True Blue no Rx (HMO)


Medicare Plan Details

2020 Plan
Monthly Premium
(select county for price)

 

by Blue Cross of Idaho
Additional Coverage
Hearing Vision Dental
Overall Government Star Rating
 4.5
out of 5 stars

State: Idaho

Select your county to view the price for this plan

 


Plan Type

Medicare Advantage (Part C)

Medicare Advantage combines Part A and Part B. This plan = Part A + Part B

 

$29
$29
$0
$0
$3,000 In-network
No
Yes
Yes
Yes

Medical Benefits

Doctor Services

$10 per visit
$25 per visit

Tests, labs, & imaging

$0 copay
$0 copay
$175
$0 copay
$90 per visit (always covered)
$25 per visit (always covered)

Hospital Services

$100 per day for days 1 through 5
$0 per day for days 6 through 90
$100 per visit

Skilled nursing facility

$0 per day for days 1 through 20
$150 per day for days 21 through 100

Preventive services

$0 copay

Ambulance

$175

Therapy services

$15
$15

Mental health services

$25
$25
$25
$25

Opioid treatment services

Covered

Other services

10% per item
10% per item
$0 copay

Prescription Drug Benefits

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

Part B Drugs

10%
10%

Extra Benefits

Hearing

$45
Not covered
$699-1,074

Preventive Dental

Covered under office visit
Covered under office visit
Not covered
Covered under office visit

Comprehensive dental

Not covered
Not covered
Not covered
Not covered
Not covered
Not covered
Not covered

Vision

$20
$0-35
$35
Not covered
Not covered
$0 copay

Other benefits

Limited coverage
Limited coverage
Not covered
Not covered
Not covered
Limited coverage
Limited coverage
 4
 3
 4
 4
 5
 4

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