WyoBlue Advantage Essential PPO (PPO)
Medicare Advantage Plan H9326-001 • 2026
WyoBlue Advantage Essential PPO (PPO) Medicare Advantage Plan H9326-001 • 2026
WyoBlue Advantage Essential PPO is a Medicare Advantage PPO plan offered by WyoBlue Advantage for the 2026 plan year. It uses a Preferred Provider Organization (PPO) provider network and comes with prescription drug coverage. CMS Plan ID H9326-001 identifies this plan.
WyoBlue Advantage Essential PPO Overview
Plan Overview for H9326-001-0 |
|
|---|---|
| CMS Plan ID: | H9326-001-0 |
| Plan Type: | PPO |
| Plan Year: | 2026 |
| Monthly Premium: | $59.00 Plus your Medicare Part B premium. |
| Medical Deductible: | $200 |
| Maximum Out-of-Pocket: | $9250.00 (In-Network) |
| Part B Give Back: | Not offered |
| Prescription Drug Coverage: | Basic, $615.00 deductible |
| Additional Benefits: | Dental, Vision, Hearing |
| Service Area: | See List |
| Enrollment (Nationwide) | 5,164 beneficiaries |
| Provided By: | WyoBlue Advantage |
Plan Availability
WyoBlue Advantage Essential PPO (H9326-001-0) is available in the following locations (click to open):
Plan Overview for WyoBlue Advantage Essential PPO
This Medicare Advantage MAPD PPO plan combines hospital, medical, and prescription drug coverage and allows access to Medicare-approved providers. The monthly premium is $59.00, and the plan includes Medicare Part A and Part B benefits along with integrated prescription drug coverage. The annual Part D deductible is $615.00.
Primary care visits have a $0 copay | Out-of-network: $0 copay, 0% coinsurance, while specialist visits come with a $55 copay | Out-of-network: $55 copay. Urgent care services carry a $40 copay, and ground ambulance transportation is $500 copay | Out-of-network: $500 copay. These costs apply toward the 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 {title_plan_id}. Cost-sharing details for key services are provided below.
Cost Sharing Expenses
WyoBlue Advantage Essential PPO 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 H9326-001.
This section outlines in-network costs for primary care and specialist office visits, along with related preventive services.
| Covered Service | In-Network Cost |
|---|---|
| Primary: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Specialist: | In-network: $55 copay | Out-of-network: $55 copay |
This section outlines in-network costs for preventive and wellness services included in the plan.
| Covered Service | In-Network Cost |
|---|---|
| Annual wellness exam: | In-network: $0 copay |
| Telehealth benefit: | In-network: $0-$55 copay |
| Routine chiropractic: | In-network: $45 copay | Out-of-network: $45 copay |
| Fitness benefits: | Not covered |
| Health education: | Not covered |
| Counseling services: | Not covered |
| Over-the-counter drug benefits: | Not covered |
| Health transportation (non-emergency): | Not covered |
This section outlines in-network costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Covered Service | In-Network Cost |
|---|---|
| Diagnostic radiology services: | In-network: $0-$500 copay | Out-of-network: $0-$500 copay |
| Lab services: | In-network: $25 copay | Out-of-network: $25 copay |
| Outpatient x-rays: | In-network: $40 copay | Out-of-network: $40 copay |
| Diagnostic tests and procedures: | In-network: $0-$350 copay | Out-of-network: $0-$350 copay |
This section outlines in-network costs for emergency services, urgent care, ambulance transportation, inpatient hospital stays, and skilled nursing facility care.
| Covered Service | In-Network Cost |
|---|---|
| Emergency room care: | $115 copay |
| Worldwide emergency care: | $115 copay |
| Urgent care: | $40 copay |
| Inpatient hospital care: | In-network: | Tier 1 | $450 per day for days 1-4 | $0 per day for days 5-90 | $0 per stay | Out-of-network: | $450 per day for days 1-4 | $0 per day for days 5-90 | $0 per stay |
| Skilled Nursing Facility: | In-network: | Tier 1 | $0 per day for days 1-20 | $218 per day for days 21-100 | Out-of-network: | $0 per day for days 1-20 | $218 per day for days 21-100 | $0 per stay |
| Ground ambulance: | In-network: $500 copay | Out-of-network: $500 copay |
This section outlines in-network costs for mental health services, including outpatient therapy and inpatient psychiatric care.
| Covered Service | In-Network Cost |
|---|---|
| Outpatient individual therapy: | In-network: $55 copay | Out-of-network: $55 copay |
| Outpatient group therapy: | In-network: $55 copay | Out-of-network: $55 copay |
| Inpatient psychiatric hospital care: | In-network: | Tier 1 | $450 per day for days 1-4 | $0 per day for days 5-90 | $0 per stay | Out-of-network: | $450 per day for days 1-4 | $0 per day for days 5-90 | $0 per stay |
This section outlines in-network costs for rehabilitation services, including physical therapy, speech and language therapy, and occupational therapy.
