medicare plans for

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

Essential (PPO)

A $0 PPO plan that includes a national network of doctors and hospitals, in addition to prescription drug coverage and valuable extra benefits.

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Access Medicare Advantage Plan

Access (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 valuable extra benefits.

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Flex Medicare Advantage Plan

Flex (no Part D) (PPO)

A $0 PPO plan that includes both the Blue Medicare Advantage network and Out-of-Network providers, is designed for veterans and people who do not want Part D Prescription Drug coverage.

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Complete Medicare Advantage Plan

Complete (HMO)

An HMO plan with hospital, medical and prescription drug coverage, a $0 monthly premium and no deductibles.

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Plus Medicare Advantage Plan

Plus (HMO)

An HMO plan with hospital, medical and prescription drug coverage and a lower maximum out-of-pocket limit.

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Spira Care Medicare Advantage Plan

Spira Care (HMO)

An HMO plan coordinated through Spira Care that takes the worry out about how and when to get care.

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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.

Request Documents

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.

Dental Coverage Icon

Dental Coverage

Choose how to use your benefits with plans that include preventive, routine and comprehensive care.

Routine Vision Coverage Icon

Routine Vision Coverage

Use your vision benefit the way you want with our easy-to-use vision allowance PPO and HMO plans.

Routine Hearing Exams and Hearing Aid Benefits Icon

Hearing Exams and Hearing Aid Benefits

All of our plans include routine exams and hearing aid coverage.

Over-the-counter (OTC) Benefits Icon

Over-the-Counter (OTC) Benefits

You’ll receive a regular allowances automatically to buy things like non-prescription drugs and everyday health-related items.

SilverSneakers Fitness Membership Icon

SilverSneakers Fitness Membership

Save money and stay fit at more than 13,000 fitness centers at no extra cost.

COVID-19 Cost Share Protection Icon

COVID-19 Cost Share Protection

Your plan will cover all costs related to COVID-19, including testing, treatment, hospitalization and vaccine beyond the emergency government order.

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.

And more...

Such as acupuncture and non-emergency transportation.

Benefits vary by plan.

Benefits Comparison Chart

Blue Medicare Advantage Plans At-A-Glance

Essential (PPO)

Total Premium

$0

Visitor Travel

Covered

Plan Deductible

$500*

Maximum Out of Pocket (MOOP)

$4,000

Inpatient Services

Inpatient Hospital - Acute

In-Network

$250, Days 1-5; $0, Days 6-90**

Out-of-Network

45% per stay

Skilled Nursing Facility

In-Network

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

Out-of-Network

45%, Days 1-100

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 *NEW* 2021)

In-Network

$300

Out-of-Network

$300

Professional Services

PCP Visit

In-Network

$5

Out-of-Network

45%

Specialist Visits

In-Network

$25

Out-of-Network

45%

Podiatry & Routine Foot Care 6/year

In-Network

$25

Out-of-Network

45%

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

$150

Out-of-Network

45%

MRI/CT at other facility

In-Network

$250

Out-of-Network

45%

Outpatient Services

Outpatient Hospital (Non-Surgical)

In-Network

20%

Out-of-Network

45%

Observation

In-Network

$250

Out-of-Network

45%

Surgery (ASC or Outpatient Hospital)

In-Network

$250

Out-of-Network

45%

Supplemental Services

Dental Services (DentaQuest) 1

In-Network

$0 Copay, 2 Exams/Cleaning, 1 X-ray/Fluoride; 50% Coinsurance for Comprehensive;

Out-of-Network

45% Coinsurance, 2 Exams/Cleaning, 1 X-ray/Fluoride; 45% Coinsurance for Comprehensive;

$1,000 Benefit Maximum Combined

Vision Eyewear Benefits (EyeMed) 2

$300 Every Year

Hearing Aid (TruHearing)

$699-$999

Access (PPO)

Total Premium

$60

Visitor Travel

Covered

Plan Deductible

$0

Maximum Out of Pocket (MOOP)

$5,900

Inpatient Services

Inpatient Hospital - Acute

In-Network

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

Out-of-Network

$500, Days 1-5; $0, Days 6-90

Skilled Nursing Facility

In-Network

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

Out-of-Network

$0, Days 1-20; $184, 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 *NEW* 2021)

