Freedom Blue PPO Standard (PPO)
Available to residents of Pike County, PA for 2026. Contract H3916, plan 015, segment 0.
Plan details
| Monthly drug premium | $98.20 |
|---|---|
| Drug deductible | $0.00 |
| Plan type | Medicare Advantage |
| Contract / plan | H3916-015-0 |
| Offered by | Highmark Blue Cross Blue Shield or Highmark Blue S |
| Parent organization | Highmark Health |
| Formulary drugs | 3,874 |
CMS star ratings
- Overall
- 4.5 out of 5 stars for Overall
- Health plan (Part C)
- 4 out of 5 stars for Health plan (Part C)
- Drug plan (Part D)
- 4.5 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H3916 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $0.00 |
| Tier 2 | $13.00 |
| Tier 3 | $45.00 |
| Tier 4 | $95.00 |
| Tier 5 | 33% |
Also available in 33 other PA counties
Plan facts come from the CMS quarterly prescription drug plan public use files.