BlueMedicare Classic (HMO) Medicare Advantage Plan H1035-019 • 2026 • Sumter County, FL
This Medicare Advantage HMO plan, identified by CMS Plan ID H1035-019, is offered by Florida Blue HMO for the 2026 plan year. The plan uses a Health Maintenance Organization (HMO) provider network and comes with prescription coverage (Part D ).
BlueMedicare Classic Overview
Plan Overview for
H1035-019-0
|
|
|---|---|
| CMS Plan ID: |
H1035-019-0
|
| Plan Type: | HMO |
| Plan Year: | 2026 |
| Monthly Premium: |
$0.00
Plus your Medicare Part B premium. |
| Medical Deductible: | $0.00 |
| Maximum Out-of-Pocket: | $6750.00 (In-Network) |
| Part B Give Back: | Not offered |
| Prescription Drug Coverage: | Enhanced, $615.00 deductible |
| Additional Benefits: | Dental, Vision, Hearing |
| Service Area: | Sumter County, FL |
| Enrollment (Nationwide): | 5,220 beneficiaries |
| Enrollment (CMS – Local) | 109 beneficiaries in Sumter County |
| Provided By: | Florida Blue HMO |
Plan Overview for BlueMedicare Classic
BlueMedicare Classic is a Medicare Advantage Prescription Drug (MAPD) Health Maintenance Organization (HMO) plan that includes hospital, medical, and prescription drug coverage under Medicare Parts A and B. The monthly premium is $0.00, and services are generally covered when received from in-network providers, except in emergency situations. The annual Part D deductible is $615.00.
Primary care visits have a $0 copay, specialist visits come with a $40-$55 copay, urgent care services carry a $50 copay, and ambulance transportation is $0-$310 copay. These costs apply toward the maximum out-of-pocket (MOOP) limit of $6750.00. After this limit is reached, in-network services are fully covered for the remainder of the year.
This plan is listed by CMS under Plan ID H1035-019. Cost-sharing details for key services are provided below.
Cost Sharing Expenses
BlueMedicare Classic has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The table below details the most common in-network out-of-pocket expenses for plan H1035-019.
Certain preventive services are covered 100% by BlueMedicare Classic as a Part B benefit.
Prescription Drug Coverage
BlueMedicare Classic includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.
This plan includes an enhanced benefit Medicare Part D plan (PDP), providing coverage beyond the standard CMS-defined minimum.
Prescription Drug Plan Premium
The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Advantage coverage.
| Basic Part D Premium: | $0.00 |
|---|---|
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $0.00 |
| Low-Income Premium Subsidy: | $4.82 |
| Low-Income Premium Subsidy Paid by CMS: | $0.00 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program.
Prescription Drug Plan Deductible
This plan has a $615.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Florida Blue HMO starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, BlueMedicare Classic may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | Coming soon |
| Generic | $0.00 copay | Coming soon |
| Preferred Brand | 21% coinsurance | Coming soon |
| Non-Preferred Drug | 30% coinsurance | Coming soon |
| Specialty Tier | 25% coinsurance | Coming soon |
| Select Care Drugs | $0.00 copay | Coming soon |
| *Deductible does not apply. | ||
CMS Star Ratings
The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage (Part C) and Part D prescription drug plans each year using a 5-star system. These ratings measure plan performance in areas such as preventive care, management of chronic conditions, and member experience.
| CMS Measure | Star Rating |
|---|---|
| 2026 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
How much does plan H1035-019 cost per month?
The plan’s monthly premium is $0.00 for 2026. The Part B premium is not included.
What is the annual out-of-pocket maximum (MOOP) for this plan?
The annual in-network MOOP is $6750.00 for 2026. After this limit is reached, covered in-network services are fully paid.
What is the CMS star rating for BlueMedicare Classic?
The 2026 CMS star rating for BlueMedicare Classic is ★4.0 out of 5.
What is the current enrollment for BlueMedicare Classic?
The plan has 5,220 enrolled beneficiaries according to CMS.
What is the prescription drug deductible for 2026?
For 2026, the prescription drug deductible is $615.00.
Contact Information for Florida Blue HMO
| Contact Type | Details |
|---|---|
| Website: | Florida Blue HMO Plan Page |
| New Members: | 1-855-601-9465 |
| Existing Members: | 1-800-926-6565 |
| Plan Address: | 4800 Deerwood Campus Pkwy | DCC Bldg 100 / 3rd Floor | Jacksonville, FL 32246 |
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at medicare.gov.
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | September 8, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | September 8, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | September 8, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | September 8, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Florida Blue HMO (official source) | http://www.fhcpmedicare.com | October 13, 2025 |
| Medicare.gov | Compare types of Medicare Advantage Plans | 25 May, 2025 |
| NCOA.org | 5 Steps to Choosing the Right Medicare Plan for You | 25 May, 2025 |
| Medicare.gov | Compare Original Medicare & Medicare Advantage | 25 May, 2025 |
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