Most Mapd Plans Feature $0 Copay On Tier 1

Tier 1: 15%: n/a Browse Formulary: Humana Gold Plus SNP-DE H4007-023 (HMO D-SNP) - H4007-023-0 Benefits & Contact Info Juncos: $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole Discount: Tier 1: 15%: n/a Browse Formulary: Plan Name County Monthly Prem. Plan Premium: $0: $0: $62: Doctors Office Visits: Primary Care Provider: $0 copay: $10 copay: 50% coinsurance: $15 copay: 50% coinsurance: Specialist: $20 copay: $50 copay: $45 copay: Prescription Drug Copay: Tier 1: $0 – $5 copay Full coverage of Tier 1 in gap: Tier 1: $0 – $5 copay Full coverage of Tier 1 in gap: Tier 1: $0 – $5 copay Full coverage of Tier 1 in gap. Use the personalized search feature on the Medicare Plan Finder at. 1-5 and a $0 copay per day for days 6-90 $0 copay per day for days 91 and beyond: Blue Cross Medicare Advantage Select (HMO) SM. $0 copay Drug Tier 2. Routine physical $0 copay; 1 per plan year Chiropractic care $5 copay (Up to 12 visits per plan year) Dental Included. See your Summary of Benefits or Evidence of Coverage for more details Hearing - routine exam $0 copay (1 exam every 12 months) Hearing aids The plan pays up to a $500 allowance for hearing aids every 3 years.

True Or False Most Mapd Plans Feature $0 Copay On Tier 1
Most Mapd Plans Feature $0 Copay On Tier 1 Mortgage
Most Mapd Plans Feature $0 Copay On Tier 1 Property
How Can Medicare Advantage Plans Offer $0 Premiums

Blue Cross Medicare Advantage Value (HMO) ^SM	Blue Cross Medicare Advantage Choice Plus (PPO)^SM		Blue Cross Medicare Advantage Choice Premier (PPO) ^SM
In-Network	Out-of-Network	In-Network	Out-of-Network
Plan Premium	$0	$0		$62
Doctors Office Visits
Primary Care Provider	$0 copay	$10 copay	50% coinsurance	$15 copay	50% coinsurance
Specialist	$20 copay	$50 copay		$45 copay
Prescription Drug Copay	Tier 1: $0 – $5 copay Full coverage of Tier 1 in gap	Tier 1: $0 – $5 copay Full coverage of Tier 1 in gap		Tier 1: $0 – $5 copay Full coverage of Tier 1 in gap
Prescription Drug Deductible	$200 Deductible Tiers 4 & 5	$435 Deductible Tiers 3, 4 & 5		$435 Deductible Tiers 3, 4 & 5
Extra Health & Wellness Benefits
Dental
Preventive	$0 copay per visit; 2 exams, 2 cleanings, 1 X-ray	$0 copay per visit; 2 exams, 2 cleanings, 1 X-ray		$0 copay per visit; 2 exams, 2 cleanings, 1 X-ray
Comprehensive	50% Basic Restorative; 70% Major Restorative $1,000 Annual Maximum	not covered		50% Basic Restorative; 70% Major Restorative $1,000 Annual Maximum
Vision
Eye Exam	$0 copay	$0 copay	$40 allowance	$0 copay	$40 allowance
Eyewear	$150 two-year maximum	not covered	not covered	$100 two-year maximum	$100 two-year maximum
Hearing
Hearing Exam	$10 copay	not covered		$10 copay
Hearing Aids	$1,000 three-year maximum	not covered		$1,000 three-year maximum
Over-the-Counter (OTC) Purchase Allowance	$50 / quarterly	not available		not available
Free SilverSneakers^® Fitness Program	✓	✓		✓
24 / 7 NurseLine	✓	✓		✓
Transportation	$0 copay / up to 12 one-way trips every year to plan-approved locations	not covered		not covered
Rewards & Incentives	✓	✓		✓

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True Or False Most Mapd Plans Feature $0 Copay On Tier 1

See the Plan Comparison Chart for details about each plan.

