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Know Your Medicare Advantage Options

The first step in your Medicare journey is knowing your options. That’s why we created an easy-to-use tool that matches you with the plans available in your area.

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Know Your Medicare Advantage Options

Essential Medicare Advantage Plan

Blue Medicare Advantage Essential (PPO)

A $0 PPO, $0 medical and prescription drug deductible and a low maximum out-of-pocket of $3,425 for in-network and out-of-network costs. This plan also includes valuable extra benefits, including Blue Benefit Bucks to use on health related services.

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Simply Blue Medicare Advantage Plan

Simply Blue (PPO)

A PPO plan that offers flexibility to access providers that are in-network and out-of-network as long as they accept Medicare, as well as Blue Benefit Bucks for use on health-related services all at a $0 monthly premium.

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Simply Blue Advantage Medicare Advantage Plan

Simply Blue Advantage (PPO)

A $0 PPO and $0 medical and prescription drug deductible. This plan offers a $75 per month Part B giveback.

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Flex Medicare Advantage Plan

Blue Medicare Advantage Flex (no Part D) (PPO)

Take advantage of all the benefits of a Blue Medicare Advantage plan even if you don’t need Part D Prescription Drug Coverage at a $0 monthly premium.

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Blue Secure Medicare Advantage Plan

Blue Secure (HMO)

An HMO plan with $0 monthly premium, coverage in the gap in Tier 1 and Tier 2, $0 deductible and low in-network out-of-pocket maximum of $3,650. Blue Secure also include extra benefits and Blue Benefit Bucks giving you the power to decided where and how you’d like to use you benefits.

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Spira Care Medicare Advantage Plan

Blue Medicare Advantage Spira Care (HMO)

An HMO plan coordinated through Spira Care that takes the worry out about how and when to get care all at a $0 monthly premium and $3,000 out-of-pocket maximum.

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Important documentation about your Medicare coverage

For those all-important details about your health plan, all you have to do is ask. Request a copy of your provider directory, Evidence of Coverage or Formulary be mailed to you.

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Supplemental Benefits

Blue Medicare Advantage plans do more than help pay for medical costs. You get valuable extra benefits to help you feel better, live better, and save money – every day.

Debit Card Icon

Blue Benefit Bucks – New for 2022

It works like a debit card so it’s simple to use. It’s loaded with the benefits from the plan you choose and you have the power to spend it on health related items.

Dental Coverage Icon

Dental

The health of your mouth, teeth and gums is closely related to your overall health. Enjoy a brighter smile with dental benefits in most Blue Medicare Advantage plans.

Routine Vision Coverage Icon

Vision

Most Blue Medicare Advantage plans offer vision coverage including eyewear, contact lenses and prescription sunglasses. They may also include vision benefits such as coverage for routine eye exams.

Routine Hearing Exams and Hearing Aid Benefits Icon

Hearing

Your hearing is important to enjoying your retirement activities, and to your overall health. Most of our plans offer the option for hearing exams and, if you need it, hearing aid fitting and purchase up to the plan’s limit.

Transportation Benefits Icon

Transportation

Getting to your appointments is important to maintaining your health. Many of our plans offer the option to use the Blue Benefit Bucks card to schedule and pay for transportation or to use a one-way trip allowance.

Over-the-counter (OTC) Benefits Icon

Over-the-Counter Allowance

With Blue Medicare Advantage plans, you get a generous over-the-counter benefit allowance loaded on our Blue Benefit Bucks pre-paid debit card for your convenience.

SilverSneakers Fitness Membership Icon

SilverSneakers® Fitness

Meet your friends at the gym and stay fit with a SilverSneakers® membership at no extra cost.

Companion & Caregiver Support Icon

Companion & Caregiver Support

If you need help with household chores, technical guidance or other daily tasks, your Blue Medicare Advantage plan can help.

Mindful By Blue KC Icon

Mindful By Blue KC

Mindful by Blue KC provides a set of behavioral health resources to help you address stress, depression, anxiety, substance use, and more. You also have 24/7 access to Mindful Advocates.

Virtual Care Icon

Virtual Care

Virtual Care allows you to get the medical care you need, when you need it, from the safety and convenience of your home, right on your smartphone, tablet or computer.

Diabetes Management Icon

Diabetes Management

The program is offered at no cost to select members with Diabetes and coverage through the Blue Medicare Advantage plan.

Personal Emergency Response System Icon

Personal Emergency Response

We’ll provide you with the devices and systems to protect your health and safety so you feel safe at home and everywhere you go with this new benefit from Best Buy Health.

Benefits vary by plan.

