Blue Medicare Advantage PPO (PPO)
Available to residents of Fayette County, IA for 2026. Contract H5900, plan 001, segment 0.
Plan details
| Monthly drug premium | $0.00 |
|---|---|
| Drug deductible | $300.00Tier 1 and 2 exempt |
| Plan type | Medicare Advantage |
| Contract / plan | H5900-001-0 |
| Offered by | Wellmark Advantage Health Plan |
| Parent organization | Blue Cross Blue Shield of Michigan Mutual Ins. Co. |
| Formulary drugs | 3,320 |
CMS star ratings
- Overall
- 3.5 out of 5 stars for Overall
- Health plan (Part C)
- 3.5 out of 5 stars for Health plan (Part C)
- Drug plan (Part D)
- 4 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H5900 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $0.00 |
| Tier 2 | $5.00 |
| Tier 3 | 20% |
| Tier 4 | 25% |
| Tier 5 | 29% |
Also available in 80 other IA counties
- Appanoose
- Audubon
- Benton
- Black Hawk
- Boone
- Buchanan
- Buena Vista
- Butler
- Calhoun
- Carroll
- Cedar
- Cerro Gordo
- Cherokee
- Clarke
- Clay
- Clayton
- Clinton
- Crawford
- Dallas
- Decatur
- Delaware
- Des Moines
- Dickinson
- Emmet
- Floyd
- Franklin
- Greene
- Grundy
- Hamilton
- Hancock
- Hardin
- Harrison
- Henry
- Howard
- Humboldt
- Ida
- Iowa
- Jackson
- Jasper
- Jefferson
- Johnson
- Jones
- Keokuk
- Kossuth
- Lee
- Linn
- Louisa
- Lucas
- Madison
- Mahaska
- Marion
- Marshall
- Mitchell
- Monona
- Monroe
- Montgomery
- Muscatine
- O'Brien
- Osceola
- Palo Alto
Plan facts come from the CMS quarterly prescription drug plan public use files.