2022 Blue Medicare Advantage Flex (no Part D) (PPO)


Blue Medicare Advantage Flex (no Part D) (PPO) H6502-003 is a 2022 Medicare Advantage Plan or Part-C by Blue Medicare Advantage available to residents in Missouri and Kansas. This plan does not provide additional prescription drug (Part-D) coverage. The Blue Medicare Advantage Flex (no Part D) (PPO) has a monthly premium of $0 and has an in-network maximum out-of-pocket limit of $4,000 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $4,000 out-of-pocket. This can be a extremely nice safety net.

Blue Medicare Advantage Flex (no Part D) (PPO) is a Local PPO *. A preferred provider organization (PPO) is a Medicare plan that has created contracts with a network of "preferred" providers for you to choose from at reduced rates. You do not need to select a primary care physician and you do not need referrals to see other providers in the network. Offering you a little more flexibility overall. You can get medical attention from a provider outside of the network but you will have to pay the difference between the out-of-network bill and the PPOs discounted rate.

Blue Medicare Advantage works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Blue Medicare Advantage Flex (no Part D) (PPO) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Blue Medicare Advantage and not Original Medicare. With Medicare Advantage you are always covered for urgently needed and emergency care. Plus you receive all the benefits of Original Medicare from Blue Medicare Advantage except hospice care. Original Medicare still provides you with hospice care even if you sign up for Medicare Advantage.




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2022 Blue Medicare Advantage Medicare Advantage Plan Costs

Name:
Blue Medicare Advantage Flex (no Part D) (PPO)
Plan ID:
H6502-003
Provider:Blue Medicare Advantage
Year:2022
Type: Local PPO *
Monthly Premium C+D: $0
Part C Premium:
MOOP: $4,000
Similar Plan: H6502-004
New Plan: 2023 H6502-004




2021 Blue Medicare Advantage Flex (no Part D) (PPO) Summary of Benefits

*This will be updated with 2022 data when available.



Additional Benefits


No



Comprehensive Dental


Diagnostic services 0-50% coinsurance (Out-of-Network)
Diagnostic services 50% coinsurance
Endodontics 50% coinsurance
Endodontics 0-50% coinsurance (Out-of-Network)
Extractions 50% coinsurance
Extractions 0-50% coinsurance (Out-of-Network)
Non-routine services 50% coinsurance
Non-routine services 0-50% coinsurance (Out-of-Network)
Periodontics 0-50% coinsurance (Out-of-Network)
Periodontics 50% coinsurance
Prosthodontics, other oral/maxillofacial surgery, other services Not covered
Restorative services 50% coinsurance
Restorative services 0-50% coinsurance (Out-of-Network)



Deductible


$0



Diagnostic Tests and Procedures


Diagnostic radiology services (e.g., MRI) 20% coinsurance (Out-of-Network)
Diagnostic radiology services (e.g., MRI) $185-285 copay
Diagnostic tests and procedures $0 copay
Diagnostic tests and procedures $0 copay (Out-of-Network)
Lab services $0 copay
Lab services $0 copay (Out-of-Network)
Outpatient x-rays $0 copay (Out-of-Network)
Outpatient x-rays $0 copay



Doctor Visits


Primary $5 copay per visit
Primary $5 copay per visit (Out-of-Network)
Specialist $20 copay per visit
Specialist $20 copay per visit (Out-of-Network)



Emergency care/Urgent Care


Emergency $90 copay per visit (always covered)
Urgent care $50 copay per visit (always covered)



Foot Care (podiatry services)


Foot exams and treatment $20 copay (Out-of-Network)
Foot exams and treatment $20 copay
Routine foot care $20 copay (Out-of-Network)
Routine foot care $20 copay



Ground Ambulance


$285 copay
$285 copay or 20% coinsurance (Out-of-Network)



Hearing


Fitting/evaluation $0 copay
Fitting/evaluation $0 copay (Out-of-Network)
Hearing aids $699-999 copay (Out-of-Network)
Hearing aids $699-999 copay
Hearing exam $20 copay
Hearing exam $20 copay (Out-of-Network)



Inpatient Hospital Coverage


$285 per day for days 1 through 6
$0 per day for days 7 through 90
$285 per day for days 1 through 6
$0 per day for days 7 through 90 (Out-of-Network)



Medical Equipment/Supplies


Diabetes supplies 0-20% coinsurance per item (Out-of-Network)
Diabetes supplies 0-20% coinsurance per item
Durable medical equipment (e.g., wheelchairs, oxygen) 20% coinsurance per item
Durable medical equipment (e.g., wheelchairs, oxygen) 0-20% coinsurance per item (Out-of-Network)
Prosthetics (e.g., braces, artificial limbs) 20% coinsurance per item
Prosthetics (e.g., braces, artificial limbs) 0-20% coinsurance per item (Out-of-Network)



Medicare Part B Drugs


Chemotherapy 20% coinsurance
Chemotherapy $285 copay or 20% coinsurance (Out-of-Network)
Other Part B drugs 0-20% coinsurance
Other Part B drugs $285 copay or 20% coinsurance (Out-of-Network)



