Blue Medicare Advantage

Plus (HMO)

Plan Overview

With this HMO product, you get hospital, medical and prescription drug coverage, plus extra benefits, all in one plan. Blue Medicare Advantage Plus has a monthly premium of $34, no deductibles and an in-network maximum out-of-pocket limit of $4,800. This means that if you get sick or need a high cost procedure, your copays are capped once you pay the $4,800. You'll be required to get most of your care from an in-network provider. You'll also be asked to choose a primary care physician who will provide your basic healthcare services.

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

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

Medical & Hospital Benefits

Monthly Premium	$34 per month
Medical Deductible	$0
Maximum Out-Of-Pocket Limit^*	$4,800 per year
Primary Care Provider Visits	$0 copay
Specialist Visits	$35 copay
Podiatrist Visits	$40 copay
Lab Services	$0 copay
Inpatient Hospital Care	$285 copay per day for days 1-6, $0 copay per day for days 7-90, $0 copay for additional days
Outpatient Hospital Services	20% coinsurance
Outpatient Hospital Surgery	$285 copay
Urgent Care^**	$40 copay
Emergency Care^**	$90 copay
Ambulance (Ground and Air)	$290 copay

^* Maximum out-of-pocket limit means you’ll 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’ll 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 Diabetic Eye Exams Eyewear Allowance	$0 copay/one per year $0 copay/one per year $300 allowance (eyewear 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 Hearing Aids	$0 copay/one per year $399-$699 copay per aid
Hearing Aids offered through TruHearing™ providers only. Advanced and Premium hearing aids only.
Dental Preventive and Comprehensive Visits	$500 allowance per year
Preventive and comprehensive in-network dental services should be delivered by and are limited to DentaQuest network providers.
Acupuncture	$20 copay per visit/20 visits per year
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
Worldwide Coverage	Worldwide emergency room and urgent care included
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.

Blue Medicare Advantage

Plus (HMO)

Blue Medicare Advantage

Plus (HMO)

Plan Overview

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Blue Medicare advantage

Access (PPO)

$49

Advantages Include

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Blue Medicare advantage

Essential (PPO)

$0

Advantages Include

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Blue Medicare advantage

Complete (HMO)

$0

Advantages Include

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Blue Medicare advantage

Plus (HMO)

$34

Advantages Include

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Blue Medicare advantage

Medicare Supplement (MEDIGAP)

$130

Advantages Include

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Medical & Hospital Benefits

Prescription Drug Benefits

Network Pharmacies

Network Pharmacies

Network Pharmacies

Network Pharmacies

Network Pharmacies

Network Pharmacies

Valuable Extra Benefits

Vision

Hearing

Dental

Acupuncture

Over-the-Counter Item Allowance