Freedom Blue PPO Valor (PPO)
4.5 stars — Above average. CMS rated contract H3916 4.5 out of 5 for 2026; every plan under H3916 carries the same rating. The rating measures the contract's past quality, member experience and service as CMS scored it (largely 2024 performance); it is not a recommendation. How CMS star ratings work
Summary of Benefits (PDF) ↗ Opens the plan's own 2026 Summary of Benefits on medicare.highmark.com · CMS material ID H3916_25_1921_M. The carrier publishes and may update this document; it governs over the CMS-file summary on this page. Read it here.
Cost sharing reported by CMS
| Primary care visit copay (minimum reported) | — |
| Specialist visit copay (minimum reported) | $10 |
| Urgent care copay | $40 |
| Emergency room copay | $130 |
"Minimum reported" is the lowest copay in the plan's bid for that service category; the plan may charge more for some providers or settings. "—" means CMS did not publish a value.
Supplemental benefits
| Benefit | Reported in bid | Allowance / plan maximum |
|---|---|---|
| Preventive dental | Yes | $3,000 |
| Comprehensive dental | Yes | Reported |
| Vision exam | Yes | Reported |
| Eyewear | Yes | $400 |
| Hearing exam | Yes | Reported |
| Hearing aids | Yes | $500 |
| Transportation | Yes | Reported |
| OTC allowance | Yes | $100 |
| Meals | No | — |
| Acupuncture | No | — |
| Chiropractic | Yes | Reported |
| Telehealth | Yes | Reported |
| Food / produce | — | — |
| Utilities support | — | — |
"Yes" means the plan's approved bid reports the benefit; it does not describe limits, frequency, networks, or eligibility. An allowance is the plan maximum CMS published for that benefit, per the period the plan defines. "Reported" means the benefit is offered but no amount was published.
Professional view: governed benefit records (14)
| Benefit | Code | Offered |
|---|---|---|
| Preventive dental | PREVENTIVE_DENTAL | Yes |
| Comprehensive dental | COMPREHENSIVE_DENTAL | Yes |
| Vision exam | VISION_EXAM | Yes |
| Eyewear | EYEWEAR | Yes |
| Hearing exam | HEARING_EXAM | Yes |
| Hearing aid | HEARING_AID | Yes |
| Transportation | TRANSPORTATION | Yes |
| Over-the-counter | OTC | Yes |
| Meals | MEALS | No |
| Acupuncture | ACUPUNCTURE | No |
| Chiropractic | CHIROPRACTIC | Yes |
| Telehealth | TELEHEALTH | Yes |
| Food and produce | FOOD_PRODUCE | — |
| Utilities support | UTILITIES | — |
Prior-year plan lineage (CMS crosswalk)
H3916-042: Renewal Plan
Part D drug coverage
Service area (28 counties)
Need help with this plan?
Member services: Use the number on your member ID card
Grievances & appeals: Appeals and grievances are handled through plan documents / Member Services
Other published numbers: Highmark tells members to call the number on the back of the member ID card
Plan website: medicare.highmark.com ↗
Medicare: 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048) · Free counseling (SHIP): 1-877-839-2675
Report a data issue on this page
What the star rating means. CMS rates every Medicare Advantage contract (the "H" number in the plan ID — all plans under it share the rating) on a 1-to-5 scale each October, from about 40 measures of care quality, member experience, complaints and appeals, customer service and, for plans with drug coverage, drug safety and pricing. The 2026 rating is largely based on performance measured in 2024.
5 Excellent4 Above average3 Average2 Below average1 Poor
Not rated means CMS published no overall rating — usually a contract too new to be measured or with too few members ("not enough data"); it is not a low score. A 5-star contract can be joined outside the normal enrollment windows (the 5-star Special Enrollment Period, Dec 8 – Nov 30). Medicare.gov flags contracts rated below 3 stars for three years running as low-performing. Stars describe the contract's past performance as CMS measured it; they are not a recommendation, and they do not tell you whether a plan's network, drugs or costs fit you.
Source and definitions
Fields come from the CMS Plan Benefit Package (PBP) and landscape public use files for contract year 2026 (see the source ledger). Premium is the CMS consolidated monthly premium. MOOP is the in-network maximum out-of-pocket. Star rating is the contract's overall rating from the CMS file used in this build; "Not rated" means CMS published none for this contract. This page reports filings and does not recommend or sell any plan; the plan's Summary of Benefits and Evidence of Coverage govern.