Blue Cross Medicare Advantage Flex (PPO)
Illinois Medicare Advantage Plan (2024 Plan)
by Blue Cross and Blue Shield of Illinois
Additional Coverage
HearingVision
Overall Government Star Rating
3.0
out of 5 stars
Plan Name
Blue Cross Medicare Advantage Flex (PPO)
Insurance Carrier
Blue Cross and Blue Shield of Illinois
Plan Type
Medicare Advantage Plan With Part D Prescription Drug Coverage
Blue Cross Medicare Advantage Flex (PPO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Illinois and offered by the health insurance company Blue Cross and Blue Shield of Illinois. 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
$0 copay
Blue Cross Medicare Advantage Flex (PPO) has a monthly premium cost of $202 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $0 In and Out-of-network
$0 In-network
$0 Out-of-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 Cross Medicare Advantage Flex (PPO) are defined below.
Yes
Part D Prescription Drug Coverage
Blue Cross Medicare Advantage Flex (PPO) 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 Cross Medicare Advantage Flex (PPO) includes coverage for hearing, vision.
Medicare Advantage health plans can offer even more additional benefits. Blue Cross Medicare Advantage Flex (PPO) includes coverage for the following additional benefits:
Other benefits
Over the counter drug benefits
Home and bathroom safety devices
Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2024, Blue Cross Medicare Advantage Flex (PPO) received an overall government quality rating of 3.0 stars out of 5 stars.
Blue Cross Medicare Advantage Flex (PPO) performed worse than Illinois’s State average overall quality score of 3.9 stars.
This Plan’s 5-star Gov’t Quality Score
Illinois State Average Score
Overall Government 5 Star Quality Rating
3.0
3.9
Summary rating of health plan quality
Staying healthy: screenings, tests, & vaccines
Managing chronic (long term) conditions
Member experience with health plan
Member complaints & changes in the health plan's performance
Health plan customer service
Summary rating of drug plan quality
Drug plan customer service
Member complaints & changes in the drug plan's performance
Member experience with the drug plan
Drug safety & accuracy of drug pricing
The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.
Blue Cross Medicare Advantage Flex (PPO) received 3 stars for its health plan quality score which is worse than the Illinois State average health plan quality score of 3.8 stars.
Blue Cross Medicare Advantage Flex (PPO) received 3.5 stars for its drug plan quality score which is worse than the Illinois State average drug plan quality score of 3.8 stars.
Health Portion of Premium
Health Plan Max Out-of-Pocket
$0 In and Out-of-network
$0 In-network
$0 Out-of-network
Nationwide Coverage included
Hearing Coverage included
Doctor Services
Primary doctor visit
In-network: $0 copay
Out-of-network: $0 copay
Specialist visit
In-network: $0 copay
Out-of-network: $0 copay
Tests, labs, & imaging
Diagnostic tests & procedures
In-network: $0 copay
Out-of-network: $0 copay
Lab services
In-network: $0 copay
Out-of-network: $0 copay
Diagnostic radiology services (like MRI)
In-network: $0 copay
Out-of-network: $0 copay
Outpatient x-rays
In-network: $0 copay
Out-of-network: $0 copay
Hospital Services
Inpatient hospital coverage
In-network: $0 copay per stay
Out-of-network: $0 copay per stay
Outpatient hospital coverage
In-network: $0 copay
Out-of-network: $0 copay
Skilled nursing facility
Skilled nursing facility
In-network: $0 copay per stay
Out-of-network: $0 copay per stay
Preventive services
Preventive services
In-network: $0 copay
Out-of-network: $0 copay
Ambulance
Ground ambulance
In-network: $0 copay
Out-of-network: $0 copay
Therapy services
Occupational therapy visit
In-network: $0 copay
Out-of-network: $0 copay
Physical therapy & speech & language therapy visit
In-network: $0 copay
Out-of-network: $0 copay
Mental health services
Outpatient group therapy with a psychiatrist
In-network: $0 copay
Out-of-network: $0 copay
Outpatient individual therapy with a psychiatrist
In-network: $0 copay
Out-of-network: $0 copay
Outpatient group therapy visit
In-network: $0 copay
Out-of-network: $0 copay
Outpatient individual therapy visit
In-network: $0 copay
Out-of-network: $0 copay
Opioid treatment services
Opioid treatment services
Other services
Durable medical equipment (like wheelchairs & oxygen)
In-network: $0 copay
Out-of-network: $0 copay
Prosthetics (like braces, artificial limbs)
In-network: $0 copay
Out-of-network: $0 copay
Diabetes supplies
In-network: $0 copay
Out-of-network: $0 copay
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
Tiers | Initial coverage phase | Gap coverage phase | Catastrophic coverage phase |
---|
Preferred Generic | $15.00 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 Tier | 25% |
Part B Drugs
Chemotherapy drugs
In-network: $0 copay
Out-of-network: $0 copay
Other Part B drugs
In-network: $0 copay
Out-of-network: $0 copay
Hearing
Hearing exam
In-network: $0 copay
Out-of-network: $0 copay
Fitting/evaluation
In-network: $0 copay
Out-of-network: $0 copay
Hearing aids - All types
In-network: $699-999 copay
Out-of-network: $699-999 copay
Preventive Dental
Comprehensive dental
Prosthodontics, other oral/maxillofacial surgery, other services
Vision
Routine eye exam
In-network: $0 copay
Out-of-network: $0 copay
Eyeglasses (frames & lenses)
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