BlueAdvantage Prime (PPO)
Tennessee Medicare Advantage Plan (2025 Plan)
by BlueCross BlueShield of Tennessee
Additional Coverage
Hearing
Overall Government Star Rating
4.5
out of 5 stars
Plan Name
BlueAdvantage Prime (PPO)
Insurance Carrier
BlueCross BlueShield of Tennessee
Plan Type
Medicare Advantage Plan With Part D Prescription Drug Coverage
BlueAdvantage Prime (PPO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Tennessee and offered by the health insurance company BlueCross BlueShield of Tennessee. This plan’s network type is PPO which determines in-network doctors who accept the health plan and whether a referral is needed.
Primary doctor visit
$0 copay
Specialist visit
$0 copay
BlueAdvantage Prime (PPO) has a monthly premium cost of $206 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $0 In and Out-of-network
$0 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 BlueAdvantage Prime (PPO) are defined below.
Yes
Part D Prescription Drug Coverage
BlueAdvantage Prime (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. BlueAdvantage Prime (PPO) includes coverage for hearing.
Medicare Advantage health plans can offer even more additional benefits. BlueAdvantage Prime (PPO) includes coverage for the following additional benefits:
Other benefits
Over the counter drug benefits
Home and bathroom safety devices
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 2025, BlueAdvantage Prime (PPO) received an overall government quality rating of 4.5 stars out of 5 stars.
BlueAdvantage Prime (PPO) performed better than Tennessee’s State average overall quality score of 4.0 stars.
This Plan’s 5-star Gov’t Quality Score
Tennessee State Average Score
Overall Government 5 Star Quality Rating
4.5
4.0
Summary rating of health plan quality
Staying healthy: screenings, tests, & vaccines
Managing chronic (long term) conditions
Member experience with health plan
Member complaints & changes in the health plan's performance
Health plan customer service
Summary rating of drug plan quality
Drug plan customer service
Member complaints & changes in the drug plan's performance
Member experience with the drug plan
Drug safety & accuracy of drug pricing
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.
BlueAdvantage Prime (PPO) received 5 stars for its health plan quality score which is better than the Tennessee State average health plan quality score of 4.0 stars.
BlueAdvantage Prime (PPO) received 4.5 stars for its drug plan quality score which is better than the Tennessee State average drug plan quality score of 3.9 stars.
Health Portion of Premium
Health Plan Max Out-of-Pocket
$0 In and Out-of-network
$0 In-network
Nationwide Coverage included
Hearing Coverage included
Doctor Services
Primary doctor visit
In-network: $0 copay
Out-of-network: $0 copay
Specialist visit
In-network: $0 copay
Out-of-network: $0 copay
Tests, labs, & imaging
Diagnostic tests & procedures
In-network: $0 copay
Out-of-network: $0 copay
Lab services
In-network: $0 copay
Out-of-network: $0 copay
Diagnostic radiology services (like MRI)
In-network: $0 copay
Out-of-network: $0 copay
Outpatient x-rays
In-network: $0 copay
Out-of-network: $0 copay
Hospital Services
Inpatient hospital coverage
In-network: $0 copay
Out-of-network: $0 copay
Outpatient hospital coverage
In-network: $0 copay
Out-of-network: $0 copay
Skilled nursing facility
Skilled nursing facility
In-network: $0 copay
Out-of-network: $0 copay
Preventive services
Preventive services
In-network: $0 copay
Out-of-network: $0 copay
Ambulance
Ground ambulance
In-network: $0 copay
Out-of-network: $0 copay
Therapy services
Occupational therapy visit
In-network: $0 copay
Out-of-network: $0 copay
Physical therapy & speech & language therapy visit
In-network: $0 copay
Out-of-network: $0 copay
Mental health services
Outpatient group therapy with a psychiatrist
In-network: $0 copay
Out-of-network: $0 copay
Outpatient individual therapy with a psychiatrist
In-network: $0 copay
Out-of-network: $0 copay
Outpatient group therapy visit
In-network: $0 copay
Out-of-network: $0 copay
Outpatient individual therapy visit
In-network: $0 copay
Out-of-network: $0 copay
Opioid treatment services
Opioid treatment services
Other services
Durable medical equipment (like wheelchairs & oxygen)
In-network: $0 copay
Out-of-network: $0 copay
Prosthetics (like braces, artificial limbs)
In-network: $0 copay
Out-of-network: $0 copay
Diabetes supplies
In-network: $0 copay
Out-of-network: $0 copay
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
Tiers | Initial coverage phase | Catastrophic coverage phase |
---|
Preferred Generic | $6.00 copay | $0 copay |
Generic | $15.00 copay | $0 copay |
Preferred Brand | $47.00 copay | $0 copay |
Non-Preferred Drug | 50% coinsurance | $0 copay |
Specialty Tier | 33% coinsurance | $0 copay |
Part B Drugs
Chemotherapy drugs
In-network: $0 copay
Out-of-network: $0 copay
Other Part B drugs
In-network: $0 copay
Out-of-network: $0 copay
Hearing
Hearing exam
In-network: $0 copay
Out-of-network: $0 copay
Fitting/evaluation
In-network: $0 copay
Out-of-network: $0 copay
Hearing aids - All types
In-network: $199-699 copay
Out-of-network: $199-699 copay
Preventive Dental
Comprehensive dental
Prosthodontics, removable
Maxillofacial prosthetics
Oral and maxillofacial surgery
Adjunctive general services
Vision
Eyeglasses (frames & lenses)
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