Medicare Advantage Plan H3909-020-0 in Chester County, PA Personal Choice 65 Achieve Rx (PPO) • 2027
Personal Choice 65 Achieve Rx (PPO), CMS Plan-ID H3909-020-0, is a 2027 Medicare Advantage Plan (Part C), with prescription drug coverage, by Independence Blue Cross. The plan uses a Preferred Provider Organization (PPO) provider network structure.
Based on the most recent CMS data, plan enrollments topped 13,428 members, with 2,355 in Chester County, Pennsylvania.
Personal Choice 65 Achieve Rx Overview
Plan Overview for
H3909-020-0
|
|
|---|---|
| CMS Plan ID: |
H3909-020-0
|
| Plan Type: | PPO |
| Plan Year: | 2027 |
| Monthly Premium: |
$0.00
Plus your Medicare Part B premium. |
| Medical Deductible: | Coming soon |
| Maximum Out-of-Pocket: | $9850.00 (In-Network) |
| Part B Give Back: | Coming soon |
| Prescription Drug Coverage: | Enhanced, $700.00 deductible |
| Additional Benefits: | None |
| Service Area: | Chester County, PA |
| Enrollment (Nationwide): | 13,428 beneficiaries |
| Enrollment (CMS – Local) | 2,355 beneficiaries in Chester County |
| Provided By: | Independence Blue Cross |
Frequently Asked Questions About Personal Choice 65 Achieve Rx (PPO)
Here are some of the most frequently asked questions people have about Plan ID H3909-020-0:
How much does Personal Choice 65 Achieve Rx cost per month?
Personal Choice 65 Achieve Rx has a $0.00 monthly premium for 2027. You must also continue to pay any Medicare Part B premium you owe.
How much could I pay out of pocket with Personal Choice 65 Achieve Rx?
The in-network maximum out-of-pocket (MOOP) limit for Personal Choice 65 Achieve Rx is $9850.00 in 2027. 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 H3909-020-0 cover prescription drugs?
Yes. Plan ID H3909-020-0 includes Medicare Part D prescription drug coverage, with a $700.00 deductible for 2027.
What is the CMS Star Rating for Personal Choice 65 Achieve Rx?
Contract H3909, which includes this plan, has a ★4.0 out of 5 CMS Star Rating for 2027.
What type of network does Plan ID H3909-020-0 have?
Plan ID H3909-020-0 uses a Preferred Provider Organization (PPO) provider network.
How many people are enrolled in Personal Choice 65 Achieve Rx?
The most recent CMS enrollment data shows approximately 13,428 beneficiaries enrolled in this plan.
Which insurance company offers Plan ID H3909-020-0?
Plan ID H3909-020-0 is offered by Independence Blue Cross.
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 .
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: | Coming soon |
| Specialist: | Coming soon |
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: | Coming soon |
| Telehealth benefit: | Coming soon |
| Routine chiropractic: | Coming soon |
| Fitness benefits: | Coming soon |
| Health education: | Coming soon |
| Counseling services: | Coming soon |
| Over-the-counter drug benefits: | Coming soon |
| Health transportation (non-emergency): | Coming soon |
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: | Coming soon |
| Lab services: | Coming soon |
| Outpatient x-rays: | Coming soon |
| Diagnostic tests and procedures: | Coming soon |
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: | Coming soon |
| Worldwide emergency care: | Coming soon |
| Urgent care: | Coming soon |
| Inpatient hospital care: | Coming soon |
| Skilled Nursing Facility: | Coming soon |
| Ground ambulance: | Coming soon |
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: | Coming soon |
| Outpatient group therapy: | Coming soon |
| Inpatient psychiatric hospital care: | Coming soon |
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: | Coming soon |
| Occupational therapy: | Coming soon |
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: | Coming soon |
| Durable medical equipment: | Coming soon |
| Prosthetics: | Coming soon |
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: | Coming soon |
| Other Part B drugs (Medicare-covered): | Coming soon |
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: | Coming soon |
| Dental x-rays: | Coming soon |
| Cleaning: | Coming soon |
| Periodontics: | Coming soon |
| Endodontics: | Coming soon |
| Restorative services: | Coming soon |
| Implant services: | Coming soon |
| Orthodontics: | Coming soon |
| Oral/Maxillofacial surgery: | Coming soon |
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: | Coming soon |
| Contact lenses: | Coming soon |
| Eyeglass frames only: | Coming soon |
| Eyeglass lenses only: | Coming soon |
| Eyeglasses (frames & lenses): | Coming soon |
| Upgrades: | Coming soon |
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: | Coming soon |
| Fitting/evaluation: | Coming soon |
| Prescription hearing aids: | Coming soon |
| OTC hearing aids: | Coming soon |
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: | Coming soon |
| Home-based palliative care: | Coming soon |
| Personal emergency response system: | Coming soon |
| Weight management programs: | Coming soon |
| Wigs for chemotherapy-related hair loss: | Coming soon |
| Alternative therapies: | Coming soon |
| Massage therapy: | Coming soon |
| Home/bathroom safety devices: | Coming soon |
Personal Choice 65 Achieve Rx covers 100% of certain preventive services as a required Part B benefit.
Prescription Drug Coverage
Part D Coverage Level (Benefit Design)
Personal Choice 65 Achieve Rx 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: | $0.00 |
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $0.00 |
| Low Income Premium Subsidy: | $12.80 |
| 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 $700.00. This is the amount you must pay at the pharmacy before Independence Blue Cross begins paying its share.
Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Personal Choice 65 Achieve Rx 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 |
|---|---|---|
| Cost data not available. | ||
| *Deductible does not apply. | ||
CMS Medicare Star Ratings
Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates Medicare Advantage PPOs 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 Independence Blue Cross plan.
| 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 Independence Blue Cross
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: |
Independence Blue Cross Plan Page
Opens the carrier website in a new window and enrollment information in this window. |
| New Members: | Coming soon |
| Existing Members: | Coming soon |
| Plan Address: | Coming soon |
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Medicare Plan Decision Resources
Medicare Plan Data Sources and Methodology
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.
| Data Source | Publisher | CMS Version |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | CY2027 Landscape (202609.1) |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | 2027 Star Ratings Data Tables |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | PBP Benefits-2027 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | 2026-09 |
| Publisher | Reference | Last Accessed |
|---|---|---|
| Independence Blue Cross (official source) | http://www.ibxmedicare.com | October 13, 2025 |
| CMS.gov | Medicare Advantage Plan Fact Sheet | 25 May, 2025 |
| Medicare.gov | Joining a plan | 25 May, 2025 |
| Medicare.gov | Your coverage options | 25 May, 2025 |