Forever Blue Value (PPO) in Genesee County, New York — 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
Forever Blue Value (PPO) (H5526-016) is a $152-premium Medicare Advantage PPO from Highmark Health available in Genesee County, New York in 2026, with a 4.5-star overall rating, a $6,700 in-network out-of-pocket maximum, and a $615 annual Part D drug deductible.
Plan facts (CMS CY2026 Landscape file)
| Organization | Highmark Health |
|---|---|
| Plan name | Forever Blue Value (PPO) |
| Contract ID | H5526 |
| Plan ID | 016 |
| Segment ID | 0 |
| Contract year | 2026 |
| Contract category | MA-PD |
| Plan type | PPO |
| SNP | No |
| Monthly consolidated premium | $152.00 |
| Part C premium | $74.60 |
| Part D basic premium | $62.50 |
| Part D total premium | $77.40 |
| Annual Part D deductible | $615.00 |
| Maximum out-of-pocket (in-network) | $6700.00 |
| Overall star rating | 4.5 |
How this plan is structured
- $152 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.
- $6,700 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 = Genesee 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 Genesee County
The CMS CY2026 Landscape file lists 60 Medicare Advantage plans in Genesee County, New York, of which 5 carry a 5.0-star overall rating and 24 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $232.20 per month, and in-network out-of-pocket maximums range from $3000.00 to $9250.00.
Other 5.0-star Medicare Advantage plans in Genesee County (first three alphabetically):
| Plan | Organization | Premium | MOOP |
|---|---|---|---|
| Independent Health's Encompass 65 (HMO) | Independent Health Association, Inc. | — | $6750.00 |
| Independent Health's Encompass 65 RED 042 (HMO) | Independent Health Association, Inc. | $40.00 | $9250.00 |
| Independent Health's Encompass 65 RED 043 (HMO) | Independent Health Association, Inc. | $190.00 | $7000.00 |
For the full county plan directory, see all Medicare plans in Genesee County, New York.
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 — H5526-016.
- Call the plan (Highmark Health) 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 H5526-016 means
CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H5526-016, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 5526 are the contract number issued to the organization, and the three-digit 016 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 Forever Blue Value (PPO) an HMO or PPO?
Forever Blue Value (PPO) is a PPO Medicare Advantage plan.
Does Forever Blue Value (PPO) include prescription drug coverage?
Yes — Forever Blue Value (PPO) is a Medicare Advantage plan with prescription drug coverage (MA-PD) and a $615.00 annual Part D drug deductible for 2026.
What is the maximum out-of-pocket cost for Forever Blue Value (PPO)?
The 2026 in-network maximum out-of-pocket limit for Forever Blue Value (PPO) is $6700.00, per the CMS CY2026 Landscape file.
What counties offer Forever Blue Value (PPO) (H5526-016)?
Forever Blue Value (PPO) (H5526-016) is offered in eight New York counties: Allegany County, Cattaraugus County, Chautauqua County, Erie County, Genesee County, Niagara County, Orleans County, and Wyoming 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.