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Blue Advantage HMO (Medicare Advantage Plan)

Overview

With Blue Advantage, you don't need to buy a separate Medicare supplement or Part D prescription drug plan.

Even better, the plan comes with the valueable extra benefits such as dental, vision, hearing and fitness coverage that helps save you even more. And with the Silver Sneakers Program, you can get a no-cost fitness facility membership with access to a broad network of participating fitness facilities nationwide or the Home Fitness option, plus rewards, challenges and much more.

Covered Benefit Member Share
Plan Year Deductible $0
Out-of-Pocket Maximum (In-Network) $2,000
Out-of-Pocket Maximum (Out-of-Network) N/A
Co-pay - Primary Care/Specialist $0/$20 per visit (In network)
Emergency Room $50 co-pay per visit
Inpatient Hospital $50/day (days 1-10 in network)
Prescription Drugs (Part D)
  • Tier 1
  • Tier 2
  • Tier 3
  • Tier 4
  • Tier 5
  • $0
  • $10
  • $25
  • $50
  • 20%

To view the formulary, visit the BlueCross website

Additional Benefits
Dental $0 copay for preventive dental, includes 2 cleanings, 2 exams, 2 fluoride treatments and 1 x-ray; $2,000 maximum benefit for preventive and comprehensive dental per year
Hearing Aides $0 copay for prescription hearing aids; Up to an $1,100 maximum benefit per year
Eye-wear $300 allowance for glasses or contact lenses per year
Over-the-Counter (OTC) Allowance $100 per quarter OTC benefit (includes over–the-counter health–related items)
Online Primary Care Provider Visits $0 copay for online primary care provider visits (available on a computer, tablet and smartphone 24 hours a day, 7 days a week) through BlueCare
Post Discharge Meals 2 meals per day, up to 5 days (after discharge from acute-care inpatient stay)
Member Wellness Rewards Up to $50 per year in gift cards for completing approved wellness exams and/or screenings

Contact Information

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