In-Network

$285

Out-of-Network

$285

Professional Services

PCP Visit

In-Network

$5

Out-of-Network

$10

Specialist Visits

In-Network

$35

Out-of-Network

$70

Podiatry & Routine Foot Care 6/year

In-Network

$35

Out-of-Network

$70

Diagnostic Testing Services

Other Diagnostic Procedures/Tests

In-Network

$0

Out-of-Network

50%

Lab Services

In-Network

$0

Out-of-Network

50%

X-Ray Services

In-Network

$0

Out-of-Network

50%

MRI/CT at physicians office or free standing

In-Network

$185

Out-of-Network

50%

MRI/CT at other facility

In-Network

$285

Out-of-Network

50%

Outpatient Services

Outpatient Hospital (Non-Surgical)

In-Network

20%

Out-of-Network

$500

Observation

In-Network

$285

Out-of-Network

$500

Surgery (ASC or Outpatient Hospital)

In-Network

$285

Out-of-Network

$500

Supplemental Services

Dental Services (DentaQuest) 1

In-Network

$0 Copay, 2 Exams/Cleaning, 1 X-ray/Fluoride; 50% Coinsurance for Comprehensive;

Out-of-Network

50% Coinsurance, 2 Exams/Cleaning, 1 X-ray/Fluoride; 50% Coinsurance for Comprehensive;

$1,000 Benefit Maximum Combined

Vision Eyewear Benefits (EyeMed) 2

$300 Every Year

Hearing Aid (TruHearing)

$399-$699

Flex (PPO)

Total Premium

$0

Visitor Travel

Not Applicable

Plan Deductible

$0

Maximum Out of Pocket (MOOP)

$4,000

Inpatient Services

Inpatient Hospital - Acute

In-Network

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

Out-of-Network

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

Skilled Nursing Facility

In-Network

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

Out-of-Network

$0, Days 1-20; $184, 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 *NEW* 2021)

In-Network

$285

Out-of-Network

$285

Professional Services

PCP Visit

In-Network

$5

Out-of-Network

$5

Specialist Visits

In-Network

$20

Out-of-Network

$20

Podiatry & Routine Foot Care 6/year

In-Network

$20

Out-of-Network

$20

Diagnostic Testing Services

Other 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

20%

MRI/CT at other facility

In-Network

$285

Out-of-Network

20%

Outpatient Services

Outpatient Hospital (Non-Surgical)

In-Network

20%

Out-of-Network

20%

Observation

In-Network

$285

Out-of-Network

$285

Surgery (ASC or Outpatient Hospital)

In-Network

$285

Out-of-Network

$285

Supplemental Services

Dental Services (DentaQuest) 1

$0 Copay, 2 Exams/Cleaning, 1 X-ray/Fluoride; 50% Coinsurance for Comprehensive;

$1,000 Benefit Maximum Combined

Vision Eyewear Benefits (EyeMed) 2

$300 Every Year

Hearing Aid (TruHearing)

$699-$999

Complete (HMO)

Total Premium

$0

Optional supplemental benefit for Dental and Vision:
Additional $25 per month.

Visitor Travel

Not Covered

Plan Deductible

$0

Maximum Out of Pocket (MOOP)

$6,200

Inpatient Services

Inpatient Hospital - Acute

In-Network

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

Skilled Nursing Facility

In-Network

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

Emergency Care/Urgent Care

Emergency Care (Worldwide)

In-Network

$90

Urgently Needed Care (Worldwide)

In-Network

$50

Ambulance Services (Worldwide *NEW* 2021)

In-Network

$325

Professional Services

PCP Visit

In-Network

$5

Specialist Visits

In-Network

$45

Podiatry & Routine Foot Care 6/year

In-Network

$45

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

$225

MRI/CT at other facility

In-Network

$325

Outpatient Services

Outpatient Hospital (Non-Surgical)

In-Network

20%

Observation

In-Network

Not Applicable

Surgery (ASC or Outpatient Hospital)

In-Network

$325

Supplemental Services

Dental Services (DentaQuest) 1

$0 Copay, 2 Exams/Cleaning, 1 X-ray/Fluoride

Optional Supplemental benefit:

20%-50% Coinsurance for Comprehensive
Our plan pays up to $2,000 every year for Comprehensive Dental Services.

