Secure Blue Courage (PPO)
Idaho Medicare Advantage Plan (2025 Plan)
Additional Coverage
HearingVisionDental
Overall Government Star Rating
(coming soon)
Plan Name
Secure Blue Courage (PPO)
Plan Type
Medicare Advantage Plan Without Prescription Drugs
Secure Blue Courage (PPO) is a Medicare Advantage Plan Without Prescription Drugs, which is available in Idaho and offered by the health insurance company Blue Cross of Idaho. This plan’s network type is PPO which determines in-network doctors who accept the health plan and whether a referral is needed.
Primary doctor visit
$0 copay
Specialist visit
$40 copay per visit
ER visit
$100 copay per visit (always covered)
Secure Blue Courage (PPO) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $7,000 In and Out-of-network
$5,200 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 Secure Blue Courage (PPO) are defined below.
No
Part D Prescription Drug Coverage
Secure Blue Courage (PPO) is a Medicare Advantage plan which does not include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Secure Blue Courage (PPO) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. Secure Blue Courage (PPO) includes coverage for the following additional benefits:
Other benefits
Over the counter drug benefits
Home and bathroom safety devices
Health Portion of Premium
Health Plan Max Out-of-Pocket
$7,000 In and Out-of-network
$5,200 In-network
Nationwide Coverage included
Hearing Coverage included
Doctor Services
Primary doctor visit
In-network: $0 copay
Out-of-network: $45 copay per visit
Specialist visit
In-network: $40 copay per visit
Out-of-network: $45 copay per visit
Tests, labs, & imaging
Diagnostic tests & procedures
In-network: $30 copay or 10% coinsurance
Out-of-network: 25% coinsurance
Lab services
In-network: $0 copay
Out-of-network: 25% coinsurance
Diagnostic radiology services (like MRI)
In-network: $0-200 copay
Out-of-network: 25% coinsurance
Outpatient x-rays
In-network: $15 copay
Out-of-network: 25% coinsurance
Emergency care
$100 copay per visit (always covered)
Urgent care
$40 copay per visit (always covered)
Hospital Services
Inpatient hospital coverage
In-network: $350 per day for days 1 through 5
$0 per day for days 6 through 90
Out-of-network: $350 per day for days 1 through 10
$0 per day for days 11 through 90
Outpatient hospital coverage
In-network: $0-325 copay per visit
Out-of-network: 20% coinsurance per visit
Skilled nursing facility
Skilled nursing facility
In-network: $0 per day for days 1 through 20
$203 per day for days 21 through 55
$0 per day for days 56 through 100
Out-of-network: $100 per day for days 1 through 12
$203 per day for days 13 through 100
Preventive services
Preventive services
In-network: $0 copay
Out-of-network: $0 copay
Ambulance
Ground ambulance
In-network: $275 copay
Out-of-network: $275 copay
Therapy services
Occupational therapy visit
In-network: $40 copay
Out-of-network: $45 copay
Physical therapy & speech & language therapy visit
In-network: $40 copay
Out-of-network: $45 copay
Mental health services
Outpatient group therapy with a psychiatrist
In-network: $40 copay
Out-of-network: 25% coinsurance
Outpatient individual therapy with a psychiatrist
In-network: $40 copay
Out-of-network: 25% coinsurance
Outpatient group therapy visit
In-network: $0 copay
Out-of-network: 25% coinsurance
Outpatient individual therapy visit
In-network: $0 copay
Out-of-network: 25% coinsurance
Opioid treatment services
Opioid treatment services
Other services
Durable medical equipment (like wheelchairs & oxygen)
In-network: 20% coinsurance per item
Out-of-network: 30% coinsurance per item
Prosthetics (like braces, artificial limbs)
In-network: 20% coinsurance per item
Out-of-network: 30% coinsurance per item
Diabetes supplies
In-network: $0 copay per item
Out-of-network: 30% coinsurance per item
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
Part B Drugs
Chemotherapy drugs
In-network: 0-20% coinsurance
Out-of-network: 0-30% coinsurance
Other Part B drugs
In-network: 0-20% coinsurance
Out-of-network: 0-30% coinsurance
Hearing
Hearing exam
In-network: $40 copay
Out-of-network: $45 copay
Fitting/evaluation
In-network: $0 copay
Out-of-network: $0 copay
Hearing aids - All types
In-network: $499-999 copay
Out-of-network: $499-999 copay
Preventive Dental
Oral exam
In-network: $0 copay
Out-of-network: 50% coinsurance
Cleaning
In-network: $0 copay
Out-of-network: 50% coinsurance
Fluoride treatment
In-network: $0 copay
Out-of-network: 50% coinsurance
Dental x-rays
In-network: $0 copay
Out-of-network: 50% coinsurance
Comprehensive dental
Restorative services
In-network: $0 copay
Out-of-network: 50% coinsurance
Endodontics
In-network: $0 copay
Out-of-network: 50% coinsurance
Periodontics
In-network: $0 copay
Out-of-network: 50% coinsurance
Prosthodontics, removable
In-network: $0 copay
Out-of-network: 50% coinsurance
Prosthodontics, fixed
In-network: $300 copay
Out-of-network: 50% coinsurance
Maxillofacial prosthetics
Implant services
In-network: $300 copay
Out-of-network: 50% coinsurance
Oral and maxillofacial surgery
In-network: $0 copay
Out-of-network: 50% coinsurance
Adjunctive general services
In-network: $0 copay
Out-of-network: 50% coinsurance
Vision
Routine eye exam
In-network: $20 copay
Out-of-network: $20 copay
Contact lenses
In-network: $0-35 copay
Out-of-network: $35 copay
Eyeglasses (frames & lenses)
In-network: $35 copay
Out-of-network: $35 copay
Upgrades
In-network: $0 copay
Out-of-network: $35 copay
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