Plan Overview

With this PPO product, you get hospital, medical and prescription drug coverage, plus extra benefits, all in one plan. Blue Medicare Advantage Essential has a monthly premium of $15 and an in-network maximum out-of-pocket limit of $6,700. This means that if you get sick or need a high cost procedure, your copays are capped once you pay the $6,700. 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 our service area. The Blue KC service area includes these counties in Kansas: Johnson and Wyandotte. And these counties in Missouri: Cass, Clay, Clinton, Jackson, Lafayette, Platte and Ray.


Advantages Include

  • $15 monthly premium
  • Access to a nationwide network of doctors and hospitals
  • Medicare Part D prescription drug coverage
  • Large network of doctors and hospitals in Kansas City’s nine-county service area
  • Routine hearing exams and hearing aid coverage
  • SilverSneakers® fitness membership at no additional cost
  • 24-hour Nurseline
  • Member Rewards program
  • Preventive dental visits
  • $0 deductibles for Medicare Part A and Part B

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

Close X

Medicare Plan Finder

We want to answer all of your Medicare needs. And that starts with a clear understanding of you and your life. Please take a moment to answer a few simple questions.

Step 1 of 5

Are you currently eligible for Medicare?

Please select one option to continue.

Step 2 of 5

Where do you live?

^

Please select a county from the dropdown.

Step 3 of 5

I prefer to pay:

Please select one option to continue.

Step 4 of 5

I need coverage

Please select one option to continue.

Step 5 of 5

I want Medicare coverage that includes these benefits

Select all that apply

Please select one or more options to see your results.

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)

Advantages Include

  • $49 premium
  • Access to a nationwide network of doctors and hospitals
  • Medicare Part D prescription drug coverage
  • Large network of doctors and hospitals in Kansas City’s nine-county service area
  • Routine hearing exams and hearing aid coverage
  • SilverSneakers® fitness membership at no additional cost
  • 24-hour Nurseline
  • Member Rewards program
  • Preventive dental visits
  • Worldwide emergency room and urgent care coverage
  • $0 deductibles for Medicare Part A and Part B

Call to learn more about this plan.

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)

Advantages Include

  • $15 premium
  • Access to a nationwide network of doctors and hospitals
  • Medicare Part D prescription drug coverage
  • Large network of doctors and hospitals in Kansas City’s nine-county service area
  • Routine hearing exams and hearing aid coverage
  • SilverSneakers® fitness membership at no additional cost
  • 24-hour Nurseline
  • Member Rewards program
  • Preventive dental visits
  • Worldwide emergency room and urgent care coverage
  • $0 deductibles for Medicare Part A and Part B

Call to learn more about this plan.

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)

Advantages Include

  • $0 premium plan
  • Large network of doctors and hospitals in Kansas City’s nine-county service area
  • All Original Medicare coverage (Part A and Part B) plus prescription drug coverage (Part D)
  • Routine hearing exams and hearing aid coverage
  • SilverSneakers® fitness membership at no additional cost
  • 24-hour Nurseline
  • Member Rewards program
  • Worldwide emergency room and urgent care coverage
  • $0 deductibles for Medicare Part A and Part B

Call to learn more about this plan.

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)

Advantages Include

  • $29 premium
  • Large network of doctors and hospitals in Kansas City’s nine-county service area
  • All Original Medicare coverage (Part A and Part B) plus prescription drug coverage (Part D)
  • Preventive dental visits
  • Routine eye exams, eyewear and contacts
  • Routine hearing exams and hearing aid coverage
  • SilverSneakers® fitness membership at no additional cost
  • 24-hour Nurseline
  • Member Rewards program
  • Worldwide emergency room and urgent care coverage
  • $0 deductibles for Medicare Part A and Part B

Call to learn more about this plan.

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)

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

Call to learn more about this plan.

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

Want another recommendation?

You've Got Questions. We've Got Answers.

Share your contact information, and we’ll reach out.**

Loading. . .

^

When’s the best time to contact you?

Please correct the errors highlighted in red.
**Providing contact information authorizes a licensed Blue KC representative to contact you.

Medical & Hospital Benefits

You must continue to pay Part B premium

Monthly Premium

$15 per month

Maximum Out-of-Pocket Limit*
In Network

$6,700 per year

Combined

$10,000 per year

Primary Care Provider Visits
In Network

$7 copay

Out of Network

35% coinsurance

Specialist Visits
In Network

$50 copay

Out of Network

35% coinsurance

Podiatrist Visits
In Network

$50 copay

Out of Network

35% coinsurance

Lab Services
In Network

$0 copay

Out of Network

35% coinsurance

Inpatient Hospital Care
In Network

$360 copay per day for days 1-5, $0 copay per day for days 6-90, $0 copay for additional days.

Out of Network

35% coinsurance

Outpatient Hospital Services (Hospital Surgery)
In Network

$350 copay

Out of Network

35% coinsurance

Urgent Care**
In Network

$50 copay

Out of Network

$50 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

$15 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 mail order prescription drug benefit with a $0 copay for all Generics (Tier 1 and Tier 2) at retail or mail order.

Valuable Extra Benefits

SilverSneakers

Included at no additional cost

24-Hour Nurseline

Included at no additional cost

Vision

Routine Eye Exams

In Network

$10 copay/one per year

Out of Network

50% coinsurance/one per year

Eyeglass Lenses

In Network

Not covered

Out of Network

Not covered

Eyeglass Frames or Contact Lenses

In Network

Not covered

Out of Network

Not covered

In-Network routine vision exams offered through EyeMed Insight Network providers only.
Hearing

Routine Hearing Exams

In Network

$45 copay/one per year

Out of Network

$45 copay/one per year

Hearing Aids

In Network

$699–$999 copay per aid

Out of Network

$699–999 copay per aid

In-Network routine hearing exam and Hearing Aids offered through TruHearing providers only.
Flyte Advanced and Premium hearing aids only.
Dental

Preventive Visits

Not covered

Ready to Enroll?

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

Enroll