Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
Freedom Blue PPO Standard, 2027
H5106Contract034Plan
PPO · 55 counties in West Virginia
Run by Highmark Senior Solutions Company (contract H5106), sold as Highmark Blue Cross Blue Shield, owned by Highmark Health
Freedom Blue PPO Standard (H5106-034) costs $152 to $172 a month in 2027, up $18 from 2026, with an in-network out-of-pocket limit of $6,500.
What changes from 2026 to 2027?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| Monthly premium | $134 to $154 | $152 to $172 | ▲up $18 |
| Drug deductible | $0 | $700 | ▲up $700 |
| 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) | $425 a year | not offered | ▼dropped |
| Drug tier 1, preferred generic | $5 | $6 | ▲up $1 |
| Drug tier 2, generic | $19 | $20 | ▲up $1 |
| Drug tier 3, preferred brand | $47 | 19% of the cost | changed |
| Drug tier 4, non-preferred drug | $100 | 25% of the cost | changed |
| Drug tier 5, specialty tier | 33% of the cost | 25% of the cost | ▼down 8 points |
| 12 lines do not change | |||
| In-network out-of-pocket limit | $6,500 | $6,500 | no 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) | $35 copay | $35 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 |
| Hospital stay, in network (best in its area) | $150 a day for days 1–7, then $0 a day for days 8–90 | $150 a day for days 1–7, then $0 a day for days 8–90 | no change |
| Ground ambulance, in network (best in its area) | $330 copay | $330 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 | 55 | 55 | 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 | $5 | $6 | $0 |
| Tier 2 | Generic | $19 | $20 | $5 |
| Tier 3 | Preferred Brand | $47 | 19% of the cost | 19% of the cost |
| Tier 4 | Non-Preferred Drug | $100 | 25% of the cost | 25% of the cost |
| Tier 5 | Specialty Tier | 33% of the cost | 25% of the cost | 25% of the cost |
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, 42 plans open to everyone are sold for 2027, this one included. Against the others, 2 plans have a lower out-of-pocket limit, 2 the same, 37 a higher one. On the premium, 41 plans have a lower premium.
Out-of-pocket limits of the 42 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 |
|---|---|---|
| $152 | $6,500 | Berkeley (WV), Braxton (WV), Brooke (WV), Cabell (WV), Clay (WV), Doddridge (WV), Fayette (WV), Greenbrier (WV), Hardy (WV), Harrison (WV), Jefferson (WV), Kanawha (WV), Lincoln (WV), Marion (WV), Marshall (WV), Mason (WV), McDowell (WV), Mercer (WV), Mingo (WV), Monongalia (WV), Nicholas (WV), Ohio (WV), Preston (WV), Putnam (WV), Raleigh (WV), Randolph (WV), Ritchie (WV), Wayne (WV), Wirt (WV), Wood (WV) |
| $172 | $6,500 | Barbour (WV), Boone (WV), Calhoun (WV), Gilmer (WV), Grant (WV), Hampshire (WV), Hancock (WV), Jackson (WV), Lewis (WV), Logan (WV), Mineral (WV), Monroe (WV), Morgan (WV), Pendleton (WV), Pleasants (WV), Pocahontas (WV), Roane (WV), Summers (WV), Taylor (WV), Tucker (WV), Tyler (WV), Upshur (WV), Webster (WV), Wetzel (WV), Wyoming (WV) |
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
- H5106-034
- Legal name of the contract
- Highmark Senior Solutions Company
- Sold as
- Highmark Blue Cross Blue Shield
- Parent company
- Highmark Health
- Plan type
- PPO
- 2026 star rating of the contract
- 3.5 of 5 overall; health plan 3.5 of 5, drug plan 3.5 of 5
- Members, September 2026
- 1,377
- Plan website, as filed with CMS
- medicare.highmark.com
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 Kanawha, WVWhere most of its members live; premiums and limits side by side
- Every Highmark Blue Cross Blue Shield plan for 2027Its contracts, counties and plans that end
- The other 3 plans of contract H5106Same 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.