Plan year 2026 · coverage ends Dec. 31, 2026CMS crosswalk of Oct. 1, 2026
Capital Blue Cross Value is not offered under this ID in 2027
H3962Contract004Plan
HMO · served 21 counties in Pennsylvania in 2026
Run by Keystone Health Plan Central, Inc. (contract H3962), sold as Capital Blue Cross, owned by CAPITAL BLUE CROSS
CMS crosswalk: renews as H3962-023
Capital Blue Cross Value (H3962-004) is not offered under this ID in 2027: the CMS plan crosswalk of October 1, 2026 moves its members into Capital Blue Cross Value (H3962-023) (the plan renews under a new ID), which is sold in every county it served. 1,171 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 Value?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| Monthly premium | $58 | $60 to $63 | ▲up $2 |
| In-network out-of-pocket limit, by county | $6,500 | $6,500 to $7,000 | ▲up $500 at the top |
| Drug deductible | $100 | $700 | ▲up $600 |
| Hospital stay, in network (best in its area) | $150 a day for days 1–5, then $0 a day for days 6–90 | $210 a day for days 1–5, then $0 a day for days 6–90 | ▲up $300for a 5-day stay |
| Skilled nursing facility, in network (best in its area) | $10 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 $30for a 30-day stay |
| Ground ambulance, in network (best in its area) | $200 copay | $110 copay | ▼down $90 |
| Eyewear, yearly limit (best in its area) | $200 a year | $125 a year | ▼down $75 |
| Over-the-counter items, yearly (best in its area) | $300 a year | $160 a year | ▼down $140 |
| Drug tier 3, preferred brand | $47 | 23% of the cost | changed |
| Drug tier 4, non-preferred drug | 37% of the cost | 26% of the cost | ▼down 11 points |
| Drug tier 5, specialty tier | 31% of the cost | 25% of the cost | ▼down 6 points |
| 10 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 |
| Medical deductible, in network (best in its area) | none | none | 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) | not offered | not offered | no change |
| Counties served | 21 | 21 | no change |
| Drug tier 1, preferred generic | $10 | $10 | no change |
| Drug tier 2, generic | $15 | $15 | 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 Capital Blue Cross Value 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 |
|---|---|---|
| Berks, PA | 237 | moves into H3962-023 |
| Lehigh, PA | 187 | moves into H3962-023 |
| Northampton, PA | 142 | moves into H3962-023 |
| Dauphin, PA | 114 | moves into H3962-023 |
| York, PA | 99 | moves into H3962-023 |
| Cumberland, PA | 91 | moves into H3962-023 |
| Schuylkill, PA | 40 | moves into H3962-023 |
| Franklin, PA | 36 | moves into H3962-023 |
| Lancaster, PA | 34 | moves into H3962-023 |
| Union, PA | 32 | moves into H3962-023 |
| Northumberland, PA | 28 | moves into H3962-023 |
| Adams, PA | 24 | moves into H3962-023 |
| Centre, PA | 18 | moves into H3962-023 |
| Snyder, PA | 17 | moves into H3962-023 |
| Lebanon, PA | 16 | moves into H3962-023 |
| Perry, PA | 16 | moves into H3962-023 |
| Juniata, PA | 15 | moves into H3962-023 |
| Mifflin, PA | 15 | moves into H3962-023 |
| Columbia, PA | fewer than 11 | moves into H3962-023 |
| Fulton, PA | fewer than 11 | moves into H3962-023 |
| Montour, PA | fewer than 11 | moves into H3962-023 |
Source: CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11).
What else should you check?
- 2027 plans in Berks, PAThe plans you can join instead
- Capital Blue Cross plans for 2027Plans the same company still offers
- Every plan not offered in 2027764 Medicare Advantage and drug plans