BlueMedicare Patriot (PPO) in Sumter County, Florida — 2026 plan details
Last updated Jul 18, 2026
Reviewed by Jason Burns, Editorial Steward
Published by Senior Direct Answers · Licensed under Citation License 1.0
BlueMedicare Patriot (PPO) (H5434-038) is a $0-premium Medicare Advantage PPO from Guidewell Mutual Holding Corporation available in Sumter County, Florida in 2026, with a 3.5-star overall rating, a $6,750 in-network out-of-pocket maximum, and a $0 annual Part D drug deductible.
Plan facts (CMS CY2026 Landscape file)
| Organization | Guidewell Mutual Holding Corporation |
|---|---|
| Plan name | BlueMedicare Patriot (PPO) |
| Contract ID | H5434 |
| Plan ID | 038 |
| Segment ID | 0 |
| Contract year | 2026 |
| Contract category | MA |
| Plan type | PPO |
| SNP | No |
| Monthly consolidated premium | — |
| Part C premium | $0.00 |
| Part D basic premium | — |
| Part D total premium | — |
| Annual Part D deductible | — |
| Maximum out-of-pocket (in-network) | $6750.00 |
| Overall star rating | 3.5 |
How this plan is structured
- $0 consolidated premium. A $0 or near-$0 consolidated premium does not remove the Part B premium — the standard 2026 Part B premium is $202.90 per month and still applies. See the 2026 Medicare Part B premium.
- PPO plan type. Plan-type rules determine in-network use and referrals. See how Medicare Advantage HMO and PPO plans differ.
- $6,750 in-network out-of-pocket maximum. The MOOP is the annual cap on what a member pays in-network for covered Part A and Part B services. See how the Medicare Advantage MOOP works.
- Service area = Sumter County. Medicare Advantage plans are sold by service area; moving out of the plan's service area triggers a Special Enrollment Period to switch plans. See how moving changes your Medicare options.
How it compares in Sumter County
The CMS CY2026 Landscape file lists 107 Medicare Advantage plans in Sumter County, Florida, of which 8 carry a 5.0-star overall rating and 85 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $184.00 per month, and in-network out-of-pocket maximums range from $500.00 to $9250.00.
Other 5.0-star Medicare Advantage plans in Sumter County (first three alphabetically):
| Plan | Organization | Premium | MOOP |
|---|---|---|---|
| DEVOTED C-SNP PLUS 091 FL (HMO C-SNP) | Devoted Health, Inc. | $4.80 | $9250.00 |
| DEVOTED C-SNP PREMIUM 070 FL (HMO C-SNP) | Devoted Health, Inc. | $4.80 | $3900.00 |
| DEVOTED CORE 027 FL (HMO) | Devoted Health, Inc. | $0.00 | $3900.00 |
For the full county plan directory, see all Medicare plans in Sumter County, Florida.
How to verify your doctors take this plan
Network participation changes throughout the year; we hold no provider-network data, so verify directly with these three sources before you decide:
- Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H5434-038.
- Call the plan (Guidewell Mutual Holding Corporation) using the member-services number listed on that plan page and ask whether each doctor, hospital, and pharmacy is in-network for 2026.
- Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.
What H5434-038 means
CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H5434-038, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 5434 are the contract number issued to the organization, and the three-digit 038 is the plan benefit package under that contract. The segment ID 0 identifies the service-area segment within the plan (0 = the default single segment).
Frequently asked questions
Is BlueMedicare Patriot (PPO) an HMO or PPO?
BlueMedicare Patriot (PPO) is a PPO Medicare Advantage plan.
Does BlueMedicare Patriot (PPO) include prescription drug coverage?
BlueMedicare Patriot (PPO) does not include Part D prescription drug coverage in its consolidated benefits.
What is the maximum out-of-pocket cost for BlueMedicare Patriot (PPO)?
The 2026 in-network maximum out-of-pocket limit for BlueMedicare Patriot (PPO) is $6750.00, per the CMS CY2026 Landscape file.
What counties offer BlueMedicare Patriot (PPO) (H5434-038)?
BlueMedicare Patriot (PPO) (H5434-038) is offered in three Florida counties: Lake County, Marion County, and Sumter County.
Sources
- CMS, Plan Year 2026 Medicare Advantage & Part D Landscape source file (March 2026) — retrieved 2026-07-18. Overall star rating year: 2026.
- Medicare.gov Plan Finder — compare plans and enroll.