Benefits Comparison Chart

Blue Medicare Advantage Plans At-A-Glance

Essential (PPO)

Total Premium

$0

Blue National Network

Covered

Plan Deductible

$0

Maximum Out of Pocket (MOOP)

$3,425

Inpatient Services

Inpatient Hospital - Acute

In-Network

$325/day, Days 1-5; $0, Days 6-90*

Out-of-Network

45% per stay

Skilled Nursing Facility

In-Network

$20/day, Days 1-20; $188/day, Days 21-100

Out-of-Network

45%, Days 1-100

Emergency Care/Urgent Care

Emergency Care (Worldwide)

In-Network

$120

Out-of-Network

$120

Urgently Needed Care (Worldwide)

In-Network

$50

Out-of-Network

$50

Ambulance Services (Worldwide)

In-Network

$300

Out-of-Network

$300

Professional Services

PCP Visit

In-Network

$0

Out-of-Network

$25

Specialist Visits

In-Network

$25

Out-of-Network

$50

Telehealth

In-Network

$0

Out-of-Network

N/A

Diagnostic Testing Services

Other Diagnostic Procedures/Tests

In-Network

$0

Out-of-Network

45%

Lab Services

In-Network

$0

Out-of-Network

45%

X-Ray Services

In-Network

$0

Out-of-Network

45%

MRI/CT at physicians office or free standing

In-Network

$100

Out-of-Network

45%

MRI/CT at other facility

In-Network

$250

Out-of-Network

45%

Outpatient Services

Observation

In-Network

$325

Out-of-Network

45%

Outpatient Hospital & ASC (Minor surgical; other services)

In-Network

20%

Out-of-Network

45%

Surgery (Ambulatory Surgical Center)

In-Network

$250

Out-of-Network

45%

Surgery (Outpatient Hospital)

In-Network

$325

Out-of-Network

45%

Supplemental Services

Dental

In-Network

$0 copay, 2 exams/cleaning, 1 X-ray/fluoride; 50% coinsurance for comprehensive

Out-of-Network

50% coinsurance preventive services; 50% coinsurance for comprehensive

$1,000 benefit max for preventive and comprehensive In- and Out-of-Network combined

Eyewear

$500 Blue Benefit Bucks for transportation and eyewear combined

Transportation

$500 Blue Benefit Bucks for transportation and eyewear combined

Hearing and Hearing Aids

$0 hearing exam; up to $500 per ear per year for hearing aids

Over-the-counter allowance

$100 per quarter

Simply Blue (PPO)

Total Premium

$0

Blue National Network

Covered

Plan Deductible

$0

Maximum Out of Pocket (MOOP)

$4,800

Inpatient Services

Inpatient Hospital - Acute

In-Network

$300/day, Days 1-5; $0, Days 6-90*

Out-of-Network

$300/day, Days 1-5; $0, Days 6-90

Skilled Nursing Facility

In-Network

$0, Days 1-20; $188/day, Days 21-100

Out-of-Network

$0, Days 1-20; $188/day, Days 21-100

Emergency Care/Urgent Care

Emergency Care (Worldwide)

In-Network

$90

Out-of-Network

$90

Urgently Needed Care (Worldwide)

In-Network

$50

Out-of-Network

$50

Ambulance Services (Worldwide)

In-Network

$300

Out-of-Network

$300

Professional Services

PCP Visit

In-Network

$0

Out-of-Network

$0

Specialist Visits

In-Network

$35

Out-of-Network

$35

Telehealth

In-Network

$0

Out-of-Network

$0

Diagnostic Testing Services

Diagnostic Procedures/Tests

In-Network

$0

Out-of-Network

$0

Lab Services

In-Network

$0

Out-of-Network

$0

X-Ray Services

In-Network

$0

Out-of-Network

$0

MRI/CT at physicians office or free standing

In-Network

$100

Out-of-Network

$100

MRI/CT at other facility

In-Network

$250

Out-of-Network

$250

Outpatient Services

Observation

In-Network

$300

Out-of-Network

$300

Outpatient Hospital & ASC (Minor surgical; other services)

In-Network

20%

Out-of-Network

20%

Surgery (Ambulatory Surgical Center)

In-Network

$250

Out-of-Network

$250

Surgery (Outpatient Hospital)

In-Network

$300

Out-of-Network

$300

Supplemental Services

Dental

$1,000 Blue Benefit Bucks allowance for dental, hearing services, transportation and eyewear combined

Eyewear

$1,000 Blue Benefit Bucks allowance for dental, hearing services, transportation and eyewear combined

