Blue Cross Blue Shield Nebraska MA Connect PPO (PPO)
Nebraska Medicare Advantage Plan (2024 Plan)
Monthly Premium
Additional Coverage
Overall Government Star Rating
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Plan Overview
Blue Cross Blue Shield Nebraska MA Connect PPO (PPO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Nebraska and offered by the health insurance company Blue Cross and Blue Shield of Nebraska. 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 Cross Blue Shield Nebraska MA Connect PPO (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 $8,000 In and Out-of-network $4,500 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 Cross Blue Shield Nebraska MA Connect PPO (PPO) are defined below.
Additional Benefits and Coverage
Blue Cross Blue Shield Nebraska MA Connect PPO (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 Blue Shield Nebraska MA Connect PPO (PPO) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. Blue Cross Blue Shield Nebraska MA Connect PPO (PPO) includes coverage for the following additional benefits:
Other benefits
Comparing the Quality Score of Blue Cross Blue Shield Nebraska MA Connect PPO (PPO) to Other Plans in Nebraska
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 Blue Shield Nebraska MA Connect PPO (PPO) received an overall government quality rating of 4.0 stars out of 5 stars.
Blue Cross Blue Shield Nebraska MA Connect PPO (PPO) performed better than Nebraska’s State average overall quality score of 3.8 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 Cross Blue Shield Nebraska MA Connect PPO (PPO) received 4 stars for its health plan quality score which is better than the Nebraska State average health plan quality score of 3.7 stars.
Blue Cross Blue Shield Nebraska MA Connect PPO (PPO) received 3.5 stars for its drug plan quality score which is worse than the Nebraska State average drug plan quality score of 3.7 stars.
Plan Benefits and Coverage Details
$4,500 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: $30-395 copay
Out-of-network: $20 copay
Out-of-network: $195 copay
Out-of-network: $30 copay
Hospital Services
$0 per day for days 5 through 90
Out-of-network: $375 per day for days 1 through 4
$0 per day for days 5 through 90
Out-of-network: $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 | 33% |
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
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