Blue Cross Medicare Advantage Basic (HMO) ^SM	Blue Cross Medicare Advantage Basic Plus (HMO‑POS)^SM		Blue Cross Medicare Advantage Premier Plus (HMO‑POS)^SM		Blue Cross Medicare Advantage Choice Plus (PPO) ^SM		Blue Cross Medicare Advantage Choice Premier (PPO) ^SM
In-Network	Out-of-Network	In-Network	Out-of-Network	In-Network	Out-of-Network	In-Network	Out-of-Network
Plan Premium	$0	$0		$83		$79		$141.10
Doctors Office Visits
Primary Care Provider	$0 copay	$10 copay	$60 copay	$5 copay	$60 copay	$25 copay	50% coinsurance	$15 copay	50% coinsurance
Specialist	$30 copay	$40 copay	$75 copay	$35 copay	$75 copay	$40 copay	50% coinsurance	$50 copay	50% coinsurance
Prescription Drug Copay	Tier 1: $0 – $5 copay Full coverage of Tier 1 in gap	Tier 1: $0 – $5 copay Full coverage of Tier 1 in gap		Tier 1: $0 – $5 copay Full coverage of Tier 1 in gap		Tier 1: $3 – $8 copay Full coverage of Tier 1 in gap		Tier 1: $0 – $5 copay Full coverage of Tier 1 in gap
Prescription Drug Deductible	$0 Deductible	$0 Deductible		$0 Deductible		$435 Deductible Tiers 4 & 5		$0 Deductible
Extra Health & Wellness Benefits
Optional Supplemental Benefits Premium	not available	$27.10^*		not available		$32.30^*		not available
Dental
Preventive	$0 copay per visit; 2 exams, 2 cleanings, 1 X-ray	^* $0 copay per visit; 2 exams, 2 cleanings, 1 X-ray		$0 copay per visit; 2 exams, 2 cleanings, 1 X-ray	not covered	^*$0 copay per visit; 2 exams, 2 cleanings, 1 X-ray		$0 copay per visit; 2 exams, 2 cleanings, 1 X-ray
Comprehensive	$500 Annual Maximum	^* 50% Basic Restorative; 70% Major Restorative $1,000 Annual Maximum		$500 Annual Maximum		^* 50% Basic Restorative; 70% Major Restorative $1,000 Annual Maximum		not covered
Vision
Eye Exam	$0 copay	$0 copay		$0 copay $25 copay lenses	not covered	$0 copay	$40 allowance	$0 copay	$40 allowance
Eyewear	$150 two-year maximum	^* $150 per year allowance		$100 two-year maximum		^* $150 per year allowance	^* $150 per year allowance
Hearing
Hearing Exam	not covered	^* $5 copay		^* $5 copay	not covered	^* $5 copay		not covered
Hearing Aids		^*$1,000 three-year maximum		^*$1,000 three-year maximum		^*$1,000 three-year maximum
Over-the-Counter (OTC) Purchase Allowance	$75 / quarterly	not available		not available		not available		not available
Free SilverSneakers^® Fitness Program	✓	✓		✓		✓		✓
24/7 NurseLine	✓	✓		✓		✓		✓
Transportation	$0 copay / up to 12 one-way trips every year to plan-approved locations	$0 copay / up to 12 one-way trips every year to plan-approved locations	not covered	$0 copay / up to 12 one-way trips every year to plan-approved locations	not covered	not covered		not covered

^* These benefits only available with Optional Supplemental Benefit package and additional premium.

Get more from your Medicare with the Benefit of Blue^SM. Enroll today.

With multiple options from which to choose, there’s a Blue Cross Medicare Advantage plan for you. Need help deciding? Talk to your licensed, authorized agent or call one of our product specialists.

Web

Our secure online form takes you through enrollment step-by-step. It’s easy.

One-on-One Help

Get personalized enrollment help from a product specialist or your licensed, authorized agent.