Transportation

$1,000 Blue Benefit Bucks allowance for dental, hearing services, transportation and eyewear combined

Hearing and Hearing Aids

$1,000 Blue Benefit Bucks allowance for dental, hearing services, transportation and eyewear combined

Over-the-counter allowance

$500 per year

Simply Blue Advantage (PPO)

Total Premium

$0

Blue National Network

Covered

Plan Deductible

$0

Maximum Out of Pocket (MOOP)

$7,250

Inpatient Services

Inpatient Hospital - Acute

In-Network

$500/day, Days 1-4; $0, Days 5-90*

Out-of-Network

$500/day, Days 1-4; $0, Days 5-90

Skilled Nursing Facility

In-Network

$0, Days 1-20; $188/day, Days 21-100

Out-of-Network

$0, Days 1-20; $188/day, Days 21-100

Emergency Care/Urgent Care

Emergency Care (Worldwide)

In-Network

$90

Out-of-Network

$90

Urgently Needed Care (Worldwide)

In-Network

$50

Out-of-Network

$50

Ambulance Services (Worldwide)

In-Network

$300

Out-of-Network

$300

Professional Services

PCP Visit

In-Network

$0

Out-of-Network

$0

Specialist Visits

In-Network

$30

Out-of-Network

$30

Telehealth

In-Network

$0

Out-of-Network

$0

Diagnostic Testing Services

Diagnostic Procedures/Tests

In-Network

$0

Out-of-Network

$0

Lab Services

In-Network

$0

Out-of-Network

$0

X-Ray Services

In-Network

$0

Out-of-Network

$0

MRI/CT at physicians office or free standing

In-Network

$150

Out-of-Network

$150

MRI/CT at other facility

In-Network

$300

Out-of-Network

$300

Outpatient Services

Observation

In-Network

$500

Out-of-Network

$500

Outpatient Hospital & ASC (Minor surgical; other services)

In-Network

20%

Out-of-Network

20%

Surgery (Ambulatory Surgical Center)

In-Network

$300

Out-of-Network

$300

Surgery (Outpatient Hospital)

In-Network

$500

Out-of-Network

$500

Supplemental Services

Dental

Not covered

Eyewear

Not covered

Transportation

Not covered

Hearing and Hearing Aids

Not covered

Over-the-counter allowance

Not covered

Flex (no Part D) (PPO)

Total Premium

$0

Blue National Network

Covered

Plan Deductible

$0

Maximum Out of Pocket (MOOP)

$4,000

Inpatient Services

Inpatient Hospital - Acute

In-Network

$285/day, Days 1-6; $0, Days 7-90*

Out-of-Network

$285/day, Days 1-6; $0, Days 7-90

Skilled Nursing Facility

In-Network

$0, Days 1-20; $184/day, Days 21-100

Out-of-Network

$0, Days 1-20; $184/day, Days 21-100

Emergency Care/Urgent Care

Emergency Care (Worldwide)

In-Network

$90

Out-of-Network

$90

Urgently Needed Care (Worldwide)

In-Network

$50

Out-of-Network

$50

Ambulance Services (Worldwide)

In-Network

$285

Out-of-Network

$285

Professional Services

PCP Visit

In-Network

$0

Out-of-Network

$0

Specialist Visits

In-Network

$20

Out-of-Network

$20

Telehealth

In-Network

$0

Out-of-Network

$0

Diagnostic Testing Services

Diagnostic Procedures/Tests

In-Network

$0

Out-of-Network

$0

Lab Services

In-Network

$0

Out-of-Network

$0

X-Ray Services

In-Network

$0

Out-of-Network

$0

MRI/CT at physicians office or free standing

In-Network

$185

Out-of-Network

$185

MRI/CT at other facility

In-Network

$285

Out-of-Network

$285

Outpatient Services

Observation

In-Network

$285

Out-of-Network

$285

Outpatient Hospital & ASC (Minor surgical; other services)

In-Network

20%

Out-of-Network

20%

Surgery (Ambulatory Surgical Center)

In-Network

$285

Out-of-Network

$285

Surgery (Outpatient Hospital)

In-Network

$285

Out-of-Network

$285

Supplemental Services

Dental

$1,000 Blue Benefit Bucks allowance for dental, hearing services, transportation and eyewear combined

Eyewear

$1,000 Blue Benefit Bucks allowance for dental, hearing services, transportation and eyewear combined

Transportation

$1,000 Blue Benefit Bucks allowance for dental, hearing services, transportation and eyewear combined

Hearing and Hearing Aids

$1,000 Blue Benefit Bucks allowance for dental, hearing services, transportation and eyewear combined

