Plan Overview

Blue Medicare Advantage Flex has a $0 monthly premium, $0 medical and prescription drug deductibles and a combined in-network and out-of-network maximum out-of-pocket limit of $4,000.

Blue KC makes it flexible for you to use your plan as you decide. The new Blue Benefit Bucks works like a debit card so it’s simple to use. It’s loaded with the benefits and you have the power to spend it based on your personal needs.

The Flex plan Benefit Bucks card comes loaded with $1,000 for use on health-related services for dental, eyewear, hearing, and transportation. You can visit any dentist you like without the worry of a network. This plan’s flexibility gives you the power to decide where and how you’d like to use it. This card also comes loaded with a generous OTC allowance of $500 per year and we’ll add your healthy activity rewards1 on the same card as you earn them.


Advantages Include

  • $0 monthly premium
  • $0 medical deductibles
  • $0 Primary care physician copay
  • $500 over-the-counter items allowance, every year
  • $1,000 Blue Benefit Bucks, flexible benefits for dental, hearing aids, eyewear and transportation combined
  • 40 hours per year for Member and Caregiver support for help to appointments or around the house
  • Low $4,000 annual out-of-pocket maximum in and out of network
  • SilverSneakers® fitness membership at no additional cost

You won't need to choose a Primary Care Physician (PCP) or get a referral to see a specialist. You have the freedom to go out-of-network with the same cost share to either in or out-of-network partners. You have worldwide emergency and urgent care coverage plus access to national BCBS network of providers.

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: Andrew, Bates, Buchanan, Cass, Clay, Clinton, Jackson, Johnson Lafayette, Platte and Ray.

1Rewards for healthy activities may not be used for any benefit cost sharing.

Plan Resources

Plan Benefits
At-A-Glance

You must continue to pay Part B premium

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 Visit
In-Network

$20
Out-of-Network

$20
Telehealth
In-Network

$0
Out-of-Network

N/A
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, Eyewear and 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

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

Sheri Blue KC Medicare Expert

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