BlueMedicare Premier Choice (PPO)
Plan costs
Premium $49.00 monthly
Benefits
Medical coverage | |
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Medical Deductible | $0.00 |
Doctor Office Visits | $0 copay |
Specialist Office Visit | $35 |
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 | $375 copay per day for days 1-5 $0 copay per day for days 6-90 |
Healthy Blue Rewards | As 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 | $3,000 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 $1,500 allowance per hearing aid (one per year) Please see plan documents for more details. |
Comprehensive vision benefits | $0 copay for 1 routine eye exam per year. $250 per year for routine eyewear (contacts, eyeglasses, and upgrades. Please see plan documents for more details. |
Walmart Wellness Benefits Card (Over-the-Counter Items) | $50 per quarter, no rollover |
Meal Benefit | $0 copay for 14 meals (two meals per day for seven days) following discharge from the hospital. |
24/7 Nurse Hotline | Access to the Nurse24 nurse advice line 24 hours a day, seven 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 program | Access 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 | $5,700 |
Medical coverage (Out-of-Network) | |
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Combined In- and Out-of-Network Maximum Out-of-Pocket | $9,550.00 |
Doctor Office Visits | $20 copay |
Specialist Office Visits | 40% coinsurance |
Inpatient Hospital Care | 40% coinsurance |
Pharmacy coverage | |
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Prescription deductible | $0.00 |
Out-of-Pocket | $2,000 |
One-Month Supply (Retail Pharmacy) with Standard Cost Sharing | |
Preferred Generic | $1 copay |
Generic | $10 copay |
Preferred Brand | $47 copay |
Non-Preferred Drug | 50% coinsurance |
Specialty Tier | 33% coinsurance |
Insulin Products | $35 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 | $131 copay |
Non-Preferred Drug | 50% coinsurance |
Specialty Tier | Not covered |
Insulin Products | $70 copay for a two-month supply or $105 for a three-months supply (excluding Tier 5) |
Plan Documents | |
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Summary of Benefits | BlueMedicare Premier Choice (PPO) 2025 Summary of Benefits |
Plan Documents | BlueMedicare Premier Choice (PPO) Plan Documents |
Preferences
Plan: H3554-007
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, 7:00 a.m. to 7:00 p.m.
- Your State Medicaid Office.