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  1. RI
  2. Blue Cross Blue Shield of Rhode Island
  3. Plan

BlueCHiP for Medicare Core (HMO)

Medicare Plan Details (2023 Plan)

Monthly Premium

 

by Blue Cross Blue Shield of Rhode Island
Additional Coverage
HearingVisionDental
Overall Government Star Rating
 5.0
out of 5 stars

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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
$3,500 In-network
No
Yes
Yes
Yes
https://www.bcbsri.com/finddoctor
http://www.BCBSRI.com/Medicare

Medical Benefits

Doctor Services

$0-5 copay per visit
$25 copay per visit

Tests, labs, & imaging

$0 copay
$0 copay
$130 copay
$0 copay
$90 copay per visit (always covered)
$50 copay per visit (always covered)

Hospital Services

$180 per day for days 1 through 5
$0 per day for days 6 through 90
$150 copay per visit

Skilled nursing facility

$0 per day for days 1 through 20
$130 per day for days 21 through 45
$0 per day for days 46 through 100

Preventive services

$0 copay

Ambulance

$150 copay

Therapy services

$15 copay
$15 copay

Mental health services

$25 copay
$25 copay
$25 copay
$25 copay

Opioid treatment services

Covered

Other services

20% coinsurance per item
20% coinsurance per item
$0 copay per item

Prescription Drug Benefits

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

Part B Drugs

20% coinsurance
20% coinsurance

Extra Benefits

Hearing

$25 copay
$0 copay
$200-1,675 copay

Preventive Dental

$0 copay
$0 copay
$0 copay
$0 copay

Comprehensive dental

50% coinsurance
Not covered
50% coinsurance
Not covered
Not covered
50% coinsurance
50% coinsurance

Vision

$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
Not covered

Other benefits

Limited coverage
Limited coverage
Limited coverage
Not covered
Limited coverage
Limited coverage
Limited coverage

Health Plan Star Ratings

(government star ratings are out of 5 stars)
 4.5
 5
 4
 4
 5
 5

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.

 

 

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