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BlueMedicare Saver Choice (PPO)

Plan costs

Premium $0.00 monthly


Medical Coverage
Medical Deductible$0.00
Doctor Office Visits$0 copay
Specialist Office Visit$30 copay
Telehealth$0 copay for urgently needed services, primary care provider services, specialist services, and outpatient mental health (mental health specialty and psychiatry - individual and group sessions).
Inpatient Hospital Care$325 copay per day for days 1-5
$0 copay per day for days 6-90
BlueMedicare Sapphire$500 pre-loaded Mastercard debit card to help reduce out-of-pocket expenses for covered dental, vision, and hearing services
Healthy Blue RewardsAs an Arkansas Blue Medicare member, you’ll be eligible to earn valuable rewards for getting exams, preventive screenings, tests, and completing other health-related activities.
Comprehensive dental benefits$2,000 per year for comprehensive (and preventive) dental services. Please see plan documents for more details.  
Comprehensive hearing benefits$0 copay for 1 routine hearing exam per year
$699/$999 copay per hearing aid (2 per year)
Please see plan documents for more details.  
Comprehensive vision benefits
$0 copay for 1 routine eye exam per year 
$100 per year for routine eyewear (contacts, eyeglasses, and upgrades) Please see plan documents for more details.
Walmart Wellness Benefits Card (Over-the-Counter Items)$65 per quarter, no rollover
Meal BenefitUp to 14 meals (two meals per day for seven days) per year following discharge from the hospital.
24/7 Nurse HotlineAccess to the Nurse24 nurse advice line 24 hours a day, 7 days a week, 365 days a year. Registered nurses can provide information on home treatment of minor illnesses and injuries, how to prepare for doctor visits, how to understand your prescription drugs, and much more.
SilverSneakers® fitness programAccess to a fitness benefit virtually and at participating SilverSneakers facilities, giving you access to instructor-led group exercise classes, exercise equipment, and options to get active outside of traditional gyms, as well as virtual options.
In-Network Maximum Out-of-Pocket$5,000.00


Medical Coverage (Out-of-Network)
Combined In- and Out-of-Network Maximum Out-of-Pocket$9,550.00
Doctor Office Visits$30 copay
Specialist Office Visit40% coinsurance
Inpatient Hospital Care40% coinsurance
Pharmacy Coverage
Prescription Deductible$250 on Tier 4 and Tier 5
Pharmacy Deductible Drug Tier ExclusionsTier(s) 1, 2, 3, 6
Initial Coverage Limit$5,030.00
One-Month Supply (Retail Pharmacy) with Standard Cost Sharing
Preferred Generic$0 copay
Generic$15 copay
Preferred Brand$47 copay
Non-Preferred Drug$100 copay
Specialty Tier29% coinsurance
Select Care Drugs$0 copay
Insulin Products$20 copay for a one-month supply
100-Day Supply (Mail-Order Pharmacy) with Standard Cost Sharing
Preferred Generic$0 copay
Generic$0 copay
Preferred Brand$141 copay
Non-Preferred Drug$300 copay
Specialty TierNot covered
Select Care Drugs$0 copay
Insulin Products$40 copay for a two-month supply or $60 for a three-month supply (excluding Tier 5)
Plan Documents
Summary of Benefits2024 Summary of Benefits [pdf]
Plan DocumentsPlan Documents



Plan: H3554-002

Limitations, copayments, and restrictions may apply. See above or contact the plan for more details.

*Enrollee must continue to pay the Medicare Part B premium.

You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for extra help, call:

  • 800-MEDICARE (800-633-4227). TTY users should call 877-486-2048. 24 hours a day, 7 days a week.
  • The Social Security Office at 800-772-1213. TTY users should call 1-800-325-0778. Monday through Friday, 7 a.m. to 7 p.m.
  • Your State Medicaid Office.