BCBSIL Blue Medicare Advantage

The Blue Medicare Advantage HMO is new for 2013

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.

  • Be sure you are eligible for Medicare. Your primary residence must be in Cook, DuPage, Kane or Will counties to enroll in Blue Medicare Advantage.
  • If you’re eligible for Medicare and planning to retire, speak with your benefits administrator at work about your benefit options.
  • Take the time to learn how Medicare Advantage works
  • Review the 2013 Blue Medicare Advantage plan benefits and built-in drug coverage below.
  • If you’d like to enroll in a Medicare Advantage plan, make sure you’re aware of enrollment periods. Members may enroll in the plan only during specific times of the year.
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    2013 Blue Medicare Advantage plan benefits:

     

    Benefit In-Network
    Monthly premium $0.00
    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
    Emergency care $65.00

    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.

     

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