Medicare Advantage Plan H3449-027-2 in Franklin County, NC Blue Medicare Essential (HMO) • 2026
Plan-ID H3449-027-2 refers to Blue Medicare Essential (HMO), a Medicare Advantage Plan (Part C) offered by Blue Cross and Blue Shield of North Carolina for the 2026 plan year. This plan is a Health Maintenance Organization (HMO) model with Part D prescription drug coverage.
According to CMS enrollment data, an estimated 6,675 beneficiaries are enrolled in this plan, 59 enrollees reside in Franklin County.
Blue Medicare Essential Overview
Plan Overview for H3449-027-2 |
|
|---|---|
| CMS Plan ID: |
H3449-027-2
|
| Plan Type: | HMO |
| Plan Year: | 2026 |
| Monthly Premium: |
$0.00
Plus your Medicare Part B premium. |
| Medical Deductible: | $0.00 |
| Maximum Out-of-Pocket: | $9250.00 (In-Network) |
| Part B Give Back: | −$62.50 reduction |
| Prescription Drug Coverage: | Enhanced, $615.00 deductible |
| Additional Benefits: | Dental, Vision, Hearing |
| Service Area: | Franklin County, NC |
| Enrollment (Nationwide): | 6,675 beneficiaries |
| Enrollment (CMS – Local) | 59 beneficiaries in Franklin County |
| Provided By: | Blue Cross and Blue Shield of North Carolina |
To learn more about your plan options, costs, and enrollment periods without agent assistance, try our helpful Medicare Resources below (click to open).
Frequently Asked Questions About Blue Medicare Essential (HMO)
Here are some of the most frequently asked questions people have about Plan ID H3449-027-2:
How much does Blue Medicare Essential cost per month?
Plan ID H3449-027-2 has a monthly premium of $0.00 for 2026, in addition to any Medicare Part B premium you must pay.
How much could I pay out of pocket with Blue Medicare Essential?
The 2026 in-network maximum out-of-pocket (MOOP) limit is $9250.00. After you reach this limit, the plan pays covered in-network Part A and Part B costs for the remainder of the year.
Does Plan ID H3449-027-2 cover prescription drugs?
Yes. Plan ID H3449-027-2 includes Medicare Part D prescription drug coverage, with a $615.00 deductible for 2026.
How many CMS stars does Blue Medicare Essential have?
Contract H3449, which includes this plan, has a ★4.0 out of 5 CMS Star Rating for 2026.
What type of network does Plan ID H3449-027-2 have?
Plan ID H3449-027-2 uses a Health Maintenance Organization (HMO) provider network.
How many people are enrolled in Blue Medicare Essential?
The most recent CMS enrollment data shows approximately 6,675 beneficiaries enrolled in Plan ID H3449-027-2.
Who provides Blue Medicare Essential (HMO)?
Plan ID H3449-027-2 is offered by Blue Cross and Blue Shield of North Carolina.
Covered Services & Costs
Office Visits
This plan lists in-network cost sharing for primary care and specialist visits, along with related office-based services.
| Covered Service | In-Network Cost |
|---|---|
| Primary: | In-network: $10 copay |
| Specialist: | In-network: $45 copay |
Preventive and Wellness Services
Preventive and wellness benefits may include routine exams, telehealth, fitness programs, health education, and other in-network services.
| Covered Service | In-Network Cost |
|---|---|
| Annual wellness exam: | In-network: $0 copay |
| Telehealth benefit: | In-network: $0-$45 copay |
| Routine chiropractic: | Not covered |
| Fitness benefits: | In-network: $0 copay |
| Health education: | Not covered |
| Counseling services: | Not covered |
| Over-the-counter drug benefits: | In-network: $0 copay |
| Health transportation (non-emergency): | Not covered |
Diagnostic, Lab, and Imaging Services
Diagnostic coverage includes in-network cost sharing for lab tests, x-rays, radiology, and other diagnostic procedures used to evaluate health conditions.
| Covered Service | In-Network Cost |
|---|---|
| Diagnostic radiology services: | In-network: $0-$300 copay, 20% coinsurance |
| Lab services: | In-network: $0-$5 copay |
| Outpatient x-rays: | In-network: $0-$15 copay |
| Diagnostic tests and procedures: | In-network: $0-$25 copay |
Emergency and Urgent Care Services
Emergency and inpatient coverage includes cost sharing for urgent care, emergency room visits, ambulance transportation, 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: | Tier 1 | $407 per day for days 1-6 | $0 per day for days 7-90 | $0 per stay |
| Skilled Nursing Facility: | Tier 1 | $0 per day for days 1-20 | $218 per day for days 21-100 |
| Ground ambulance: | In-network: $275 copay |
Mental Health Services
Mental health coverage includes in-network cost sharing for outpatient individual and group therapy, as well as inpatient psychiatric hospital care.
| Covered Service | In-Network Cost |
|---|---|
| Outpatient individual therapy: | In-network: $40 copay |
| Outpatient group therapy: | In-network: $40 copay |
| Inpatient psychiatric hospital care: | Tier 1 | $407 per day for days 1-6 | $0 per day for days 7-90 | $0 per stay |
Rehabilitation Services
Rehabilitation coverage includes in-network cost sharing for physical therapy, speech and language therapy, and occupational therapy services.
| Covered Service | In-Network Cost |
|---|---|
| Physical therapy and speech and language therapy: | In-network: $25 copay |
| Occupational therapy: | In-network: $25 copay |
Medical Equipment and Supplies
Medical equipment coverage includes in-network cost sharing for diabetes supplies, durable medical equipment, prosthetics, and related supplies.