| Covered Service | In-Network Cost |
|---|---|
| Physical therapy and speech and language therapy: | In-network: $55 copay | Out-of-network: $55 copay |
| Occupational therapy: | In-network: $35 copay | Out-of-network: $35 copay |
This section outlines in-network costs for medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Covered Service | In-Network Cost |
|---|---|
| Diabetes supplies: | In-network: $0 copay | Out-of-network: 35% coinsurance |
| Durable medical equipment: | In-network: 20% coinsurance | Out-of-network: 35% coinsurance |
| Prosthetics: | In-network: 20% coinsurance | Out-of-network: 35% coinsurance |
This section outlines in-network cost sharing for chemotherapy and other Medicare Part B-covered drugs.
| Covered Service | In-Network Cost |
|---|---|
| Chemotherapy: | In-network: 0%-20% coinsurance | Out-of-network: 20% coinsurance |
| Other Part B drugs (Medicare-covered): | In-network: 0%-20% coinsurance | Out-of-network: 35% coinsurance |
This section outlines in-network cost sharing for dental services, including preventive care, exams, x-rays, cleanings, and comprehensive dental procedures.
| Covered Service | In-Network Cost |
|---|---|
| Oral exam: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Dental x-rays: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Cleaning: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Periodontics: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Endodontics: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Restorative services: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Implant services: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Orthodontics: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Oral/Maxillofacial surgery: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
This section outlines in-network cost sharing for vision services, including eye exams, eyeglasses, and contact lenses.
| Covered Service | In-Network Cost |
|---|---|
| Routine eye exam: | In-network: $0 copay | Out-of-network: 50% coinsurance |
| Contact lenses: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Eyeglass frames only: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Eyeglass lenses only: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Eyeglasses (frames & lenses): | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Upgrades: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
This section outlines in-network cost sharing for hearing-related services, including exams, fittings, and hearing aids.
| Covered Service | In-Network Cost |
|---|---|
| Hearing exam: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Fitting/evaluation: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Prescription hearing aids: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| OTC hearing aids: | Not covered |
This section outlines in-network cost sharing for additional and special needs services that may be included in the plan.
| Covered Service | In-Network Cost |
|---|---|
| Adult day health services: | Not covered |
| Home-based palliative care: | Not covered |
| Personal emergency response system: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Weight management programs: | Not covered |
| Wigs for chemotherapy-related hair loss: | Not covered |
| Alternative therapies: | Not covered |
| Massage therapy: | Not covered |
| Home/bathroom safety devices: | Not covered |
Certain preventive services are covered 100% by WyoBlue Advantage Essential PPO as a Part B benefit.
Prescription Drug Coverage
WyoBlue Advantage Essential PPO 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 a basic benefit Medicare Part D plan (PDP), meeting the minimum coverage requirements defined by CMS.
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: | $33.70 |
|---|---|
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $33.70 |
| Low-Income Premium Subsidy: | $41.47 |
| Low-Income Premium Subsidy Paid by CMS: | $33.70 |
| 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 WyoBlue Advantage starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, WyoBlue Advantage Essential PPO may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $4.00 copay | Coming soon |
| Generic | $9.00 copay | Coming soon |
| Preferred Brand | 20% coinsurance | Coming soon |
| Non-Preferred Drug | 35% coinsurance | Coming soon |
| Specialty Tier | 25% coinsurance | 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 | Plan too new to be measured |
| Managing Chronic (Long Term) Conditions | Plan too new to be measured |
| Member Experience with Health Plan | Plan too new to be measured |
| Complaints and Changes in Plans Performance | Plan too new to be measured |
| Health Plan Customer Service | Plan too new to be measured |
| Drug Plan Customer Service | Plan too new to be measured |
| Complaints and Changes in the Drug Plan | Plan too new to be measured |
| Member Experience with the Drug Plan | Plan too new to be measured |
| Drug Safety and Accuracy of Drug Pricing | Plan too new to be measured |
How much does plan H9326-001 cost per month?
The plan’s monthly premium is $59.00 for 2026. The Part B premium is not included.
What is the MOOP for WyoBlue Advantage Essential PPO in 2026?
The 2026 in-network MOOP is $9250.00. Once this limit is reached, covered in-network costs are fully covered.
What is the CMS star rating for WyoBlue Advantage Essential PPO?
The 2026 CMS star rating for WyoBlue Advantage Essential PPO is ★0.0 out of 5.
How many beneficiaries are enrolled in this plan?
CMS reports 5,164 beneficiaries enrolled in this plan.
What is the prescription drug deductible for 2026?
For 2026, the prescription drug deductible is $615.00.
Contact Information for WyoBlue Advantage
| Contact Type | Details |
|---|---|
| Website: | WyoBlue Advantage Plan Page |
| New Members: | 1-888-468-0179 |
| Existing Members: | 1-844-682-9966 |
| Plan Address: | P.O. Box 21451 | Eagan, MN 55121 |
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at medicare.gov.
- CMS.gov, Landscape Source Files — Last accessed May 2, 2026
- CMS.gov, Medicare Part C & D Performance — Last accessed May 2, 2026
- CMS.gov, Plan Benefits Package — Last accessed May 2, 2026
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County — Last accessed May 2, 2026
Data sources and methodology documentation..
- WyoBlue Advantage (official source), http://WyoBlueAdvantage.com — Last accessed October 13, 2025
- Medicare.gov, "Understanding Medicare Advantage Plans" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — Last accessed 25 May, 2025
- Medicare.gov, "Compare Original Medicare & Medicare Advantage" — Last accessed 25 May, 2025
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