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Blue Medicare Advantage Flex (no Part D) (PPO)
Medicare Plan Details (2022 Plan)
Monthly Premium

by Blue Medicare Advantage
Additional Coverage
HearingVisionDental
Overall Government Star Rating
4.0out 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
Plan Details
$0
$0
$0
$0
$4,000 In and Out-of-network
$4,000 In-network
$4,000 In-network
No
Yes
Yes
Yes
Medical Benefits
Doctor Services
In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
In-network: $20 copay per visit
Out-of-network: $20 copay per visit
Out-of-network: $20 copay per visit
Tests, labs, & imaging
In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
In-network: $185-285 copay
Out-of-network: $185-285 copay
Out-of-network: $185-285 copay
In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
$90 copay per visit (always covered)
$50 copay per visit (always covered)
Hospital Services
In-network: $285 per day for days 1 through 6
$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
$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
In-network: $285 copay or 20% coinsurance per visit
Out-of-network: $285 copay or 20% coinsurance per visit
Out-of-network: $285 copay or 20% coinsurance per visit
Skilled nursing facility
In-network: $0 per day for days 1 through 20
$184 per day for days 21 through 100
Out-of-network: $0 per day for days 1 through 20
$184 per day for days 21 through 100
$184 per day for days 21 through 100
Out-of-network: $0 per day for days 1 through 20
$184 per day for days 21 through 100
Preventive services
In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Ambulance
In-network: $285 copay
Out-of-network: $285 copay
Out-of-network: $285 copay
Therapy services
In-network: $20 copay
Out-of-network: $20 copay
Out-of-network: $20 copay
In-network: $20 copay
Out-of-network: $20 copay
Out-of-network: $20 copay
Mental health services
In-network: $20 copay
Out-of-network: $20 copay
Out-of-network: $20 copay
In-network: $20 copay
Out-of-network: $20 copay
Out-of-network: $20 copay
In-network: $20 copay
Out-of-network: $20 copay
Out-of-network: $20 copay
In-network: $20 copay
Out-of-network: $20 copay
Out-of-network: $20 copay
Opioid treatment services
Covered
Other services
In-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item
In-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item
In-network: 0-20% coinsurance per item
Out-of-network: 0-20% 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
In-network: 20% coinsurance
Out-of-network: 0-20% coinsurance
Out-of-network: 0-20% coinsurance
In-network: 0-20% coinsurance
Out-of-network: 0-20% coinsurance
Out-of-network: 0-20% coinsurance
Extra Benefits
Hearing
In-network: $20 copay
Out-of-network: $20 copay
Out-of-network: $20 copay
In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Preventive Dental
Covered under office visit
Covered under office visit
Covered under office visit
Covered under office visit
Comprehensive dental
In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Vision
In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Not covered
Not covered
Not covered
Other benefits
Limited coverage
Limited coverage
Not covered
Not covered
Not covered
Limited coverage
Limited coverage
Health Plan Star Ratings
(government star ratings are out of 5 stars)
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