$25/Additional Monthly premium buy-up for Dental and Vision.

Vision Eyewear Benefits (EyeMed) 2

Optional Supplemental benefit:

Our plan pays up to $250 every year for eyewear.

$25/Additional Monthly premium buy-up for Dental and Vision.

Hearing Aid (TruHearing)

$699-$999

Plus (HMO)

Total Premium

$45

Visitor Travel

Not Covered

Plan Deductible

$0

Maximum Out of Pocket (MOOP)

$5,200

Inpatient Services

Inpatient Hospital - Acute

In-Network

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

Skilled Nursing Facility

In-Network

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

Emergency Care/Urgent Care

Emergency Care (Worldwide)

In-Network

$90

Urgently Needed Care (Worldwide)

In-Network

$40

Ambulance Services (Worldwide *NEW* 2021)

In-Network

$285

Professional Services

PCP Visit

In-Network

$5

Specialist Visits

In-Network

$40

Podiatry & Routine Foot Care 6/year

In-Network

$45

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

$185

MRI/CT at other facility

In-Network

$285

Outpatient Services

Outpatient Hospital (Non-Surgical)

In-Network

20%

Observation

In-Network

Not Applicable

Surgery (ASC or Outpatient Hospital)

In-Network

$285

Supplemental Services

Dental Services (DentaQuest) 1

$0 Copay, 2 Exams/Cleaning, 1 X-ray/Fluoride; 50% Coinsurance for Comprehensive;

$1,000 Benefit Maximum Combined

Vision Eyewear Benefits (EyeMed) 2

$250 Every Year

Hearing Aid (TruHearing)

$399-$699

Spira Care (HMO)

Total Premium

$0

Optional supplemental benefit for Dental and Vision:
Additional $25 per month.

Visitor Travel

Not Covered

Plan Deductible

$0

Maximum Out of Pocket (MOOP)

$4,800

Inpatient Services

Inpatient Hospital - Acute

In-Network

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

Skilled Nursing Facility

In-Network

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

Emergency Care/Urgent Care

Emergency Care (Worldwide)

In-Network

$90

Urgently Needed Care (Worldwide)

In-Network

$50

Ambulance Services (Worldwide *NEW* 2021)

In-Network

$300

Professional Services

PCP Visit

In-Network

$0

Specialist Visits

In-Network

$30

Podiatry & Routine Foot Care 6/year

In-Network

$30

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

$200

MRI/CT at other facility

In-Network

$300

Outpatient Services

Outpatient Hospital (Non-Surgical)

In-Network

20%

Observation

In-Network

Not Applicable

Surgery (ASC or Outpatient Hospital)

In-Network

$300

Supplemental Services

Dental Services (DentaQuest) 1

$0 Copay, 2 Exams/Cleaning, 1 X-ray/Fluoride

Optional Supplemental benefit:

20%-50% Coinsurance for Comprehensive
Our plan pays up to $2,000 every year for Comprehensive Dental Services.

$25/Additional Monthly premium buy-up for Dental and Vision.

Vision Eyewear Benefits (EyeMed) 2

Optional Supplemental benefit:

Our plan pays up to $250 every year for eyewear.

$25/Additional Monthly premium buy-up for Dental and Vision.

Hearing Aid (TruHearing)

$399-$699

* 2021 Deductible applies to these In-network services: dialysis services, inpatient acute & psychiatric hospital, partial hospitalization, outpatient hospital services, observation services, and ambulatory surgical center (ASC) services. All out-of-network Medicare-covered services, except zero-dollar preventive services, apply to the deductible.

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

1 Member is responsible for charges over the Dental Benefit Maximum.

2 Member is responsible for charges over the Eyewear Benefit Maximum.

This information is not a complete description of benefits.

Benefits Comparison Chart

Blue Medicare Advantage Prescription Drug Benefits

We offer a 90-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 Buchanan, Cass, Clay, Clinton, Jackson, 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

Buchanan county residents eligible for Essential plan only.

Spira Care is only available to residents in the Kansas counties of Johnson and Wyandotte.

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.

Korey Blue KC Medicare Expert

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The right Medicare Advantage plan is right around the corner. And we’ll make it easy for you to sign up.

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