| Covered Service | In-Network Cost |
|---|---|
| Diabetes supplies: | In-network: 0%-20% coinsurance |
| Durable medical equipment: | In-network: 20% coinsurance |
| Prosthetics: | In-network: 20% coinsurance |
Medicare Part B Drugs
Medicare Part B drug coverage includes in-network cost sharing for chemotherapy and other medications covered under Medicare Part B.
| Covered Service | In-Network Cost |
|---|---|
| Chemotherapy: | In-network: 0%-20% coinsurance |
| Other Part B drugs (Medicare-covered): | In-network: 0%-20% coinsurance |
Dental Services
Dental coverage includes in-network cost sharing for preventive care, exams, x-rays, cleanings, and comprehensive dental procedures.
| Covered Service | In-Network Cost |
|---|---|
| Oral exam: | In-network: $0 copay |
| Dental x-rays: | In-network: $0 copay |
| Cleaning: | In-network: $0 copay |
| Periodontics: | In-network: $0 copay |
| Endodontics: | Not covered |
| Restorative services: | Not covered |
| Implant services: | Not covered |
| Orthodontics: | Not covered |
| Oral/Maxillofacial surgery: | Not covered |
Vision Services
Vision coverage includes in-network cost sharing for routine eye exams, contact lenses, eyeglass frames and lenses, and related eyewear services.
| Covered Service | In-Network Cost |
|---|---|
| Routine eye exam: | In-network: $0 copay |
| Contact lenses: | In-network: $0 copay |
| Eyeglass frames only: | In-network: $0 copay |
| Eyeglass lenses only: | In-network: $0 copay |
| Eyeglasses (frames & lenses): | In-network: $0 copay |
| Upgrades: | In-network: $0 copay |
Hearing Services
Hearing coverage includes in-network cost sharing for hearing exams, fittings and evaluations, prescription hearing aids, and over-the-counter hearing aids.
| Covered Service | In-Network Cost |
|---|---|
| Hearing exam: | In-network: $0 copay |
| Fitting/evaluation: | In-network: $0 copay |
| Prescription hearing aids: | In-network: $499-$999 copay |
| OTC hearing aids: | Not covered |
Additional and Special Needs Services
Additional benefits may include in-network services for adult day health, palliative care, personal emergency response systems, weight management, alternative therapies, and home safety needs.
| 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 |
| 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 |
Blue Medicare Essential covers 100% of certain preventive services as a required Part B benefit.
Prescription Drug Coverage
Part D Coverage Level (Benefit Design)
Blue Medicare Essential includes an enhanced benefit Medicare Part D plan (PDP). Enhanced plans have a higher actuarial value than basic plans. Actuarial value simply refers to the percentage of cost that's covered by the plan.
Plan Premium
The following table outlines the prescription drug plan premium details of this plan.
| Part D Premium Component | Amount |
|---|---|
| Basic Part D Premium: | $-12.50 |
| Supplemental Part D Premium: | $12.50 |
| Total Part D Premium: | $0.00 |
| Low Income Premium Subsidy: | $36.17 |
| Low Income Premium Subsidy CMS Pays: | $0.00 |
| Low Income Subsidy Premium: | $0.00 |
For more information about the Low Income Subsidy, refer to the Social Security Extra Help page.
Plan Deductible
The Medicare Part D annual deductible with this plan is $615.00. This is the amount you must pay at the pharmacy before Blue Cross and Blue Shield of North Carolina begins paying its share.
Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Blue Medicare Essential has out-of-pocket costs that you must pay when you pick up your prescriptions. The following table shows you those costs.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | Coming soon |
| Generic | $4.00 copay | Coming soon |
| Preferred Brand | 25% coinsurance | Coming soon |
| Non-Preferred Drug | 25% coinsurance | Coming soon |
| Specialty Tier | 25% coinsurance | Coming soon |
| Select Care Drugs | $0.00 copay | Coming soon |
| *Deductible does not apply. | ||
CMS Medicare Star Ratings
Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates Medicare Advantage HMOs across nine broad categories using a 5-star rating system. These star ratings provide insight into the quality of care and service you can expect from this Blue Cross and Blue Shield of North Carolina plan.
| 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 |
Contact Blue Cross and Blue Shield of North Carolina
Call 833-748-3201 (TTY 711) to speak with a licensed HealthCompare insurance agent (M-F 8AM-10PM, Sat 9AM-8PM EST) and learn more about this plan and other plans on this site. You may also Enroll Online .
| Contact Type | Details |
|---|---|
| Website: | Blue Cross and Blue Shield of North Carolina Plan Page |
| New Members: | 1-866-760-0823 |
| Existing Members: | 1-888-310-4110 |
| Plan Address: | PO Box 3633 | Durham, NC 27702 |
Medicare Plan Decision Resources
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | CMS Version |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | 202608 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | 2026-08 |
| Publisher | Reference | Last Accessed |
|---|---|---|
| Blue Cross and Blue Shield of North Carolina (official source) | https://www.bluecrossnc.com/medicare | October 13, 2025 |
| Medicare.gov | Compare types of Medicare Advantage Plans | 25 May, 2025 |
| Medicare.gov | Joining a plan | 25 May, 2025 |
| Medicare.gov | Compare Original Medicare & Medicare Advantage | 25 May, 2025 |
Medicare.org independently compiles and interprets Medicare plan information using data published by the Centers for Medicare & Medicaid Services (CMS), official plan information, and other authoritative Medicare sources. The sources used for this plan are documented below.
Medicare.org is an independent Medicare information and enrollment resource and is not affiliated with or endorsed by the U.S. Government or the federal Medicare program. Enrollment assistance is provided through HealthCompare, an Allstate company.
Medicare plan data and editorial content curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for Medicare plan interpretation and publication.