Over-the-counter allowance

$500 per year

Blue Secure (HMO)

Total Premium

$0

Blue National Network

N/A

Plan Deductible

$0

Maximum Out of Pocket (MOOP)

$3,650

Inpatient Services

Inpatient Hospital - Acute

In-Network

$285/day, Days 1-5; $0, Days 6-90*

Skilled Nursing Facility

In-Network

$0, Days 1-20; $184/day, Days 21-100

Emergency Care/Urgent Care

Emergency Care (Worldwide)

In-Network

$90

Urgently Needed Care (Worldwide)

In-Network

$50

Ambulance Services (Worldwide)

In-Network

$285

Professional Services

PCP Visit

In-Network

$0

Specialist Visits

In-Network

$40

Telehealth

In-Network

$0

Diagnostic Testing Services

Other Diagnostic Procedures/Tests

In-Network

$0

Lab Services

In-Network

$0

X-Ray Services

In-Network

$0

MRI/CT at physicians office or free standing

In-Network

$100

MRI/CT at other facility

In-Network

$285

Outpatient Services

Observation

In-Network

$285

Outpatient Hospital & ASC (Minor surgical; other services)

In-Network

20%

Surgery (Ambulatory Surgical Center)

In-Network

$285

Surgery (Outpatient Hospital)

In-Network

$285

Supplemental Services

Dental

In-Network

100% coverage for preventive; 50% coverage for comprehensive

$1,000 benefit maximum

Eyewear

$500 allowance for transportation and eyewear combined

Transportation

$500 allowance for transportation and eyewear combined

Hearing and Hearing Aids

$0 hearing exam; up to $500 per ear per year for hearing aids

Over-the-counter allowance

$100 per quarter

Spira Care (HMO)

Total Premium

$0

Blue National Network

N/A

Plan Deductible

$0

Maximum Out of Pocket (MOOP)

$3,000

Inpatient Services

Inpatient Hospital - Acute

In-Network

$300/day, Days 1-5; $0, Days 6-90*

Skilled Nursing Facility

In-Network

$20/day, Days 1-20
$188/day, Days 21-100

Emergency Care/Urgent Care

Emergency Care (Worldwide)

In-Network

$120

Urgently Needed Care (Worldwide)

In-Network

$50

Ambulance Services (Worldwide)

In-Network

$300

Professional Services

PCP Visit

In-Network

$0

Specialist Visits

In-Network

$30

Telehealth

In-Network

$0

Diagnostic Testing Services

Diagnostic Procedures/Tests

In-Network

$0

Lab Services

In-Network

$0

X-Ray Services

In-Network

$0

MRI/CT at physicians office or free standing

In-Network

$200

MRI/CT at other facility

In-Network

$300

Outpatient Services

Observation

In-Network

$300

Outpatient Hospital & ASC (Minor surgical; other services)

In-Network

20%

Surgery (Ambulatory Surgical Center)

In-Network

$300

Surgery (Outpatient Hospital)

In-Network

$300

Supplemental Services

Dental

In-Network

100% coverage for preventive; 50% coverage for comprehensive

$1,000 benefit maximum

Eyewear

$300 per year

Transportation

20 one-way trips

Hearing and Hearing Aids

$0 hearing exam; up to $500 per ear per year for hearing aids

Over-the-counter allowance

$100 per quarter

*After 90 days, our plan covers an unlimited number of additional days for an inpatient hospital stay at $0 copay.

Benefits Comparison Chart

Blue Medicare Advantage Prescription Drug Benefits

We offer a 100-day mail order and retail drug benefit with a $0 copay for all Tier 1 and Tier 2 prescription drugs.

Essential (PPO)

Annual Deductible

$0

Preferred Generics (Tier 1)

30-day Supply

$3 copay

90-day Supply

$0 copay

Generics (Tier 2)

30-day Supply

$10 copay

90-day Supply

$0 copay

Preferred Brands (Tier 3)

30-day Supply

$47 copay

90-day Supply

$141 copay

Non-Preferred Drugs (Tier 4)

30-day Supply

$100 copay

90-day Supply

$300 copay

Specialty Drugs (Tier 5)

30-day Supply

33%

90-day Supply

N/A

Gap Coverage

Original Medicare Standard: 25% for all Tiers

Access (PPO)

Annual Deductible

$0

Preferred Generics (Tier 1)

30-day Supply

$0 copay

90-day Supply

$0 copay

Generics (Tier 2)

30-day Supply

$5 copay

90-day Supply

$0 copay

Preferred Brands (Tier 3)

30-day Supply

$47 copay

90-day Supply

$141 copay

Non-Preferred Drugs (Tier 4)

