Plan Overview

With this PPO product, you get hospital, medical and prescription drug coverage, plus extra benefits, all in one plan. Blue Medicare Advantage Access has a monthly premium of $49 and an in-network maximum out-of-pocket limit of $5,500. This means that if you get sick or need a high cost procedure, your copays are capped once you pay the $5,500. This plan offers great flexibility and freedom.

You won't need to choose a Primary Care Physician (PCP) or get a referral to see a specialist. By seeing preferred providers, you'll make the most of your benefits, but you also have the freedom to go out-of-network for care at a higher rate.

To join, you must be entitled to Medicare Part A, be enrolled in Medicare Part B, and live in the following counties in Kansas: Johnson and Wyandotte, and these counties in Missouri: Cass, Clay, Clinton, Jackson, Lafayette, Platte and Ray.


Advantages Include

  • $49 monthly premium
  • Access to a nationwide network of doctors and hospitals
  • Part D prescription drug coverage
  • Large network of doctors and hospitals in Kansas City’s 10-county service area
  • No referral requirements
  • $750 yearly dental allowance
  • $300 annual eyewear allowance
  • Routine hearing exams and hearing aid coverage
  • Monthly $25 over-the-counter items allowance
  • SilverSneakers® fitness membership at no additional cost
  • 24-hour Nurseline
  • Member Rewards program - $25 gift cards for completing $0 cost-sharing services
  • Acupuncture coverage
  • Non-emergency medical transportation
  • Post-discharge meals

Wondering which Medicare plan is right for you? We can help.

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We can only recommend a Medicare plan if you are eligible for our Medicare plans.

You should be eligible for Medicare at the age of 65 if:

  1. You are a U.S. citizen or legal resident
  2. You have resided in the United States for a minimum of 5 years
  3. You have worked at least 10 years in Medicare-covered employment
  4. You live in the Blue KC service area, which includes 32 counties in Kansas and Missouri

Based on your selections, we recommend...

Blue Medicare advantage

Access (PPO)

$49

month

Advantages Include

  • $49 monthly premium
  • Access to a nationwide network of doctors and hospitals
  • Part D prescription drug coverage
  • Large network of doctors and hospitals in Kansas City’s 10-county service area
  • No referral requirements
  • $750 yearly dental allowance
  • $300 annual eyewear allowance
  • Routine hearing exams and hearing aid coverage
  • Monthly $25 over-the-counter items allowance
  • SilverSneakers® fitness membership at no additional cost
  • 24-hour Nurseline
  • Member Rewards program - $25 gift cards for completing $0 cost-sharing services
  • Acupuncture coverage
  • Non-emergency medical transportation
  • Post-discharge meals

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Call 1-855-208-8246 (TTY: 711) 8 a.m. to 8 p.m., 7 days a week

Based on your selections, we recommend...

Blue Medicare advantage

Essential (PPO)

$0

month

Advantages Include

  • $0 monthly premium
  • Low $3,300 annual out-of-pocket maximum
  • Access to a nationwide network of doctors and hospitals
  • Part D prescription drug coverage
  • Large network of doctors and hospitals in Kansas City’s 10-county service area
  • No referral requirements
  • $750 yearly dental allowance
  • $350 annual eyewear allowance
  • Routine hearing exams and hearing aid coverage
  • Monthly $25 over-the-counter items allowance
  • SilverSneakers® fitness membership at no additional cost
  • 24-hour Nurseline
  • Member Rewards program - $25 gift cards for completing $0 cost-sharing services
  • Acupuncture and therapeutic massage coverage
  • Non-emergency medical transportation
  • Post-discharge meals

Share this plan with yourself (or someone else) to review later.

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Call 1-855-208-8246 (TTY: 711) 8 a.m. to 8 p.m., 7 days a week

Based on your selections, we recommend...

Blue Medicare advantage

Complete (HMO)

$0

month

Advantages Include

  • $0 monthly premium
  • No yearly deductibles
  • Medicare Part D prescription drug coverage
  • Vast, local network of doctors and hospitals
  • No referral requirements
  • $500 yearly dental allowance
  • $150 annual eyewear allowance
  • Routine hearing exams and hearing aid coverage
  • Monthly $25 over-the-counter items allowance
  • SilverSneakers® fitness membership at no additional cost
  • 24-hour Nurseline
  • Member Rewards program - $25 gift cards for completing $0 cost-sharing services
  • Acupuncture coverage
  • Non-emergency medical transportation
  • Post-discharge meals

Share this plan with yourself (or someone else) to review later.

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Call 1-855-208-8246 (TTY: 711) 8 a.m. to 8 p.m., 7 days a week

Based on your selections, we recommend...

Blue Medicare advantage

Plus (HMO)

$34

month

Advantages Include

  • $34 monthly premiums
  • No yearly deductibles
  • Medicare Part D prescription drug coverage
  • Vast, local network of doctors and hospitals
  • No referral requirements
  • $500 yearly dental allowance
  • $300 annual eyewear allowance
  • Routine hearing exams and hearing aid coverage
  • Monthly $25 over-the-counter items allowance
  • SilverSneakers® fitness membership at no additional cost
  • 24-hour Nurseline
  • Member Rewards program - $25 gift cards for completing $0 cost-sharing services
  • Acupuncture coverage
  • Non-emergency medical transportation
  • Post-discharge meals

Share this plan with yourself (or someone else) to review later.

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Success, we’ve emailed your Blue KC Medicare plan recommendation!

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Call 1-855-208-8246 (TTY: 711) 8 a.m. to 8 p.m., 7 days a week

Based on your selections, we recommend...

