Blue Medicare Freedom+ (PPO) Medicare Advantage Plan H3404-004 • 2026 • New Hanover County, NC

Blue Medicare Freedom+ Overview

Plan Overview for Blue Medicare Freedom+

This Medicare Advantage PPO plan 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 20% coinsurance | Out-of-network: 40% coinsurance, specialist visits come with a 20% coinsurance | Out-of-network: 40% coinsurance, urgent care services carry a $40 copay, and ambulance transportation is 20% coinsurance | Out-of-network: 40% coinsurance. These costs apply toward the plan’s annual maximum out-of-pocket (MOOP) limit of $9250.00. 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 H3404-004. Cost-sharing details for key services are provided below.

Cost Sharing Expenses

Blue Medicare Freedom+ 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 H3404-004.

Certain preventive services are covered 100% by Blue Medicare Freedom+ as a Part B benefit.

Prescription Drug Coverage

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

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.