Blue KC Valor (PPO)
Missouri Medicare Advantage Plan (2024 Plan)
Monthly Premium
Additional Coverage
Overall Government Star Rating
3.5Ready to Enroll Online?
Plan Overview
Blue KC Valor (PPO) is a Medicare Advantage Plan Without Prescription Drugs, which is available in Missouri and offered by the health insurance company Blue Medicare Advantage. This plan’s network type is PPO which determines in-network doctors who accept the health plan and whether a referral is needed.
Cost Summary
Blue KC Valor (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 $4,000 In and Out-of-network $4,000 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 KC Valor (PPO) are defined below.
Additional Benefits and Coverage
Blue KC Valor (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. Blue KC Valor (PPO) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. Blue KC Valor (PPO) includes coverage for the following additional benefits:
Other benefits
Comparing the Quality Score of Blue KC Valor (PPO) to Other Plans in Missouri
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 KC Valor (PPO) received an overall government quality rating of 3.5 stars out of 5 stars.
Blue KC Valor (PPO) performed worse than Missouri’s State average overall quality score of 3.9 stars.
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 KC Valor (PPO) received 3.5 stars for its health plan quality score which is worse than the Missouri State average health plan quality score of 3.8 stars.
Plan Benefits and Coverage Details
$4,000 In-network
Medical Benefits
Doctor Services
Out-of-network: $0 copay
Out-of-network: $20 copay per visit
Tests, labs, & imaging
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $185-285 copay
Out-of-network: $0 copay
Hospital Services
$0 per day for days 7 through 90
Out-of-network: $285 per day for days 1 through 6
$0 per day for days 7 through 90
Out-of-network: $50-285 copay per visit
Skilled nursing facility
$203 per day for days 21 through 100
Out-of-network: $10 per day for days 1 through 20
$203 per day for days 21 through 100
Preventive services
Out-of-network: $0 copay
Ambulance
Out-of-network: $285 copay
Therapy services
Out-of-network: $20 copay
Out-of-network: $20 copay
Mental health services
Out-of-network: $20 copay
Out-of-network: $20 copay
Out-of-network: $20 copay
Out-of-network: $20 copay
Opioid treatment services
Other services
Out-of-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item
Out-of-network: 0-20% coinsurance per item
Prescription Drug Benefits
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
Part B Drugs
Out-of-network: $35 copay or 0-20% coinsurance
Out-of-network: $35 copay or 0-20% coinsurance
Extra Benefits
Hearing
Out-of-network: $20 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Preventive Dental
Comprehensive dental
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Vision
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
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