Jefferson Health Plans Flex (PPO) in Delaware County, Pennsylvania — 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
Jefferson Health Plans Flex (PPO) (H1619-001) is a $0-premium Medicare Advantage PPO from Thomas Jefferson University available in Delaware County, Pennsylvania in 2026, with a —-star overall rating, a $7,000 in-network out-of-pocket maximum, and a $0 annual Part D drug deductible.
Plan facts (CMS CY2026 Landscape file)
| Organization | Thomas Jefferson University |
|---|---|
| Plan name | Jefferson Health Plans Flex (PPO) |
| Contract ID | H1619 |
| Plan ID | 001 |
| Segment ID | 0 |
| Contract year | 2026 |
| Contract category | MA-PD |
| Plan type | PPO |
| SNP | No |
| Monthly consolidated premium | $0.00 |
| Part C premium | $0.00 |
| Part D basic premium | $0.00 |
| Part D total premium | $0.00 |
| Annual Part D deductible | $0.00 |
| Maximum out-of-pocket (in-network) | $7000.00 |
| Overall star rating | — |
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.
- $7,000 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 = Delaware 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 Delaware County
The CMS CY2026 Landscape file lists 100 Medicare Advantage plans in Delaware County, Pennsylvania, of which 6 carry a 5.0-star overall rating and 46 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $214.00 per month, and in-network out-of-pocket maximums range from $1000.00 to $9250.00.
Other 5.0-star Medicare Advantage plans in Delaware County (first three alphabetically):
| Plan | Organization | Premium | MOOP |
|---|---|---|---|
| Erickson Advantage Champion (HMO-POS C-SNP) | UnitedHealth Group, Inc. | $182.00 | $3400.00 |
| Erickson Advantage Freedom (HMO-POS) | UnitedHealth Group, Inc. | $89.00 | $4900.00 |
| Erickson Advantage Guardian (HMO-POS I-SNP) | UnitedHealth Group, Inc. | $0.00 | $1000.00 |
For the full county plan directory, see all Medicare plans in Delaware County, Pennsylvania.
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 — H1619-001.
- Call the plan (Thomas Jefferson University) 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 H1619-001 means
CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H1619-001, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 1619 are the contract number issued to the organization, and the three-digit 001 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 Jefferson Health Plans Flex (PPO) an HMO or PPO?
Jefferson Health Plans Flex (PPO) is a PPO Medicare Advantage plan.
Does Jefferson Health Plans Flex (PPO) include prescription drug coverage?
Yes — Jefferson Health Plans Flex (PPO) is a Medicare Advantage plan with prescription drug coverage (MA-PD) and a $0.00 annual Part D drug deductible for 2026.
What is the maximum out-of-pocket cost for Jefferson Health Plans Flex (PPO)?
The 2026 in-network maximum out-of-pocket limit for Jefferson Health Plans Flex (PPO) is $7000.00, per the CMS CY2026 Landscape file.
What counties offer Jefferson Health Plans Flex (PPO) (H1619-001)?
Jefferson Health Plans Flex (PPO) (H1619-001) is offered in 20 Pennsylvania counties: Adams County, Berks County, Bradford County, Bucks County, Carbon County, Chester County, Cumberland County, Dauphin County, Delaware County, Franklin County, Lancaster County, Lebanon County, Lehigh County, Monroe County, Montgomery County, Northampton County, Perry County, Philadelphia County, Schuylkill County, and York 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.