh, PA | 288 | moves into H3916-069 |
| Pike, PA | 287 | moves into H3916-069 |
| Lancaster, PA | 247 | moves into H3916-069 |
| Wayne, PA | 241 | moves into H3916-069 |
| Cumberland, PA | 199 | moves into H3916-069 |
| Bradford, PA | 197 | moves into H3916-069 |
| Berks, PA | 194 | moves into H3916-069 |
| Lebanon, PA | 164 | moves into H3916-069 |
| Dauphin, PA | 157 | moves into H3916-069 |
| Centre, PA | 149 | moves into H3916-069 |
| Luzerne, PA | 135 | moves into H3916-069 |
| Lackawanna, PA | 92 | moves into H3916-069 |
| Northumberland, PA | 89 | moves into H3916-069 |
| Perry, PA | 42 | moves into H3916-069 |
| Juniata, PA | 27 | moves into H3916-069 |
| Columbia, PA | 25 | moves into H3916-069 |
| Mifflin, PA | 23 | moves into H3916-069 |
| Wyoming, PA | 16 | moves into H3916-069 |
| Union, PA | 12 | moves into H3916-069 |
| Montour, PA | fewer than 11 | moves into H3916-069 |
| Snyder, PA | fewer than 11 | moves into H3916-069 |
Source: CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11).
What else should you check?
- 2027 plans in Northampton, PAThe plans you can join instead
- Highmark Blue Cross Blue Shield or Highmark Blue Shield plans for 2027Plans the same company still offers
- Every plan not offered in 2027764 Medicare Advantage and drug plans