Freedom Blue PPO Valor (PPO) Medicare Advantage Plan H5106-038 • 2027 • Ritchie County, WV
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $6000.00In-network
- Part B Giveback
- −$75.00 reduction
- Prescription Coverage
- Not Included
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Ritchie County, WV
- Local Enrollment
- 0 beneficiaries in Ritchie County
Freedom Blue PPO Valor (PPO) Introduction
This Medicare Advantage PPO plan, Freedom Blue PPO Valor, is offered by Highmark Blue Cross Blue Shield and uses a Preferred Provider Organization (PPO) provider network. It comes without prescription drug coverage. For the 2027 plan year, the monthly premium is $0.00, the medical deductible is $0.00, and the in-network maximum out-of-pocket is $6000.00. The plan is identified by CMS Plan ID H5106-038.
Enrollment in this plan requires residence in Ritchie County, West Virginia. CMS enrollment data reports 0 plan members in Ritchie County. New members can call the plan directly at (866)739-1899 (TTY 711) for assistance.
Compare Similar Plans in Ritchie County
Compare this plan with the two most-enrolled PPO plans available in Ritchie County, West Virginia. Enrollment is based on CMS local enrollment data.
| Plan Detail | Freedom Blue PPO Valor | Humana Essentials Plus Giveback | HumanaChoice H5216-425 |
|---|---|---|---|
| CMS Plan ID | H5106-038-0 |
H7617-065-0 |
H5216-425-0 |
| Local Enrollment | 0 | 96 | 65 |
| Monthly Premium | $0.00 | $0.00 | $29.00 |
| Medical Deductible | $0.00 | $650 | $0.00 |
| Maximum Out-of-Pocket | $6,000.00 | $9,850.00 | $7,600.00 |
| Part B Giveback | −$75.00 reduction | −$115.00 reduction | Not offered |
| Primary Care | $0 copay | $0 copay | $0 copay |
| Specialist | $10 copay | $50 copay | $40 copay |
| Part D Deductible | Not Applicable | $700.00 | $700.00 |
| CMS Star Rating | 3.5 | 4.5 | 4.0 |
| Dental | $0 copay | $0 copay | $0 copay |
| Vision | $0 copay | $0 copay | $0 copay |
| Hearing | $0 copay | $0 copay | $0 copay |
Want to explore more options? Browse all Medicare Advantage plans in Ritchie County, or compare Medicare Advantage plans across West Virginia, including premiums, out-of-pocket costs, CMS ratings, and enrollment.
Plan Benefits
Cost-sharing for Freedom Blue PPO Valor includes out-of-pocket expenses for covered healthcare services. The following tables provide a summary of typical in-network out-of-pocket costs for plan H5106-038.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H5106-038-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
Out-of-network: 40% coinsurance - Specialist
- In-network: $10 copay
Out-of-network: 40% coinsurance
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance - Telehealth benefit
- In-network: $0-$50 copay
- Routine chiropractic
- In-network: $15 copay
Out-of-network: 40% coinsurance - Fitness benefits
- Coming soon
- Health education
- Not covered
- Counseling services
- Not covered
- Over-the-counter drug benefits
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance - Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: $225 copay
Out-of-network: 40% coinsurance - Lab services
- In-network: $0-$10 copay
Out-of-network: 40% coinsurance - Outpatient x-rays
- In-network: $20 copay
Out-of-network: 40% coinsurance - Diagnostic tests and procedures
- In-network: $0-$10 copay
Out-of-network: 40% coinsurance
Emergency and Urgent Care Services
- Emergency room care
- $130 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $50 copay
- Inpatient hospital care
- In-network:
Tier 1
$275 per stay
Out-of-network:
$395 per stay - Skilled Nursing Facility
- In-network:
Tier 1
$0 per day for days 1-20
$221 per day for days 21-100
Out-of-network:
30% per stay - Ground ambulance
- In-network: $320 copay
Out-of-network: $320 copay, 30% coinsurance
Mental Health Services
- Outpatient individual therapy
- In-network: $5 copay
Out-of-network: 40% coinsurance - Outpatient group therapy
- In-network: $5 copay
Out-of-network: 40% coinsurance - Inpatient psychiatric hospital care
- In-network:
Tier 1
$275 per stay
Out-of-network:
$395 per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $15 copay
