For details about the plan's coverage of out-of-network care, please refer to the Summary of Benefits or the Evidence of Coverage. BlueMedicare Value (PPO) Note that companies can be upgraded or downgraded based on the performance and quality they demonstrated the previous year, so its important to have the most updated information. Members are generally happy with Florida Blue. Enroll on the phone or online! If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. We do not offer every plan available in your area. Search for your current providers to see if they are in-network for the 24 hours a day/7 days a week or consult, When enrolling in a Medicare Advantage plan, you must continue to pay your. The Centers for Medicare and Medicaid Services (CMS), the agency that runs Medicare, allows you to get Part A and Part B benefits from Medicare Advantage. Medicare Advantage has an annual out-of-pocket maximum whereas Original Medicare does not cap your out-of-pocket costs. If this benefit interests you, verify that your Medicare Advantage plan offers it. The amount you must pay before our plan begins to pay its share of your covered drugs. HMO coverage is offered by Health Options Inc., an HMO subsidiary of Blue Cross and Blue Shield of Florida. You relocated to an area outside your plans service area. Medicare MSA Plans do not cover prescription drugs. Inpatient Hospital Care. 1. If a five-star-rated plan becomes available in your area, you can switch from your current plan during the 5-star Special Enrollment Period. Premium: $0.00 This page features plan details for 2023 BlueMedicare Value (PPO) H5434 039 0 , Most Medicare Advantage plans include extra benefits like vision, hearing, dental, and wellness programs. We do not offer every plan available in your area. We only use data released publicly each year. BlueMedicare Value (PPO) | Medicare Plan Details & Help | FL Additional Sessions of Smoking and Tobacco Cessation Counseling: Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline): Everyone in your household can use the same card, including your pets. Need Help? www.flblue.com (including a wireless phone). You can access it here. Thats why its called a gap. Any information we provide is limited to those plans we do offer in your area. Portugus, Member Login | Florida Blue Florida Blue sells Medigap plans A through N and This website is not connected with the federal government or the federal Medicare program. This is allowed one time between December 8 and November 30. Enrollment Periods for Medicare Advantage/Part D. Part B Premium give-back is not available with all plans. during the calendar year will owe a portion of the account deposit back to the plan. These companies are affiliates of Blue Cross and Blue Shield of Florida, Inc., and Independent Licensees of the Blue Cross and Blue Shield Association. Florida Blue and Florida Combined Life Insurance Company, Inc. do not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of their plans, including enrollment and benefit determinations. Members will present to your office with a Florida Blue BlueMedicare HMO or PPO Medicare Advantage ID card. We are not compensated for Medicare plan enrollments. I consent to the agent using an automated telephone dialing system when calling me back. , money from Medicare into the account. Call (888)902-5707or TTY 800-955-8770, Read more about There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Please contactMedicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. We have noticed that you are using a browser that will prevent you from accessing all of the features on this If you have opted out of participation with Medicare, you are prohibited from providing services to Medicare members. Call Member Services at 1-800-926-6565 (TTY 1-800-955-8770 ) From October 1 - March 31, from 8 a.m. - 8 p.m. local time, 7 days a week, except for Thanksgiving and Christmas. , Health insurance is offered by Blue Cross and Blue Shield of Florida, Inc., D/B/A Florida Blue. Call us today. Premium = broad network + competitive benefits, combine competitive out-of-pocket costs and rich drug formulary with large networks provider and pharmacy, Fixed costs for medical and prescription care with the freedom to use the plan how and when they desire, Able to travel outside of the state for emergency planned and consultative care and still have in-network cost-share, if care is needed, Dont mind paying more for the blue brand, Has more prescription needs and requires a broad drug list, Combine competitive out-of-pocket costs