Personal Choice 65 Achieve Rx (PPO) Medicare Advantage Plan H3909-020 • 2027 • Philadelphia County, PA

This Medicare Advantage PPO plan, Personal Choice 65 Achieve Rx, is offered by Independence Blue Cross and uses a Preferred Provider Organization (PPO) provider network. It comes with prescription drug coverage. For the 2027 plan year, the monthly premium is $0.00, the medical deductible is Coming soon, and the in-network maximum out-of-pocket is $9850.00. The plan is identified by CMS Plan ID H3909-020. The 2027 Part D prescription drug deductible is $700.00.

Enrollment in this plan requires residence in Philadelphia County, Pennsylvania. CMS enrollment data reports 2,403 plan members in Philadelphia County. New members can call the plan directly at (877)393-6733 (TTY 711) for assistance.

Personal Choice 65 Achieve Rx 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 Special Needs Plan coverage.

For more details, visit the Social Security Extra Help program .

Prescription Drug Plan Deductible

This plan has a $700.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Independence Blue Cross starts contributing towards your prescription costs.

Prescription Drug Plan Out-of-Pocket Costs

Beyond premiums and deductibles, Personal Choice 65 Achieve Rx may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.

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.