Out-of-network: 40% coinsurance - Occupational therapy
- In-network: $15 copay
Out-of-network: 40% coinsurance
Medical Equipment and Supplies
- Diabetes supplies
- In-network: 0%-20% coinsurance
Out-of-network: 40% coinsurance - Durable medical equipment
- In-network: 0%-50% coinsurance
Out-of-network: 40%-50% coinsurance - Prosthetics
- In-network: 20% coinsurance
Out-of-network: 40% coinsurance
Medicare Part B Drugs
- Chemotherapy
- In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance - Other Part B drugs (Medicare-covered)
- In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance
Dental Services
- Oral exam
- In-network: $0 copay
Out-of-network: 30% coinsurance - Dental x-rays
- In-network: $0 copay
Out-of-network: 30% coinsurance - Cleaning
- In-network: $0 copay
Out-of-network: 30% coinsurance - Periodontics
- In-network: $0 copay
Out-of-network: 50% coinsurance - Endodontics
- In-network: $0 copay
Out-of-network: 50% coinsurance - Restorative services
- In-network: $0 copay
Out-of-network: 50% coinsurance - Implant services
- Not covered
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- In-network: $0 copay
Out-of-network: 50% coinsurance
Vision Services
- Routine eye exam
- In-network: $0 copay
Out-of-network: $50 copay - Contact lenses
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance - Eyeglass frames only
- In-network: $0-$40 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-$40 copay
Out-of-network: $0 copay, 0% coinsurance - Upgrades
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance
Hearing Services
- Hearing exam
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance - Fitting/evaluation
- Not covered
- Prescription hearing aids
- In-network: $699-$999 copay
Out-of-network: $0 copay, 0% coinsurance - OTC hearing aids
- Not covered
Additional and Special Needs Services
- Adult day health services
- Not covered
- Home-based palliative care
- Not covered
- Personal emergency response system
- Coming soon
- Weight management programs
- Not covered
- Wigs for chemotherapy-related hair loss
- Coming soon
- Alternative therapies
- Not covered
- Massage therapy
- Not covered
- Home/bathroom safety devices
- In-network: 20% coinsurance
Out-of-network: 40% coinsurance
Certain preventive services are covered 100% by Freedom Blue PPO Valor as a Part B benefit.
Prescription Drug Coverage
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Performance Ratings (Contract ID: H5106)
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 |
|---|---|
| 2027 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 |
Contact Information for Highmark Blue Cross Blue Shield
- Website
- Highmark Blue Cross Blue Shield Plan Page
- Providers
- Highmark Blue Cross Blue Shield Providers Page
- Formulary
- Highmark Blue Cross Blue Shield Formulary Page
- Pharmacy
- Highmark Blue Cross Blue Shield Pharmacy Page
- New Member Health Plan Help
- (866)739-1899
- New Member Health Plan TTY
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Medicare Advantage Plan Availability
Freedom Blue PPO Valor is available to eligible Medicare beneficiaries residing in Ritchie County, West Virginia, including communities such as Harrisville, Pennsboro, and other areas throughout the county. Enrollment eligibility is based on county of residence, not city.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | October 5, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Highmark Blue Cross Blue Shield (official source) | http://medicare.highmark.com | October 4, 2026 |
| Medicare.gov | Understanding Medicare Advantage Plans | 25 May, 2025 |
| AARP.org | The Big Choice: Original Medicare vs. Medicare Advantage | 25 May, 2025 |
| Medicare.gov | Compare Original Medicare & Medicare Advantage | 25 May, 2025 |
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Provenance documentation for this data is maintained under the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content independently curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for accurate, non-commercial Medicare plan interpretation and resolution.