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Blue Medicare Advantage HMO, a plan that offers all of the coverage of Original Medicare — plus benefits not covered by Medicare or most Medicare Supplement insurance plans, including built-in prescription drug coverage. Think of it is as an all-in-one plan.
Whether you’re new to Medicare or thinking about switching plans, here are some important things to consider before choosing Blue Medicare Advantage.
2013 Blue Medicare Advantage plan benefits:
|Maximum medical out-of-pocket cost||$3,400.00|
|Doctor office visits||$7 copay for each Medicare-covered primary care doctor visit
$45 copay for each Medicare-covered specialist visit
|Inpatient hospital care||Days 1-7: $240 copay per day
Days 8-100: $0 copay per day
2013 Blue Medicare Advantage built-in drug coverage:
|Prescription deductible||$325 for tiers 3, 4 & 5 only|
|Copay Tier 1 Preferred Generic Drugs||$3.00|
|Copay Tier 2 Non-preferred Generic Drugs||$11.00|
|Copay Tier 3 Preferred Brand Drugs||$45.00|
|Copay Tier 4 Non-preferred Brand Drugs||$95.00|
|Coinsurance Tier 5 Specialty Drugs||25%|
|Copay gap coverage||After your total yearly drug costs reach $2,970, you receive limited coverage by the plan on certain drugs. You will also receive a discount on brand name drugs and generally pay no more than 47.5% for the plan’s costs for brand drugs and 79% of the plan’s costs for generic drugs until your yearly out-of-pocket drug costs reach $4,750.|
Evidence of Coverage
H3822_BEN_IL_MAPDEOC2013 Accepted 09052012
Evidence of Coverage en Espanol
H3822_BEN_IL_MAPDEOC2013aSPA Accepted 09052012
Summary of Benefits
H3822_IL_BEN_BNFTSMRY13 Accepted 09152012
Summary of Benefits en Espanol
H3822_IL_BEN_BNFTSMRY13SPA Accepted 09152012
You must continue to pay your Medicare Part B premium. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1 of each year. Limitations, copayments, and restrictions may apply. Find more information here . If you would like to submit feedback directly to Medicare, please use the Medicare Complaint Form or contact the Office of the Medicare Ombudsman .