30-day Supply

$100 copay

90-day Supply

$300 copay

Specialty Drugs (Tier 5)

30-day Supply

33%

90-day Supply

N/A

Gap Coverage

T1 & T2 with same copay amounts & Tiers 3, 4 & 5 at 25%

Complete (HMO)

Annual Deductible

$0

Preferred Generics (Tier 1)

30-day Supply

$3 copay

90-day Supply

$0 copay

Generics (Tier 2)

30-day Supply

$10 copay

90-day Supply

$0 copay

Preferred Brands (Tier 3)

30-day Supply

$47 copay

90-day Supply

$141 copay

Non-Preferred Drugs (Tier 4)

30-day Supply

$100 copay

90-day Supply

$300 copay

Specialty Drugs (Tier 5)

30-day Supply

33%

90-day Supply

N/A

Gap Coverage

Original Medicare Standard: 25% for all Tiers

Plus (HMO)

Annual Deductible

$0

Preferred Generics (Tier 1)

30-day Supply

$0 copay

90-day Supply

$0 copay

Generics (Tier 2)

30-day Supply

$5 copay

90-day Supply

$0 copay

Preferred Brands (Tier 3)

30-day Supply

$47 copay

90-day Supply

$141 copay

Non-Preferred Drugs (Tier 4)

30-day Supply

$100 copay

90-day Supply

$300 copay

Specialty Drugs (Tier 5)

30-day Supply

33%

90-day Supply

N/A

Gap Coverage

T1 & T2 with same copay amounts & Tiers 3, 4 & 5 at 25%

Spira Care (HMO)

Annual Deductible

$0

Preferred Generics (Tier 1)

30-day Supply

$0 copay

90-day Supply

$0 copay

Generics (Tier 2)

30-day Supply

$5 copay

90-day Supply

$0 copay

Preferred Brands (Tier 3)

30-day Supply

$47 copay

90-day Supply

$141 copay

Non-Preferred Drugs (Tier 4)

30-day Supply

$100 copay

90-day Supply

$300 copay

Specialty Drugs (Tier 5)

30-day Supply

33%

90-day Supply

N/A

Gap Coverage

T1 & T2 with same copay amounts & Tiers 3, 4 & 5 at 25%

This information is not a complete description of benefits.

This information is not a complete description of benefits. Contact the plan for more information. You may also see our Summary of Benefits for more information. Benefits, premium and/or copayments/coinsurance may change on January 1 of each year. The Formulary, pharmacy network and/or provider network may change at any time. You will receive notice when necessary. For HMO plan, members must use plan providers except in emergency or urgent care situations. If a member obtains routine care from an out-of-network provider without prior approval from Blue KC, neither Medicare nor Blue KC will be responsible for the costs. For PPO plan members, Blue Medicare Advantage (PPO) members are encouraged to use in-network plan providers. Out-of-network/non-contracted providers are under no obligation to treat members, except in emergency situations. For a decision about whether Blue KC will cover an out-of-network service, we encourage you or your provider to ask Blue KC for a pre-service organization determination before the service is received. Please call Blue Medicare Advantage Customer Service or refer to the Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. Limitations, copayments, and restrictions may apply. Part D drug expenses are not covered under the maximum out-of-pocket limit.

Anyone with Medicare Parts A and B living in the Missouri counties of Andrew, Bates, Buchanan, Cass, Clay, Clinton, Jackson, Johnson, Lafayette, Platte and Ray, or in the Kansas counties of Johnson and Wyandotte may apply to join Blue Medicare Advantage. Please note that enrollment may be limited to specific times of the year.

Medicare Coverage you can count on.

We’ve put our years of local knowledge to work building affordable, high-quality Medicare plans that meet the needs of our community across 32 counties.

  • Blue Medicare Advantage & Medicare Supplement

  • Medicare Supplement Only

  • Kansas City

Key Enrollment Dates

Initial Coverage Enrollment Period (IEP)

For those turning 65 (and therefore becoming eligible for Medicare for the first time), you may enroll from three months before to three months after you become eligible for Medicare.

Special Enrollment Period (SEP)

You may be able to enroll at a different time of the year. To learn more about special enrollment periods, visit http://www.medicare.gov.

Annual Enrollment Period (AEP)

From October 15 to December 7, you can switch to, drop, or join a different Medicare plan.

Open Enrollment Period

During Open Enrollment, Medicare beneficiaries are allowed to make “Like plan” changes from January 1 to March 31. Medicare beneficiaries can disenroll from their current plan and select a new plan with their existing carrier of competitor.