and rich drug formulary with large networks (provider and pharmacy), Health only PPO plan, but does not offer Rx coverage, has alternative Rx coverage through VA, TriCare, Employer, ETC, Can go in- or out-of-network, in and out-of-state, Partial Part B refund and competitive benefits, Flexibility to use alternative Rx coverage, No need to get referrals from your primary care physician to see specialists, Referral network enables plan to keep your out-pocket-costs down, Chronic Condition (C-SNP): for people with certain conditions like end-stage renal disease or chronic heart failure, Institutional (I-SNP): for nursing home residents and recipients of nursing care at home, Dual Eligible (D-SNP): for dual-eligible Medicare beneficiaries, Three-month period before the month of your 65th birthday, Three month period after the month of your 65th birthday. You can change your MA or Part D plan if: You can join, switch or drop an MA or Part D plan if: After assessing the performance and quality of Florida Blue and other Medicare Advantage plans, Medicare awards the best plans with a five-star rating. , If you provide services, you will not be reimbursed by Florida Combined Life. HealthCompare Insurance Services represents Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. TTY 1-800-955-8770. Check your plans Evidence of Coverage for more details about what you pay. Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. If the time you choose is on a holiday, after hours or on weekends, we will call you back the next available business day. 2023Blue Cross and Blue Shield of Florida, Inc. DBA Florida Blue. also provides the following benefits. , Tagalog, Contact the Medicare plan for more information. WebCall now to speak to a Medicare expert: 1-800-966-4092 Good Evening! H5434 039 0 available in Alachua and Citrus counties. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan. You were covered under a group health plan through your employer or a union and no longer have that coverage. Our. 2023 Blue Cross and Blue Shield of Florida, Inc., DBA Florida Blue. All rights reserved. If you are eligible for the Extra Help program for prescription drug coverage, you may be allowed to change your drug coverage one time during each of the first three quarters of the year: During the fourth quarter, you can use the Open Enrollment Period to make changes. You may access the Nondiscrimination and Accessibility notice Thank you for contacting Florida Blue Medicare Plans. Sign into your account for 24/7 access to check your benefits, find a doctor and more! Join, change or leave a Medicare drug plan. Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). This booklet Florida Blue is a PPO, RPPO and Rx (PDP) plan with a Medicare contract. Do I need to do any special training for Medicare Advantage. })(); A non-government resource for the Medicare community. $45 Copayment in-network. If you participate in our BlueDental Choice Copayment network, you are in-network for Medicare Advantage. Advantage Plans Contact the plan provider for additional information. Advantage Plans Kreyol Ayisien, Enrollment is offered through our partners including HealthCompare Insurance Services. Following are the main differences between these coverage options: You are responsible for the Part B premium whether you have Original Medicare, Medicare Advantage, or Medigap. WebH5434-035 Florida Blue | Local PPO Rating Overview Prescription Coverage Plan Benefits Other Plan Options Rating Overview Prescription Coverage Plan Benefits Other Plan Ready to sign up for BlueMedicare Value (PPO) There are three populations that qualify for an SNP: Dual eligible is the term used to describe eligibility for both Medicare and Medicaid. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. per month. From April 1 - September 30, from 8 a.m. - 8 p.m. local time, Florida Blue Medicare Advantage Your Part B premium may differ based on factors including late enrollment, income, and disability status. Florida Blue Medicare Advantage Plans 2023 Use your drug discount card to save on medications for the entire family ‐ including your pets. If not included, inquire about comparable programs. Florida Blue has proudly served Medicare beneficiaries since 1965. area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Health coverage is offered by Blue Cross and Blue Shield of Florida, Inc., DBA Florida Blue. Limitations, copayments, and restrictions may apply. Limitations and exclusions may apply. Our insurance agents stay abreast of these changes and can help you find