Blue Cross Medicare AdvantageSM

Blue Cross Medicare Advantage
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Blue Cross Medicare Advantage offers all of the coverage of Original Medicare — plus benefits not covered by Medicare or most Medicare Supplement insurance plans, including built-in prescription drug coverage. Think of it as an all-in-one plan.

Whether you're new to Medicare or thinking about switching plans, here are some important things to consider before choosing Blue Cross Medicare Advantage.


  • Be sure you are eligible for Medicare. Your primary residence must be in Bernalillo, Cibola, Guadalupe, Los Alamos, Mora, Rio Arriba, San Miguel, Sandoval, Santa Fe, Socorro, Torrance, and Valencia counties to enroll in Blue Cross Medicare Advantage.
  • If you're eligible for Medicare and planning to retire, speak with your benefits administrator at work about your benefit options.
  • Learn how Medicare Advantage works.
  • Review the 2014 Blue Cross Medicare Advantage plan benefits and built-in drug coverage below.
  • If you'd like to enroll in a Medicare Advantage plan, make sure you're aware of enrollment periods. Members may enroll in the plan only during specific times of the year.

 

2014 Blue Cross Medicare Advantage Plans

Monthly Premium Maximum Out of Pocket Doctors' Office Visits Prescription Deductible Inpatient Hospital Skilled Nursing Facility Supplemental Benefits
HMO - Basic $0 $2,400 $0 Primary Care Physician copay
$20 Specialist copay
$0 $150/day (days 1-5)
$750annual max
$0/day (days 1-20)
$40/day (days 21-100)
Vision
Hearing
SilverSneakers
HMO - Value $0 (Buy-down $10) $2,800 $5 Primary Care Physician copay
$20 Specialist copay
$0 $350/day (days 1-5) $0/day (days 1-20)
$100/day (days 21-100)
Vision
Hearing
SilverSneakers
HMO - Premier $32 $1,500 $0 Primary Care Physician copay
$15 Specialist copay
$0 $100/day (days 1-4)
$400 annual max
$0/day (days 1-20)
$40/day (days 21-100)
Dental
Vision
Hearing
SilverSneakers
HMO
Evidence of Coverage
English - Y0096_BEN_NM_HMOANOCEOC2014a Accepted 09182013
Espanol - Y0096_BEN_NM_HMOANOCEOC2014aSPA Accepted 09182013
HMO POS - Premier Plus $37 $2,350 $5 Primary Care Physician copay
$20 Specialist copay
$0 $200/day (days 1-4) $0/day (days 1-20)
$100/day (days 21-100)

Vision
Hearing
SilverSneakers
HMO POS - Evidence of Coverage English - Y0096_BEN_NM_HMOPOSEOC2014 Accepted 09052013
Espanol - Y0096_BEN_TMP_MAEOCCVR14SPA Approved 08222013
PPO - Choice $27 $4,500 $10 Primary Care Physician copay
$35 Specialist copay
$0 $150/day (days 1-7) $0/day (days 1-14);
$25 (days 15-20);
$100/day (days 21-100)
Dental
Vision
Hearing
SilverSneakers
PPO - Evidence of Coverage English - H8634_BEN_NM_PPOEOC2014 Accepted 09052013
Espanol - H8634_BEN_TMP_MAEOCCVR14SPA Approved 08192013
Summary of Benefits HMO and HMO-POS English - Y0096_BEN_NM_MAPDSB14 Accepted 10012013
HMO and HMO-POS Espanol - Y0096_BEN_TX_MAPDSB14SPA Accepted 10012013
PPO English - H8634_BEN_NM_MAPDSB14 Accepted 10012013
PPO Espanol - H8634_BEN_NM_MAPDSB14SPA Accepted 10012013

You must continue to pay your Medicare Part B premium. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Limitations, copayments, and restrictions may apply. If you would like to submit feedback directly to Medicare, please use the Medicare Complaint Form  or contact the Office of the Medicare Ombudsman .

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