2022 Platinum Blue Core Plan with Rx (Cost)


Platinum Blue Core Plan with Rx (Cost) H2461-008 is a 2022 Medicare Advantage Plan or Part-C by Blue Cross and Blue Shield of Minnesota available to residents in Minnesota. This plan includes additional prescription drug (Part-D) coverage. The Platinum Blue Core Plan with Rx (Cost) has a monthly premium of $43.20 and has an in-network maximum out-of-pocket limit of $6,000 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $6,000 out-of-pocket. This can be a extremely nice safety net.

Platinum Blue Core Plan with Rx (Cost) is a Cost plan. A Cost plan is operated by a Health Maintenance Organization (HMO) in accordance with a cost reimbursement contract. A Medicare Cost Plan is a type of HMO. These plans may work in much the same way, and have some of the same rules, as Medicare Advantage Plans. You may use the cost plans network of providers or receive their health care services through Original Medicare. With a Cost Plan, if you go to a non-network provider, the services are covered under Original Medicare. You would pay the Medicare Part A and Part B coinsurance and deductibles.

Blue Cross and Blue Shield of Minnesota works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Platinum Blue Core Plan with Rx (Cost) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Blue Cross and Blue Shield of Minnesota 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 Cross and Blue Shield of Minnesota except hospice care. Original Medicare still provides you with hospice care even if you sign up for Medicare Advantage.




Ready to Enroll?

Click Here

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




2022 Blue Cross and Blue Shield of Minnesota Medicare Advantage Plan Costs

Name:
Platinum Blue Core Plan with Rx (Cost)
Plan ID:
H2461-008
Provider:Blue Cross and Blue Shield of Minnesota
Year:2022
Type: Cost
Monthly Premium C+D: $43.20
Part C Premium:
MOOP: $6,000
Part D (Drug) Premium:$18.20
Part D Supplemental Premium$0.00
Total Part D Premium:$18.20
Drug Deductible:$480.00
Tiers with No Deductible:0
Gap Coverage:No
Benchmark:below the regional benchmark
Type of Medicare Health:Actuarially Equivalent Standard
Drug Benefit Type:Basic
Similar Plan: H2461-009
New Plan: 2023 H2461-009




Platinum Blue Core Plan with Rx (Cost) Part-C Premium

Blue Cross and Blue Shield of Minnesota charges a Part-C premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.



H2461-008 Part-D Deductible and Premium

Platinum Blue Core Plan with Rx (Cost) has a monthly drug premium of $18.20 and a $480.00 drug deductible. This Blue Cross and Blue Shield of Minnesota plan offers a $18.20 Part-D Basic Premium that is below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0.00 this Premium covers any enhanced plan benefits offered by Blue Cross and Blue Shield of Minnesota above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $18.20 . The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lowered due to negative basic or supplemental premiums.



Blue Cross and Blue Shield of Minnesota Gap Coverage

In 2022 once you and your plan provider have spent $4430 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will be required to pay 25% for prescription drugs unless your plan offers additional coverage. This Blue Cross and Blue Shield of Minnesota plan does not offer additional coverage through the gap.



Premium Assistance

The Low Income Subsidy (LIS) helps people with Medicare pay for prescription drugs, and lowers the costs of Medicare prescription drug coverage. Depending on your income level you may be eligible for full 75%, 50%, 25% premium assistance. The Platinum Blue Core Plan with Rx (Cost) medicare insurance offers a $0.00 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $4.50 for 75% low income subsidy $9.10 for 50% and $13.60 for 25%.



Full LIS Premium:$0.00
75% LIS Premium:$4.50
50% LIS Premium:$9.10
25% LIS Premium:$13.60


H2461-008 Formulary or Drug Coverage

Platinum Blue Core Plan with Rx (Cost) formulary is divided into Tiers or levels of coverage based on usage and according to the medication costs. Each tier will have a defined copay that you must pay to receive the drug. Drugs in lower tiers will usually cost less than those in higher tiers. By reviewing different Medicare Drug formularies, you can pick a Medicare Advantage plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price. You can see complete 2022 Platinum Blue Core Plan with Rx (Cost) H2461-008 Formulary here.

Drug Tier Copay
Preferred
Pharmacy
Copay
Nonpreferred
Pharmacy
Tier 1 NA $0
Tier 2 NA $15
Tier 3 NA 25%
Tier 4 NA 50%
Tier 5 NA 25%
*Initial Coverage Phase and 30 day supply





2021 Platinum Blue Core Plan with Rx (Cost) Summary of Benefits

*This will be updated with 2022 data when available.



Additional Benefits


No



Comprehensive Dental


Diagnostic services Not covered
Endodontics Not covered
Extractions Not covered
Non-routine services Not covered
Periodontics Not covered
Prosthodontics, other oral/maxillofacial surgery, other services Not covered
Restorative services Not covered



Deductible


$0



Diagnostic Tests and Procedures


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



Doctor Visits


Primary $20 copay or 20% coinsurance per visit
Specialist 20% coinsurance per visit



Emergency care/Urgent Care


Emergency $90 copay per visit (always covered)
Urgent care $25 copay per visit (always covered)



Foot Care (podiatry services)


Foot exams and treatment 20% coinsurance
Routine foot care Not covered



Ground Ambulance


20% coinsurance



Hearing


Fitting/evaluation $20 copay
Hearing aids $699-999 copay
Hearing exam $20 copay



Inpatient Hospital Coverage


$600 per stay



Medical Equipment/Supplies


Diabetes supplies $0 copay
Durable medical equipment (e.g., wheelchairs, oxygen) 20% coinsurance per item
Prosthetics (e.g., braces, artificial limbs) 20% coinsurance per item



Medicare Part B Drugs


Chemotherapy 20% coinsurance
Other Part B drugs 20% coinsurance



Mental Health Services


Inpatient hospital - psychiatric $600 per stay
Outpatient group therapy visit 20% coinsurance
Outpatient group therapy visit with a psychiatrist 20% coinsurance
Outpatient individual therapy visit 20% coinsurance
Outpatient individual therapy visit with a psychiatrist 20% coinsurance



MOOP


$6,000 In-network



Option


No



Optional supplemental benefits


No



Outpatient Hospital Coverage


20% coinsurance per visit



Preventive Care


$0 copay



Preventive Dental


Cleaning Not covered
Dental x-ray(s) Not covered
Fluoride treatment Not covered
Oral exam Not covered



Rehabilitation Services


Occupational therapy visit 20% coinsurance
Physical therapy and speech and language therapy visit 20% coinsurance



Skilled Nursing Facility


$0 per day for days 1 through 20
$184 per day for days 21 through 100



Transportation


Not covered



Vision


Contact lenses Not covered
Eyeglass frames Not covered
Eyeglass lenses Not covered
Eyeglasses (frames and lenses) Not covered
Other Not covered
Routine eye exam Not covered
Upgrades Not covered



Wellness Programs (e.g. fitness nursing hotline)


Covered




CMS Star Ratings for Platinum Blue Core Plan with Rx (Cost) H2461



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 Platinum Blue Core Plan with Rx (Cost) Plans Performance

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


Health Plan Customer Service Rating for Platinum Blue Core Plan with Rx (Cost)

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


Platinum Blue Core Plan with Rx (Cost) 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 Platinum Blue Core Plan with Rx (Cost)

(Click county to compare all available Advantage plans)



Go to top

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.

      Site Search:

MedicareHelp.org is a privately-owned Non-governmental agency. The government website can be found at HealthCare.gov.

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.

Every year, Medicare evaluates plans based on a 5-star rating system.