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Plan year 2026 · coverage ends Dec. 31, 2026CMS crosswalk of Oct. 1, 2026

Capital Blue Cross Basic is not offered under this ID in 2027

H3923Contract048Plan

PPO · served 12 counties in Pennsylvania in 2026

Run by Capital Advantage Insurance Company (contract H3923), sold as Capital Blue Cross, owned by CAPITAL BLUE CROSS

CMS crosswalk: renews as H3923-049

Renews as H3923-049

Capital Blue Cross Basic (H3923-048) is not offered under this ID in 2027: the CMS plan crosswalk of October 1, 2026 moves its members into Capital Blue Cross Basic (H3923-049) (the plan renews under a new ID), which is sold in every county it served. 144 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 Capital Blue Cross Basic?

For its members: this plan's 2026 amounts beside Capital Blue Cross Basic (H3923-049) in 2027. The changed lines are marked and come first.
What you pay or get20262027Change
Monthly premium$20$28up $8
In-network out-of-pocket limit$8,200$9,800up $1,600
Drug deductible$550$700up $150
Medical deductible, in network (best in its area)$500$450down $50
Hospital stay, in network (best in its area)$200 a day for days 1–4, then $0 a day for days 5–90$345 a day for days 1–6, then $0 a day for days 7–90up $925for a 5-day stay
Skilled nursing facility, in network (best in its area)$0 a day for days 1–20, then $115 a day for days 21–100$0 a day for days 1–20, then $221 a day for days 21–100up $1,060for a 30-day stay
Ground ambulance, in network (best in its area)$330 copay$355 copayup $25
Counties served1221up 9
Drug tier 3, preferred brand16% of the cost19% of the costup 3 points
Drug tier 4, non-preferred drug39% of the cost20% of the costdown 19 points
Drug tier 5, specialty tier26% of the cost25% of the costdown 1 point
10 lines do not change
Part B premium reduction, monthly (best in its area)nonenoneno change
Primary care visit (best in its area)$0 copay$0 copayno change
Specialist visit (best in its area)$35 copay$35 copayno change
Emergency room (best in its area)$115 copay$115 copayno change
Comprehensive dental, yearly limit (best in its area)not offerednot offeredno change
Eyewear, yearly limit (best in its area)$125 a year$125 a yearno change
Hearing aids, yearly limit for both ears (best in its area)not offerednot offeredno change
Over-the-counter items, yearly (best in its area)$120 a year$120 a yearno change
Drug tier 1, preferred generic$10$10no change
Drug tier 2, generic$15$15no 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 Capital Blue Cross Basic 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.

All 12 counties, most members first; CMS hides counts under 11 per county, so the counties add up to a little less than the plan's total
CountyMembers, Sept. 2026For 2027
Franklin, PA46moves into H3923-049
York, PA35moves into H3923-049
Adams, PA20moves into H3923-049
Northampton, PA12moves into H3923-049
Berks, PAfewer than 11moves into H3923-049
Columbia, PAfewer than 11moves into H3923-049
Lehigh, PAfewer than 11moves into H3923-049
Montour, PAfewer than 11moves into H3923-049
Northumberland, PAfewer than 11moves into H3923-049
Schuylkill, PAfewer than 11moves into H3923-049
Snyder, PAfewer than 11moves into H3923-049
Union, PAfewer than 11moves into H3923-049

Source: CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11).

What else should you check?