Complete Blue PPO Merit (PPO) in Pennsylvania
Highmark Blue Cross Blue Shield or Highmark Blue Shield, PPO, for 2026. No monthly premium, and your spending is capped at $8,300 a year in network.
What CMS publishes about it
| Insurer | Highmark Blue Cross Blue Shield or Highmark Blue Shield (part of Highmark Health) |
|---|---|
| Plan type | PPO |
| Contract and plan id | H3916-066 |
| Monthly premium | $0 |
| Of which drug coverage | $0.00 |
| Most you can pay in a year | $8,300 |
| Drug coverage | Yes — Enhanced |
| Annual drug deductible | $615 |
| Overall star rating | 4.5/5 |
| Medicare Advantage stars | 4.0/5 |
| Part D stars | 4.5/5 |
| Counties it is sold in | 25 |
| Contract year | 2026 |
Plan types: PPO: Preferred Provider Organization — you can see any Medicare provider, and pay less inside the plan's network. Enhanced: Enhanced drug benefit — more than the standard Part D benefit -- a lower deductible, a lower copay, or more drugs covered.
Among the 185 other plans sold in the same counties, the average monthly premium is $28.11, the average out-of-pocket cap $7,156, and the average star rating 4.2 across the 168 that CMS rated. These averages are ours, from the same CMS file; everything else on this page is as published.
How many people chose it
5,644 people were enrolled in 23 of the 25 counties it is sold in (CMS published no count for the rest) in September 2026. CMS suppresses any county count of ten or fewer, so the real total is a little higher than this.
How CMS rates it, domain by domain
Each domain is rated 1 to 5. 0 of 9 domains carry no rating — CMS either did not require this contract to report them or had too little data.
Where it is sold
Pennsylvania
Adams · Berks · Bradford · Carbon · Centre · Columbia · Cumberland · Dauphin · Juniata · Lackawanna · Lancaster · Lebanon · Lehigh · Luzerne · Mifflin · Montour · Northampton · Northumberland · Perry · Pike · Snyder · Union · Wayne · Wyoming · York
Get told when this changes
Its premium, out-of-pocket maximum, star rating or sanction status changing — and whether it is ending next year.
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CMS files as loaded on 17 September 2026. Premiums, deductibles, maximum out-of-pocket amounts, star ratings and sanctions are reproduced from the Centers for Medicare & Medicaid Services landscape file. Enrolment counts are from the CMS monthly enrolment file; CMS suppresses any count of ten or fewer, which is why many plans show “fewer than 11” rather than a number. The only figures we calculate are the averages and medians marked as ours, from those same files. This is not a complete list of your options and it is not advice: see Medicare.gov or call 1-800-MEDICARE.