five-star plans in your county. All rights reserved. The $150.00 annual deductible only applies to drugs on certain tiers. Thank you! Inpatient Hospital Care. website. $225 copay per day for days 1-7 in-network. Medicare uses a five-star rating system for Medicare Advantage, Medicare drug plans, and Medicare Cost plans. Services received at a hospital facility's Emergency department, including both Professional and Facility services. BlueMedicare Value (PPO) here.Language Assistance Available: Espaol, Web4. Availability varies by carrier and location. If youre a Florida Blue Medicare member please call1-800-926-6565. You can find samples of the benefit plans and member ID cards in our Dental Manual. WebFlorida Blue is a Blue Cross Blue Shield company headquartered in Jacksonville Florida servicing the entire state of Florida. WebFind and compare Blue Cross Medicare & Medicare Supplement Plans Within Florida FL. 888-606-1406. Web2023 Medicare Advantage Plan Details ; Medicare Plan Name: BlueMedicare Value (PPO) Location: Manatee, Florida Click to see other locations: Plan ID: H5434 - 024 - 0 Click to The attached documents contain information for you to review today. Espaol, Kreyl Ayisyen, (See "Plan Documents" below.). The 5-star Special Enrollment Period is when you can switch to a 5-star plan if one is available in your area. HMO coverage Medicare evaluates plans based on a 5-Star rating system. If a service isnt covered by a members Medicare Advantage benefit plan, you are required by law to inform members in writing and in advance of treatment, outlining their financial responsibility. WebMedicare Advantage We serve members through many different plans, including Florida Blues Medicare Advantage members. Italiano, Our payment system is currently not available. Any information we provide is limited to those plans we do offer in your area. These ratings can help you compare plans on the basis of quality and performance. Level 1 $35 Copayment in-networkLevel 2 (All Other) $47 Copayment in-network. The Initial Enrollment Period encompasses the: Between October 15 December 7, you can: If you are enrolled in a Florida Blue MA plan, here is what you can do during the annual Medicare Advantage Open Enrollment Period, which is between January 1 and March 31: There are specific scenarios that qualify you to enroll in a Florida Blue Medicare Advantage plan outside the annual enrollment periods. These are the benefits of the regional PPO over some of the cheaper Advantage Calls will be returned during normal business hours. By using this website you are authorizing a licensed insurance agent from Secure Health Options to contact you on the phone number you provided Next year, there will be some changes to the plans costs and benefits. $300 copay per day for days 1-6 in-network, $350 copay per day for days 1-4 in-network, Emergency Services (In and out-of-network). Medicare appoints star ratings annually. We do not feature every plan available in your area. In certain situations, you can. Advantage Plans When you are a Medicare Advantage member, your Medicare Part A, and Medicare Part B benefits will come from your MA plan, administered by a private insurance company. $300 copay per day for The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins. , HMO coverage is offered by Florida Blue Medicare, Inc., DBA Florida Blue Medicare. Ting Vit, Also, with prescription drug plans and additional coverage folded in, a Medicare Advantage plan will offer benefits you cant get with Original Medicare. Deutsch, You will find that availability and cost vary from one county to the next. You can find more information, including ID card examples, in. Florida Blue Medicare is an HMO plan with a Medicare contract. 2023 Florida Blue | BlueMedicare Value (PPO) | US News You pay the greater of $9.85 or 5% for brand name drugs. var cx = 'partner-pub-9185979746634162:fhatcw-ivsf'; To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). (function() { This gives you the opportunity to see more patients All insurance agents and enrollment platforms linked to this site have their own terms and conditions. Providers who do not contract with the plan are not required to see you except in an emergency. , This plan does not charge an annual deductible for all drugs. How much you pay depends on which plan you have, what tier your prescription is in, and where and how you fill your prescription. WebYou can request information on Florida Blue Medicare Advantage plans for 2023 in your own local area. Florida Blue Medicare Advantage Regional PPO All plan-related information on this site is from CMS.gov and Medicare.gov. , For 2021, there are 178 Medicare Advantage Prescription Drug (MAPD) plans across Florida with an average monthly premium of $13.17. If you participate in our BlueDental Choice Copayment (PPO) network, you are considered an in-network provider for Florida Blues Medicare Advantage members. Questions? Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Y0011_FBM1462_M_2023, Need Help? From April 1 - September 30, from 8 a.m. - 8 p.m. local time, we are open Monday to Friday, except for major holidays. Gujarati, gcse.async = true; The Initial Enrollment Period is your earliest opportunity to sign up for Original Medicare. , Florida Blue and Florida Blue Medicare are Independent Licensees of the Blue Cross and Blue Shield Association. BlueMedicare Value (PPO) Call 888-902-5707 or TTY 800-955-8770. (including a wireless phone). 2023 Blue Cross and Blue Shield of Florida, Inc. You are currently using an outdated or unsupported browser. View and download important forms and documents about your BlueMedicare plan from Florida Blue. Home Find a Plan Learn about Medicare Resources & Tools View Cart Is My Doctor In-Network? For more information contact the plan. HealthCompare Insurance Services does not offer every plan available in your area. But we can still help you. BlueMedicare Value (PPO) For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227. In several counties, only one Florida Blue Medicare Advantage plan is available at a cost of $52 per month. Level 2 (All Other) $47 Copayment in-network. We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. During designated enrollment periods, you can switch back to Original Medicare. After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7,400.00, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs. We generally cover drugs filled at an out-of-network pharmacy only if you are not able to use one of our network pharmacies (for example, because you are traveling, need emergency or urgent care, or need a drug that it not available at an accessible network pharmacy). In addition, you are required by law to inform members in writing, and in advance of treatment, that you do not participate and they will be responsible for all charges. WebMedicare Advantage Plan with Part D Prescription Drug Coverage BlueMedicare Value (PPO) H5434-030 1/1/2022 12/31/2022 The plans service area includes: Charlotte, Collier and All parts of Medicare bundled under one plan, often including Part D, Limited financial exposure because of out-of-pocket maximum, Usually includes extra benefits that Original Medicare does not cover, Requires use of network providers to get the maximum benefits, Restrictive networks and required referrals for HMO plans, Puts onus on members to take responsibility for reconciling medical bills, paying copays, and researching options when plan makes annual changes, Expects you to perform a reevaluation of plan every year when changes are announced, unlike. We serve members through many different plans, including Florida Blues Medicare Advantage members. For some people, latitude with network and referral requirements is critical. You did have Medicaid but no longer qualify. Level 1 $35 Copayment in-network. Call 1-877-486-2048.24 hours a day, 7 days week (except some federal holidays.). Summit Group - Blue Cross Medicare Florida FL You will pay no more than 25% of the costs for generics in all other tiers. From October 1 - March 31, from 8 a.m. - 8 p.m. local time, 7 days a week, except Thanksgiving and Christmas. For these tiers, you continue to pay the same cost-sharing amounts as in the Initial Coverage Stage. Enrollment depends on the plans contract renewal. You must continue to pay your Part B premium. Medicare Advantage | Florida Blue Dental Find a Doctor Florida Blue Medicare Advantage Regional PPO. P, Tier 6 (select care) medications are covered in the coverage gap. Please feel free to call us at 800-966-4092 and we can complete the application for you. Benefits may vary by carrier and location. For all brand drugs you pay no more than 25% of the costs. Summary of Beneifts HMO D-SNP Charlotte, Clay, Collier, Duval, Hernando, Lee, Manatee, Marion, Pasco, Pinellas and Sarasota, Summary of Benefits HMO D-SNP Brevard, Lake, Orange, Osceola, Seminole, Sumter, Hillsborogh and Polk, Summary of Benefits HMO D-SNP Broward, Miami-Dade, Palm Beach and St Lucie, Blue Medicare Supplement Insurance Policies -, 2023 Florida BlueMedicare Choice (Regional PPO) Summary of Benefits: (Statewide), Summary of Benefits HMO Brevard and St Lucie Premier 2023, Summary of Benefits HMO Broward Premier & Classic 2023, Summary of Benefits HMO Charlotte, Collier, Hernando, Lee, Manatee, Pasco, Pinellas and Sarasota Premier 2023, Summary of Benefits HMO Citrus Classic + & Classic 2023, Summary of Benefits HMO Clay and Duval Premier & Classic 2023, Summary of Benefits HMO Hernando, Hillsborough, Pasco Summary of Benefits Premier & Classic 2023, Summary of Benefits HMO Lake, Marion and Sumter Premier 2023, Summary of Benefits HMO Miami-Dade Premier & Classic 2023, Summary of Benefits HMO Orange, Osceola and Seminole Premier & Classic 2023, Summary of Benefits HMO Palm Beach Premier & Classic 2023, Summary of Benefits HMO Saver Broward, Miami-Dade and Palm Beach 2023, Summary of Benefits HMO Saver Hillsborough, Orange, Osceola, Pinellas and Polk 2023, Summary of Benefits PPO Value Bay, Escambia, Leon, Okaloosa, Santa Rosa and Walton & Patroit Bay, Escambia, Okaloosa, Santa Rose and Walton 2023, Summary of Benefits PPO Value Brevard, Orange, Osceola and Seminole; Patriot Brevard and Orange 2023, Summary of Benefits PPO Value Broward, Indian River, Martin, Miami-Dade, Palm Beach & St. Lucie 2022, Summary of Benefits PPO Value Charlotte, Collier and Lee, Manatee and Sarasota 2023, Summary of Benefits PPO Value Clay, Duval, Flagler, Nassau, St. Johns and Volusia & Patriot Clay, Duval, Nassau & St. Johns 2022, Summary of Benefits PPO Value Hernando and Pasco 2023, Summary of Benefits PPO Value Highlands, Manatee, and Sarasota; Patriot Hillsborough, Pasco and Pinellas 2023, Summary of Benefits RX Premier & Complete 2023, Summary of Benefits PPO Value Pinellas 2023, Summary of Benefits PPO Value Hernando Pasco and Pinellas 2023. 2021 BlueMedicare Comprehensive Formulary While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. Please check the plans formulary for specific drugs covered. If you need help understanding your options, enrolling, or managing your plan, a Florida Blue agent is here for you. Every year, Medicare evaluates plans based on a 5-star rating system. To verify benefits, please refer to MyPatientsBenefits or contact Customer Service at 866-445-5148. We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. *Required fields. The Primary Care Doctor you choose will focus on your needs and coordinate your care with other network providers. Franais, Chapter 5 of the Evidence of Coverage provides a full list of situations in which we may cover drugs from an out-of-network pharmacy. We do not sell leads or share your personal information. Certain specialists do not require a Primary Care Doctor referral. You pay no more than $0 for Tier 6 medications at a network retail pharmacy. is a Medicare Advantage (Part C) Plan by Florida Blue. The benefit information provided is a brief summary, not a complete description of benefits. Medicare has neither approved nor endorsed any information on this site. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Florida Blue Medicare Advantage ? Please contact the plan for further details. You may also qualify for Extra Help on drug costs. Language assistance available: Espaol, Kreyol Ayisien, Ting Vit, Portugus, , franais, Tagalog, , , italiano, Deutsche , , Polskie, Gujarati, , , . Please ensure that all required fields are filled out before you submit. Members may enroll in a Medicare Advantage plan only during specific times of the year. DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN Formulary ID 00021184, Version 21 This formulary was updated on 11/19/2021. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. The plan deposits is offered in the following locations. Call for details (888) 414-4547. After your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00, you will pay no more than the amounts below for any drug tier until you reach $7,400.00. Able to travel outside of the state for emergency planned and consultative care and still have in-network cost-share, if care is needed. Once you reach the Catastrophic Stage, you pay a small copay and the plan will pay most of the cost of your drugs for the rest of the year. Switch to another Medicare Advantage plan in Florida. Value You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. s.parentNode.insertBefore(gcse, s); In the coverage gap, you may pay more for your drugs than you did in the initial coverage stage. We comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability or gender.
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florida blue medicare advantage value plan
