Blue Medicare Advantage Valor PPO (PPO) H5900-006 is a 2023 Medicare Advantage Plan or Part-C by Wellmark Advantage Health Plan available to residents in Iowa. This plan does not provide additional prescription drug (Part-D) coverage. Wellmark Advantage Health Plan Blue Medicare Advantage Valor PPO (PPO) has a monthly premium of $0 and has an in-network maximum out-of-pocket limit of $4,500 (MOOP). This means that if you get sick or need a high-cost procedure the co-pays are capped once you pay
$4,500 out-of-pocket. This can be an extremely nice safety net.
Wellmark Advantage Health Plan works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Blue Medicare Advantage Valor PPO (PPO) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance)
and Part B (Medical Insurance) coverage from Wellmark Advantage Health Plan and not Original Medicare. With 2023 Medicare Advantage Plan you are always covered for urgently needed and emergency care. Plus, you receive all
the benefits of Original Medicare from Wellmark Advantage Health Plan except hospice care. Original Medicare still provides you with hospice care if you sign up for
Medicare Advantage in Iowa.
What type of plan is Blue Medicare Advantage Valor PPO (PPO)
Blue Medicare Advantage Valor PPO (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.
How much does Blue Medicare Advantage Valor PPO (PPO) cost?
Part-C Premium
A monthly premium is the fee you pay to the plan in exchange for coverage. Wellmark Advantage Health Plan charges a $0 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.
MOOP
The maximum out-of-pocket (MOOP) is a yearly limit on your out-of-pocket costs. Blue Medicare Advantage Valor PPO (PPO) by Wellmark Advantage Health Plan MOOP is $4,500. Once you spend $4,500 you will pay nothing for Part A or Part B covered services. Copayments and coinsurance for Medicare approved services apply toward your out-of-pocket limit. Remember Original Medicare (Parts A and B) doesn’t have a MOOP.
2023 Summary of Benefits
The benefit information provided is a summary of what Blue Medicare Advantage Valor PPO (PPO) covers and what you pay (such as copayments and coinsurance amounts) for certain common medical events. The Summary of Benefits from Wellmark Advantage Health Plan helps
get an idea of how much financial protection the plan is generally expected to provide for common health conditions. This section also contains information on coverage for in-network and out-of-network providers.
(Click county or state to compare all available Advantage plans)
The availability of Medicare Advantage Plans will vary according to your region. This is why the Coverage Area matters in terms of Medicare eligibility. You will always be eligible for Original Medicare, but eligibility for Blue Medicare Advantage Valor PPO (PPO) requires you to live in that plan’s service area. The service area is listed below:
How much does Blue Medicare Advantage Valor PPO (PPO) cost?
Wellmark Advantage Health Plan charges a $0 monthly premium. A monthly premium is the fee you pay to the plan in exchange for coverage. The premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.
How much is Blue Medicare Advantage Valor PPO (PPO) MOOP?
The maximum out-of-pocket (MOOP) is a yearly limit on your out-of-pocket costs. Blue Medicare Advantage Valor PPO (PPO) by Wellmark Advantage Health Plan MOOP is $4,500. Once you spend $4,500 you will pay nothing for Part A or Part B covered services.
What type of plan is Blue Medicare Advantage Valor PPO (PPO)?
Blue Medicare Advantage Valor PPO (PPO) is a Local PPO *. A (PPO) is a Medicare plan that has contracts with a network of preferred providers. You do not need to select a primary care physician and you do not need referrals to see other providers in the network.
Notes: Data are subject to change as contracts are finalized. For 2023, 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 2023 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.
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*Licensed Agent Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options.