BlueMedicare Patriot (PPO) Medicare Advantage Plan H5434-040 • 2026 • Walton County, FL

BlueMedicare Patriot Overview

Coverage Overview for BlueMedicare Patriot

As a Medicare Advantage PPO plan, BlueMedicare Patriot covers Medicare Part A and Part B services and allows access to Medicare-approved providers. The monthly premium is $0.00, with lower costs when using in-network providers.

Primary care visits have a $0 copay | Out-of-network: 50% coinsurance, specialist visits come with a $55 copay | Out-of-network: 50% coinsurance, urgent care services carry a $50 copay, and ambulance transportation is $0-$275 copay | Out-of-network: $275 copay. These expenses apply toward the annual maximum out-of-pocket (MOOP) limit of $6750.00. After this limit is reached, in-network services are fully covered.

This plan is registered with CMS under Plan ID H5434-040. Cost-sharing details are outlined below.

Cost-Sharing Overview

Cost-sharing for BlueMedicare Patriot includes out-of-pocket expenses for covered healthcare services. The table below provides a summary of typical in-network out-of-pocket costs for plan H5434-040.

Certain preventive services are covered 100% by BlueMedicare Patriot as a Part B benefit.

Prescription Drug Coverage

This plan does not include a Medicare Part D plan for prescriptions.

CMS 5-Star Ratings

CMS evaluates Medicare Advantage (Part C) and Part D plans annually using a 5-star rating system. Ratings reflect performance in preventive care, chronic condition management, and member experience.