Blue Cross Medicare Advantage Protect (PPO)

Medicare Plan Details (2023 Plan)

Monthly Premium

by Blue Cross and Blue Shield of Illinois

Additional Coverage

HearingVisionDental

Overall Government Star Rating

3.5

out of 5 stars

Ready to Enroll Online?

Plan Type

Medicare Advantage (Part C)

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

Monthly Premium

Health Portion of Premium

Drug Portion of Premium

Health Plan Deductible

Health Plan Max Out-of-Pocket

$8,950 In and Out-of-network
$5,900 In-network
$8,950 Out-of-network

Nationwide Coverage included

Hearing Coverage included

Yes

Vision Coverage included

Yes

Dental Coverage included

Yes

Doctor Lookup Link

http://getblueil.com/mapd/providers

Plan Link

http://getblueil.com/mapd

Doctor Services

Primary doctor visit

In-network: $0 copay
Out-of-network: $30 copay per visit

Specialist visit

In-network: $50 copay per visit
Out-of-network: $75 copay per visit

Tests, labs, & imaging

Diagnostic tests & procedures

In-network: $0-100 copay
Out-of-network: $200 copay

Lab services

In-network: $5 copay
Out-of-network: $200 copay

Diagnostic radiology services (like MRI)

In-network: $0-300 copay
Out-of-network: $400 copay

Outpatient x-rays

In-network: $0-100 copay
Out-of-network: $200 copay

Emergency care

$90 copay per visit (always covered)

Urgent care

$40 copay per visit (always covered)

Hospital Services

Inpatient hospital coverage

In-network: $370 per day for days 1 through 6
$0 per day for days 7 through 90
Out-of-network: $500 per day for days 1 and beyond

Outpatient hospital coverage

In-network: $375 copay per visit
Out-of-network: $400 copay per visit

Skilled nursing facility

In-network: $0 per day for days 1 through 20
$196 per day for days 21 through 59
$0 per day for days 60 through 100
Out-of-network: $250 per day for days 1 and beyond

Preventive services

In-network: $0 copay
Out-of-network: $0 copay

Ambulance

Ground ambulance

In-network: $225 copay
Out-of-network: $225 copay

Therapy services

Occupational therapy visit

In-network: $40 copay
Out-of-network: $75 copay

Physical therapy & speech & language therapy visit

In-network: $40 copay
Out-of-network: $75 copay

Mental health services

Outpatient group therapy with a psychiatrist

In-network: $40 copay
Out-of-network: $50 copay

Outpatient individual therapy with a psychiatrist

In-network: $40 copay
Out-of-network: $50 copay

Outpatient group therapy visit

In-network: $40 copay
Out-of-network: $50 copay

Outpatient individual therapy visit

In-network: $40 copay
Out-of-network: $50 copay

Opioid treatment services

Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)

In-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item

Prosthetics (like braces, artificial limbs)

In-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item

Diabetes supplies

In-network: 0-20% coinsurance per item
Out-of-network: 20% coinsurance per item

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

Part B Drugs

Chemotherapy drugs

In-network: 20% coinsurance
Out-of-network: 50% coinsurance

Other Part B drugs

In-network: 20% coinsurance
Out-of-network: 50% coinsurance

Hearing

Hearing exam

In-network: $40 copay
Out-of-network: $75 copay

Fitting/evaluation

In-network: $0 copay
Out-of-network: 50% coinsurance

Hearing aids - All types

In-network: $0 copay
Out-of-network: $0 copay

Preventive Dental

Oral exam

In-network: $0 copay
Out-of-network: $0 copay

Cleaning

In-network: $0 copay
Out-of-network: $0 copay

Fluoride treatment

Not covered

Dental x-rays

In-network: $0 copay
Out-of-network: $0 copay

Comprehensive dental

Non-routine services

In-network: 0-50% coinsurance
Out-of-network: 0-50% coinsurance

Diagnostic services

Not covered

Restorative services

In-network: 0% coinsurance
Out-of-network: 0-50% coinsurance

Endodontics

Not covered

Periodontics

Not covered

Extractions

In-network: 50% coinsurance
Out-of-network: 0-50% coinsurance

Prosthodontics, other oral/maxillofacial surgery, other services

Not covered

Vision

Routine eye exam

In-network: $0 copay
Out-of-network: $0 copay

Contact lenses

In-network: $0 copay
Out-of-network: $0 copay

Eyeglasses (frames & lenses)

Not covered

Eyeglass frames (only)

In-network: $0 copay
Out-of-network: $0 copay

Eyeglass lenses (only)

In-network: $0 copay
Out-of-network: $0 copay

Upgrades

Not covered

Other benefits

Fitness benefit

Limited coverage

Over the counter drug benefits

Not covered

In-home support services

Not covered

Home and bathroom safety devices

Not covered

Meals for short duration

Not covered

Annual physical exams

Limited coverage

Telehealth

Limited coverage

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

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Health Plan Radar

In this article we rank Illinois 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.

Health Plan Radar

The Medicare landscape in Illinois is constantly changing. In this article we show a summary of new and returning health insurance companies offering Medicare Advantage Plans (Part C) and Medicare Prescription Drug Plans (Part D) in Illinois.

Blue Cross Medicare Advantage Protect (PPO)

Medicare Plan Details (2023 Plan)

Monthly Premium

by Blue Cross and Blue Shield of Illinois

Additional Coverage

Overall Government Star Rating

Ready to Enroll Online?

Plan Type

Medicare Advantage (Part C)

Plan Details

Medical Benefits

Doctor Services

Tests, labs, & imaging

Hospital Services

Skilled nursing facility

Preventive services

Ambulance

Therapy services

Mental health services

Opioid treatment services

Other services

Prescription Drug Benefits

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

Part B Drugs

Extra Benefits

Hearing

Preventive Dental

Comprehensive dental

Vision

Other benefits

Health Plan Star Ratings

(government star ratings are out of 5 stars)

When Can I Sign Up for Medicare?

Ready to Enroll Online?

Medicare Health Plans

Get Advice & Sign Up Help

Best Illinois Medicare Advantage Health Insurance Companies for 2023

New Illinois Medicare Advantage Health Insurance Companies for 2023