Blue Medicare advantage

Medicare Supplement (MEDIGAP)

starting at

$130

month*

Medicare Supplement (Medigap) insurance can help pay some of the healthcare costs that Original Medicare doesn't cover, like copayments, coinsurance and deductibles. Benefits may vary depending on whether you live in Kansas or Missouri.

Advantages Include

  • Hospitalization: Part A coinsurance plus coverage for 365 additional days after Medicare benefits end
  • Medical expenses: Part B coinsurance (generally 20% of Medicare-approved expenses) or copayments for hospital outpatient services. Certain plans require you to pay a portion of Part B coinsurance or copayments.
  • Foreign travel: Emergency care services needed for trips outside the U.S.
  • Hospice: Part A coinsurance

*Quote based on state, gender, product availability and underwriting.

These policies have limitations. For costs and complete details of the coverage, call us today.

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Call 1-855-208-8246 (TTY: 711) 8 a.m. to 8 p.m., 7 days a week

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Medical & Hospital Benefits

You must continue to pay Part B premium

Monthly Premium

$49 per month

Medical Deductible

$0

Maximum Out-of-Pocket Limit*
In Network

$5,500 per year

Combined

$10,000 per year

Primary Care Provider Visits
In Network

$0 copay

Out of Network

20% coinsurance

Specialist Visits
In Network

$35 copay

Out of Network

20% coinsurance

Podiatrist Visits
In Network

$40 copay

Out of Network

20% coinsurance

Lab Services
In Network

$0 copay

Out of Network

20% coinsurance

Inpatient Hospital Care
In Network

$285 copay per day for days 1-6, $0 copay per day for days 7-90, $0 copay for additional days.

Out of Network

20% coinsurance

Outpatient Hospital Services
In Network

20% coinsurance

Out of Network

20% coinsurance

Outpatient Hospital Surgery
In Network

$285 copay

Out of Network

20% coinsurance

Urgent Care**
In Network

$40 copay

Out of Network

$40 copay

Emergency Care**
In Network

$90 copay

Out of Network

$90 copay

Ambulance (Ground & Air)
In Network

$290 copay

Out of Network

$290 copay

* Maximum out-of-pocket limit means you will never pay more than the above dollar amount per year for your Medicare-covered medical expenses, even if you have an unexpected illness or injury. If you reach this limit, you will no longer have to pay any copays or coinsurance.

** Blue Medicare Advantage provides worldwide emergency room and urgent care coverage.

Prescription Drug Benefits

Deductible
Network Pharmacies

$0

Preferred Generics
Network Pharmacies

$3 copay

Generics
Network Pharmacies

$12 copay

Preferred Brands
Network Pharmacies

$47 copay

Non-Preferred Brands
Network Pharmacies

$100 copay

Specialty Medications
Network Pharmacies

33% of the cost

We offer a 90-day mail order and retail drug benefit with a $0 copay for all Tier 1 and Tier 2 prescription drugs.

Valuable Extra Benefits

SilverSneakers

Included at no additional cost

24-Hour Nurseline

Included at no additional cost

Vision

Routine Eye Exams

In Network

$0 copay/one per year

Out of Network

50% coinsurance/one per year

Diabetic Eye Exams

In Network

$0 copay/one per year

Out of Network

20% coinsurance

Eyewear Allowance

$300 allowance per year for eyeglass frames or contact lenses

Get the most out of your vision benefits by using an EyeMed Insight in-network provider. Members receive a $0 copay on routine exams when using the EyeMed Insight network.
Hearing

Routine Hearing Exams

In Network

$0 copay/one per year

Out of Network

$40 copay/one per year

Hearing Aids

In Network

$399-$699 copay per aid

Hearing Aids offered through TruHearing (TM) providers only. Advanced and Premium hearing aids only.
Dental

Preventive and Comprehensive Visits


$750 allowance per year

Acupuncture
In Network

$20 copay per visit/20 visits per year

Out of Network

50% coinsurance/20 visits per year

Maximum of 12 acupuncture visits per year per member (in- and out-of-network combined).
Get the most out of your acupuncture benefit by using an American Specialty Health (ASH) in-network provider.

Over-the-Counter Item Allowance

$25/month

Visitor/Travel Benefit

Blue Medicare Advantage (PPO) plans include a Visitor/Travel Benefit through the Blue Cross Blue Shield MA PPO network sharing arrangement.

The network sharing benefit allows Blue Medicare Advantage (PPO) members to obtain in-network benefits from a contracted Blue Cross Blue Shield Medicare Advantage PPO provider when traveling or living outside of the Blue Medicare Advantage 10-county service area.

Blue Medicare Advantage (PPO) shared networks are available in 39 states and one territory: Alabama, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Missouri, Montana, North Carolina, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, Ohio, Oregon, Oklahoma, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin, and West Virginia. For some of the states listed, MA PPO networks are only available in portions of the state.

Non-Emergency Medical Transportation

12 one-way trips per year, limited to ground transportation (examples: medical appointments or prescription pick-up)

Transportation offered through ALC Solutions.
Post-Discharge Meals

Up to 14 fresh, locally prepared meals delivered to your home post inpatient facility stay.

Member Rewards Program

The Member Rewards Program is available to all Blue Medicare Advantage members. The program rewards members with $25 gift cards to popular retailers for completing varying activities. Members can earn a $25 gift card for the following $0 cost-sharing services:

  • Annual Wellness Exam or other qualified wellness visits
  • Breast cancer screening
  • Diabetic eye exams
  • Flu vaccine

The maximum gift card reward per member is $50 per plan year.

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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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