Medicare Advantage Plan H5900-006-0 Blue Medicare Advantage Valor PPO (PPO) • 2026
Plan H5900-006-0, marketed as Blue Medicare Advantage Valor PPO (PPO), is a Medicare Advantage Plan offered by Wellmark Advantage Health Plan, without prescription drug coverage. This 2026 Part C plan has a Preferred Provider Organization (PPO) provider network.
The most recent CMS data shows an estimated 40 beneficiaries enrolled in this plan.
Blue Medicare Advantage Valor PPO Overview
Plan Overview for H5900-006-0 |
|
|---|---|
| CMS Plan ID: |
H5900-006-0
|
| 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: | See List |
| Enrollment (Nationwide): | 40 beneficiaries |
| Provided By: | Wellmark Advantage Health Plan |
To learn more about your plan options, costs, and enrollment periods without agent assistance, try our helpful Medicare Resources below (click to open).
Medicare Plan Decision Resources
Plan Availability
Blue Medicare Advantage Valor PPO (H5900-006-0) is available in the following locations (click to open):
Frequently Asked Questions About Blue Medicare Advantage Valor PPO (PPO)
Here are some of the most frequently asked questions people have about Plan ID H5900-006-0:
What is the 2026 premium for Plan ID H5900-006-0?
The 2026 monthly premium is $0.00, in addition to any Medicare Part B premium you must pay.
What is the out-of-pocket maximum for Plan ID H5900-006-0?
The in-network maximum out-of-pocket (MOOP) limit for Blue Medicare Advantage Valor PPO is $6750.00 in 2026. After you reach this limit, the plan pays covered in-network Part A and Part B costs for the remainder of the year.
How many CMS stars does Blue Medicare Advantage Valor PPO have?
Contract H5900, which includes this plan, has a ★3.5 out of 5 CMS Star Rating for 2026.
What type of network does Plan ID H5900-006-0 have?
Blue Medicare Advantage Valor PPO is a Preferred Provider Organization (PPO) Medicare Advantage plan.
How many people are enrolled in Blue Medicare Advantage Valor PPO?
The most recent CMS enrollment data shows approximately 40 beneficiaries enrolled in this plan.
Who provides Blue Medicare Advantage Valor PPO (PPO)?
Wellmark Advantage Health Plan provides Blue Medicare Advantage Valor PPO (PPO).
CMS Medicare Star Ratings
The Centers for Medicare & Medicaid Services (CMS) annually rates Medicare Advantage PPOs in nine key categories using a 5-star system. These ratings help you gauge the quality of care and service you might receive with this Wellmark Advantage Health Plan 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 |
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: $0 copay | Out-of-network: $25 copay |
| Specialist: | In-network: $50 copay | Out-of-network: $75 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-$50 copay |
| Routine chiropractic: | In-network: $30 copay | Out-of-network: $0 copay, 0% coinsurance |
| Fitness benefits: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| 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): | 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: $250 copay | Out-of-network: $300 copay |
| Lab services: | In-network: $15 copay | Out-of-network: $20 copay |
| Outpatient x-rays: | In-network: $20 copay | Out-of-network: $30 copay |
| Diagnostic tests and procedures: | In-network: $70 copay | Out-of-network: $95 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: | $130 copay |
| Worldwide emergency care: | $130 copay |
| Urgent care: | $50 copay |
| Inpatient hospital care: | In-network: | Tier 1 | $450 per day for days 1-6 | $0 per day for days 7-90 | $0 per stay | Out-of-network: | 40% 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 | $230 per day for days 21-100 | $0 per stay |
| Ground ambulance: | In-network: $400 copay | Out-of-network: $400 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: $50 copay | Out-of-network: $75 copay |
| Outpatient group therapy: | In-network: $50 copay | Out-of-network: $75 copay |
| Inpatient psychiatric hospital care: | In-network: | Tier 1 | $450 per day for days 1-6 | $0 per day for days 7-90 | $0 per stay | Out-of-network: | 40% 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: $50 copay | Out-of-network: $75 copay |
| Occupational therapy: | In-network: $50 copay | Out-of-network: $75 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 copay | Out-of-network: 20% coinsurance |
| Durable medical equipment: | In-network: 0%-20% coinsurance | Out-of-network: 30% coinsurance |
| Prosthetics: | In-network: 20% coinsurance | Out-of-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 | Out-of-network: 30% coinsurance |
| Other Part B drugs (Medicare-covered): | In-network: 0%-20% coinsurance | Out-of-network: 30% 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 | 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%-25% coinsurance | Out-of-network: 0%-50% coinsurance |
| Endodontics: | In-network: 25% coinsurance | Out-of-network: 50% coinsurance |
| Restorative services: | In-network: 25% coinsurance | Out-of-network: 50% coinsurance |
| Implant services: | Not covered |
| Orthodontics: | Not covered |
| Oral/Maxillofacial surgery: | In-network: 0%-25% coinsurance | Out-of-network: 0%-50% coinsurance |
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 | Out-of-network: 50% coinsurance |
| Contact lenses: | In-network: $0 copay | Out-of-network: 50% coinsurance |
| Eyeglass frames only: | In-network: $0 copay | Out-of-network: 50% coinsurance |
| Eyeglass lenses only: | In-network: $0 copay | Out-of-network: 50% coinsurance |
| Eyeglasses (frames & lenses): | In-network: $0 copay | Out-of-network: 50% coinsurance |
| Upgrades: | In-network: $0 copay | Out-of-network: 50% coinsurance |
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 | Out-of-network: $0 copay, 0% coinsurance |
| Fitting/evaluation: | Not covered |
| Prescription hearing aids: | Not covered |
| OTC hearing aids: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
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 | 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 |
Blue Medicare Advantage Valor PPO covers 100% of certain preventive services as a required Part B benefit.
Prescription Drug Coverage
This plan does not include a Medicare Part D plan for prescriptions.
Contact Wellmark Advantage Health Plan
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: | 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 |
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 |
|---|---|---|
| Wellmark Advantage Health Plan (official source) | http://www.Wellmarkadvantagehealthplan.com | October 13, 2025 |
| 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 |
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.