Mental Health Services


Inpatient hospital - psychiatric $285 per day for days 1 through 6
$0 per day for days 7 through 90
Inpatient hospital - psychiatric $285 per day for days 1 through 6
$0 per day for days 7 through 90 (Out-of-Network)
Outpatient group therapy visit $20 copay
Outpatient group therapy visit $20 copay (Out-of-Network)
Outpatient group therapy visit with a psychiatrist $20 copay
Outpatient group therapy visit with a psychiatrist $20 copay (Out-of-Network)
Outpatient individual therapy visit $20 copay (Out-of-Network)
Outpatient individual therapy visit $20 copay
Outpatient individual therapy visit with a psychiatrist $20 copay
Outpatient individual therapy visit with a psychiatrist $20 copay (Out-of-Network)



MOOP


$4,000 In and Out-of-network
$4,000 In-network



Option


Yes, contact plan for further details



Optional supplemental benefits


No



Outpatient Hospital Coverage


$285 copay or 20% coinsurance per visit (Out-of-Network)
$285 copay or 20% coinsurance per visit



Preventive Care


$0 copay (Out-of-Network)
$0 copay



Preventive Dental


Cleaning $0 copay
Cleaning 0-50% coinsurance (Out-of-Network)
Dental x-ray(s) 0-50% coinsurance (Out-of-Network)
Dental x-ray(s) $0 copay
Fluoride treatment 0-50% coinsurance (Out-of-Network)
Fluoride treatment $0 copay
Oral exam 0-50% coinsurance (Out-of-Network)
Oral exam $0 copay



Rehabilitation Services


Occupational therapy visit $20 copay (Out-of-Network)
Occupational therapy visit $20 copay
Physical therapy and speech and language therapy visit $20 copay
Physical therapy and speech and language therapy visit $20 copay (Out-of-Network)



Skilled Nursing Facility


$0 per day for days 1 through 20
$184 per day for days 21 through 100 (Out-of-Network)
$0 per day for days 1 through 20
$184 per day for days 21 through 100



Transportation


Not covered



Vision


Contact lenses $0 copay
Contact lenses $0 copay (Out-of-Network)
Eyeglass frames Not covered
Eyeglass lenses Not covered
Eyeglasses (frames and lenses) $0 copay
Eyeglasses (frames and lenses) $0 copay (Out-of-Network)
Other Not covered
Routine eye exam $0 copay
Routine eye exam $0 copay (Out-of-Network)
Upgrades Not covered



Wellness Programs (e.g. fitness nursing hotline)


Covered




CMS Star Ratings for Blue Medicare Advantage Flex (no Part D) (PPO) H6502



2021 Overall Rating
Part C Summary Rating
Part-D Summary Rating
Staying Healthy: Screenings, Tests, Vaccines
Managing Chronic (Long Term) Conditions
Member Experience with Health Plan
Complaints and Changes in Plans Performance
Health Plan Customer Service
Drug Plan Customer Service
Complaints and Changes in the Drug Plan
Member Experience with the Drug Plan
Drug Safety and Accuracy of Drug Pricing


Staying Healthy, Screening, Testing, & Vaccines

Total Preventative Rating
Breast Cancer Screening
Colorectal Cancer Screening
Annual Flu Vaccine
Monitoring Physical Activity


Managing Chronic And Long Term Care for Older Adults

Total Rating
SNP Care Management
Medication Review
Functional Status Assessment
Osteoporosis Management
Diabetes Care - Eye Exam
Diabetes Care - Kidney Disease
Diabetes Care - Blood Sugar
Rheumatoid Arthritis
Reducing Risk of Falling
Improving Bladder Control
Medication Reconciliation
Statin Therapy


Member Experience with Health Plan

Total Experience Rating
Getting Needed Care
Getting Appointments
Customer Service
Health Care Quality
Rating of Health Plan
Care Coordination


Member Complaints and Changes in Blue Medicare Advantage Flex (no Part D) (PPO) Plans Performance

Total Rating
Complaints about Health Plan
Members Leaving the Plan
Health Plan Quality Improvement


Health Plan Customer Service Rating for Blue Medicare Advantage Flex (no Part D) (PPO)

Total Customer Service Rating
Timely Decisions About Appeals
Reviewing Appeals Decisions
Call Center, TTY, Foreign Language


Blue Medicare Advantage Flex (no Part D) (PPO) Drug Plan Customer Service Ratings

Total Rating
Call Center, TTY, Foreign Language


Ratings For Member Complaints and Changes in the Drug Plans Performance

Total Rating
Complaints about the Drug Plan
Members Choosing to Leave the Plan
Drug Plan Quality Improvement


Member Experience with the Drug Plan

Total Rating
Rating of Drug Plan
Getting Needed Prescription Drugs


Drug Safety and Accuracy of Drug Pricing

Total Rating
MPF Price Accuracy
Drug Adherence for Diabetes Medications
Drug Adherence for Hypertension (RAS antagonists)
Drug Adherence for Cholesterol (Statins)
MTM Program Completion Rate for CMR
Statin with Diabetes



Ready to Enroll?

Click Here

Or Call
1-855-778-4180
Mon-Fri 8am-8pm EST
Sat 8am-8pm EST




Coverage Area for Blue Medicare Advantage Flex (no Part D) (PPO)

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Source: CMS.
Data as of September 1, 2021.
Notes: Data are subject to change as contracts are finalized. For 2022, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit. Includes 2022 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.

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Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Enrollment depends on the plan’s contract renewal.

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