Blue Medicare Advantage HMO (HMO)

Iowa Medicare Advantage Plan (2024 Plan)


Monthly Premium

Your Cost
$0
by Wellmark Advantage Health Plan

Additional Coverage

HearingVisionDental

Overall Government Star Rating

No Rating (new plan)

Ready to Enroll Online?


Plan Name
Blue Medicare Advantage HMO (HMO)
Insurance Carrier
Wellmark Advantage Health Plan
Plan Type
Medicare Advantage Plan With Part D Prescription Drug Coverage
Network Type
HMO

Blue Medicare Advantage HMO (HMO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Iowa and offered by the health insurance company Wellmark Advantage Health Plan. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.

Monthly Premium
$0
Annual Deductible
$0
Max Out-of-Pocket
$3,450
Primary doctor visit
$0 copay
Specialist visit
$35 copay per visit
ER visit
$120 copay per visit (always covered)
Ambulance
$300 copay

Blue Medicare Advantage HMO (HMO) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $3,450 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for Blue Medicare Advantage HMO (HMO) are defined below.

Yes
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing

Blue Medicare Advantage HMO (HMO) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Blue Medicare Advantage HMO (HMO) includes coverage for hearing, vision, dental.

Medicare Advantage health plans can offer even more additional benefits. Blue Medicare Advantage HMO (HMO) includes coverage for the following additional benefits:

Other benefits

Fitness benefit
Limited coverage
Over the counter drug benefits
Limited coverage
In-home support services
Not covered
Home and bathroom safety devices
Not covered
Meals for short duration
Limited coverage
Annual physical exams
Limited coverage
Telehealth
Limited coverage

Monthly Premium
$0
Health Portion of Premium
$0
Drug Portion of Premium
$0
Health Plan Deductible
$0
Health Plan Max Out-of-Pocket
$3,450 In-network
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
Yes
Dental Coverage included
Yes

Doctor Services

Primary doctor visit
$0 copay
Specialist visit
$35 copay per visit

Tests, labs, & imaging

Diagnostic tests & procedures
$0-100 copay
Lab services
$5 copay
Diagnostic radiology services (like MRI)
$0-100 copay
Outpatient x-rays
$20 copay
Emergency care
$120 copay per visit (always covered)
Urgent care
$45 copay per visit (always covered)

Hospital Services

Inpatient hospital coverage
$360 per day for days 1 through 5
$0 per day for days 6 through 90
Outpatient hospital coverage
$35-300 copay per visit

Skilled nursing facility

Skilled nursing facility
$0 per day for days 1 through 20
$184 per day for days 21 through 55
$0 per day for days 56 through 100

Preventive services

Preventive services
$0 copay

Ambulance

Ground ambulance
$300 copay

Therapy services

Occupational therapy visit
$35 copay
Physical therapy & speech & language therapy visit
$35 copay

Mental health services

Outpatient group therapy with a psychiatrist
$35 copay
Outpatient individual therapy with a psychiatrist
$35 copay
Outpatient group therapy visit
$35 copay
Outpatient individual therapy visit
$35 copay

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
0-20% coinsurance per item
Prosthetics (like braces, artificial limbs)
20% coinsurance per item
Diabetes supplies
20% coinsurance per item

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

TiersInitial coverage phaseGap coverage phaseCatastrophic coverage phase
Preferred Generic$10.00 copay


Generic drugs :
25%

Brand-name drugs :
25%


Generic drugs :
$0 copay

Brand-name drugs :
$0 copay

Generic$20.00 copay
Preferred Brand$47.00 copay
Non-Preferred Drug$100.00 copay
Specialty Tier33%

Part B Drugs

Chemotherapy drugs
0-20% coinsurance
Other Part B drugs
0-20% coinsurance

Hearing

Hearing exam
$0-35 copay
Fitting/evaluation
$0 copay
Hearing aids - All types
$0 copay

Preventive Dental

Oral exam
$0 copay
Cleaning
$0 copay
Fluoride treatment
$0 copay
Dental x-rays
$0 copay

Comprehensive dental

Non-routine services
Not covered
Diagnostic services
25% coinsurance
Restorative services
25% coinsurance
Endodontics
25% coinsurance
Periodontics
25% coinsurance
Extractions
25% coinsurance
Prosthodontics, other oral/maxillofacial surgery, other services
25% coinsurance

Vision

Routine eye exam
$0 copay
Contact lenses
$0 copay
Eyeglasses (frames & lenses)
$0 copay
Eyeglass frames (only)
$0 copay
Eyeglass lenses (only)
$0 copay
Upgrades
$0 copay

When Can I Sign Up for Medicare?

Enter your birthday month and year to learn when you can sign up for different Medicare plan options.

 

 


Ready to Enroll Online?

Please Support Our Sponsor

Advertisement

Medicare Health Plans

Get Advice & Sign Up Help

TTY 711

Speak with a Licensed Insurance Agent

Mon-Fri: 8am - 11pm ET
Sat-Sun: 8am - 11pm ET

Medicare65quote

  • Medicare Advantage Plans
  • Medicare Prescription Drug Plans
  • Medicare Supplement Insurance Plans

No obligation to enroll. Find your plan online or speak with a licensed insurance agent to get help signing up for the right plan for you! See www.medicare65quote.com for our Third-Party Marketing Organization disclaimer.

Related Articles
Best Iowa Medicare Advantage Health Insurance Companies for 2024

In this article we rank Iowa Medicare Advantage plans based on our evaluation of government 5-star quality scores. Each year the government rates the quality of Medicare Advantage health insurance plans with a 5-star quality score. An overall quality score is assigned to each plan which is based on the scores of various quality metrics.

Read more →