Blue Cross Blue Shield Nebraska MA Connect PPO (PPO)
Medicare Plan Details (2023 Plan)
Monthly Premium
by Blue Cross and Blue Shield of Nebraska
Additional Coverage
Overall Government Star Rating
4.0Ready to Enroll Online?
Plan Type
Medicare Advantage (Part C) with Prescription Drug (Part D)
Medicare Advantage combines Part A and Part B. This plan = Part A + Part B + Part D
Plan Details
$5,950 In-network
Medical Benefits
Doctor Services
Out-of-network: $15 copay per visit
Out-of-network: 50% coinsurance per visit
Tests, labs, & imaging
Out-of-network: $20-395 copay
Out-of-network: $20-395 copay
Out-of-network: $20-395 copay
Out-of-network: $20-395 copay
Hospital Services
$0 per day for days 5 through 90
Out-of-network: $420 per day for days 1 through 4
$0 per day for days 5 through 90
Out-of-network: $350-395 copay per visit
Skilled nursing facility
$196 per day for days 21 through 50
$0 per day for days 51 through 100
Out-of-network: $0 per day for days 1 through 20
$196 per day for days 21 through 65
$0 per day for days 66 through 100
Preventive services
Out-of-network: $0 copay
Ambulance
Out-of-network: $350 copay
Therapy services
Out-of-network: $40 copay
Out-of-network: $40 copay
Mental health services
Out-of-network: $40 copay
Out-of-network: $40 copay
Out-of-network: $40 copay
Out-of-network: $40 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
| Tiers | Initial coverage phase | Gap coverage phase | Catastrophic coverage phase |
|---|---|---|---|
| Preferred Generic | $0.00 copay |
Brand-name drugs :
|
Brand-name drugs :
|
| Generic | $14.00 copay | ||
| Preferred Brand | $47.00 copay | ||
| Non-Preferred Drug | $100.00 copay | ||
| Specialty Tier | 30% |
Part B Drugs
Out-of-network: 20% coinsurance
Out-of-network: 20% coinsurance
Extra Benefits
Hearing
Out-of-network: $15 copay or 50% coinsurance
Out-of-network: $0 copay
Out-of-network: $0 copay
Preventive Dental
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
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
Vision
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Other benefits
Health Plan Star Ratings
(government star ratings are out of 5 stars)
Prescription Drug Plan Star Ratings
(government star ratings are out of 5 stars)
When Can I Sign Up for Medicare?
Enter your birthday month and year to learn when you can sign up for different Medicare plan options.
Medicare Health Plans
Get Advice & Sign Up Help
Speak with a Licensed Insurance Agent
No obligation to enroll. Find your plan online or speak with a licensed insurance agent to get help signing up for the right plan for you! Plan availability depends on your location. Licensed agents may not be able to provide assistance for all plans shown on this site.
Best Nebraska Medicare Advantage Health Insurance Companies for 2023
Health Plan RadarIn this article we rank Nebraska 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.
New Nebraska Medicare Advantage Health Insurance Companies for 2023
Health Plan RadarThe Medicare landscape in Nebraska 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 Nebraska.