Blue Cross Medicare Advantage Classic (PPO)
Available to residents of Custer County, MT for 2026. Contract H0107, plan 003, segment 0.
Plan details
| Monthly drug premium | $0.00 |
|---|---|
| Drug deductible | $450.00Tier 1 and 2 exempt |
| Plan type | Medicare Advantage |
| Contract / plan | H0107-003-0 |
| Offered by | Blue Cross and Blue Shield of Montana |
| Parent organization | Health Care Service Corporation |
| Formulary drugs | 3,539 |
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)
- 3.5 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H0107 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $0.00 |
| Tier 2 | $1.00 |
| Tier 3 | 17% |
| Tier 4 | 38% |
| Tier 5 | 27% |
Also available in 38 other MT counties
- Beaverhead
- Big Horn
- Broadwater
- Carbon
- Cascade
- Chouteau
- Deer Lodge
- Fergus
- Flathead
- Gallatin
- Glacier
- Golden Valley
- Granite
- Hill
- Jefferson
- Judith Basin
- Lake
- Lewis and Clark
- Liberty
- Lincoln
- Madison
- Meagher
- Mineral
- Missoula
- Musselshell
- Park
- Pondera
- Powell
- Ravalli
- Rosebud
- Sanders
- Silver Bow
- Stillwater
- Sweet Grass
- Teton
- Toole
- Wheatland
- Yellowstone
Plan facts come from the CMS quarterly prescription drug plan public use files.