Blue Medicare Advantage Valor PPO (PPO) Medicare Advantage Plan H5900-007 • 2026 • Ziebach County, SD
Blue Medicare Advantage Valor PPO is a Medicare Advantage PPO plan offered by Wellmark Advantage Health Plan for the 2026 plan year. It is identified by CMS Plan ID H5900-007 and uses a Preferred Provider Organization (PPO) provider network. The plan comes without prescription drug coverage.
Blue Medicare Advantage Valor PPO Overview
Plan Overview for
H5900-007-0
|
|
|---|---|
| CMS Plan ID: |
H5900-007-0
|
| Plan Type: | PPO |
| 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: | Not Included |
| Additional Benefits: | Dental, Vision, Hearing |
| Service Area: | Ziebach County, SD |
| Enrollment (Nationwide): | 212 beneficiaries |
| Enrollment (CMS – Local) | 0 beneficiaries in Ziebach County |
| Provided By: | Wellmark Advantage Health Plan |
Coverage Overview for Blue Medicare Advantage Valor PPO
As a Medicare Advantage PPO plan, Blue Medicare Advantage Valor PPO 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: $25 copay, specialist visits come with a $50 copay | Out-of-network: $75 copay, urgent care services carry a $50 copay, and ambulance transportation is $400 copay | Out-of-network: $400 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 H5900-007. Cost-sharing details are outlined below.
Out-of-Pocket Costs
Cost-sharing for Blue Medicare Advantage Valor PPO 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 H5900-007.
Certain preventive services are covered 100% by Blue Medicare Advantage Valor PPO as a Part B benefit.
Prescription Drug Coverage
This plan does not include a Medicare Part D plan for prescriptions.
Medicare Plan 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.
| 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 H5900-007 cost per month?
The 2026 monthly premium is $0.00. The Medicare Part B premium is paid separately.
What is the in-network MOOP for plan H5900-007?
For 2026, the in-network maximum out-of-pocket is $6750.00. The plan pays 100% of covered in-network services beyond this amount.
How many beneficiaries are enrolled in this plan?
Total enrollment is 212 beneficiaries based on the latest CMS data.
What is the Part D deductible for plan H5900-007?
The plan’s Part D deductible is $0.00, applied to covered prescription drug costs.
Contact Information for Wellmark Advantage Health Plan
| Contact Type | Details |
|---|---|
| Website: | Wellmark Advantage Health Plan Plan Page |
| New Members: | 1-800-213-3771 |
| Existing Members: | 1-855-716-2544 |
| Plan Address: | P.O. Box 211501 | 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.
| 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 |
|---|---|---|
| Wellmark Advantage Health Plan (official source) | http://www.Wellmarkadvantagehealthplan.com | October 13, 2025 |
| CMS.gov | Medicare Advantage Plan Fact Sheet | 25 May, 2025 |
| Medicare.gov | Joining a plan | 25 May, 2025 |
| Medicare.gov | Explore your Medicare coverage options | 25 May, 2025 |
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