BlueMedicare Freedom Giveback (PPO)

Plan costs

Premium $0.00 monthly

Benefits

Medical coverage
Medical Deductible$0.00
Part B Premium Reduction$75
Doctor Office Visits$0 copay
Specialist Office Visit$35 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
$375 copay per day for days 1-5.
$0 copay per day for days 6-90.
BlueMedicare Sapphire$300 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.
in-Home Support Services
$0 copay for 40 hours per year.
For help with activities of daily living (ADLs) (e.g., ambulating, bathing, and dressing) and instrumental activities of daily living (IADLs) (e.g., errands, grocery shopping, and help with medication adherence).
Services are provided in two-hour and four-hour increments depending on the scheduled service.
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.
$1,000 allowance per 3 years for 2 hearing aids (one per ear).
Please see plan documents for more details.
Comprehensive vision benefits
$0 copay for 1 routine eye exam per year.
$150 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 per year (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$4,500

 

Medical coverage (Out-of-Network)
Combined In- and Out-of-Network Maximum Out-of-Pocket$9,550.00
Doctor Office Visits$20 copay
Specialist Office Visits40% coinsurance
Inpatient Hospital Care40% coinsurance

 

Plan Documents
Summary of BenefitsBlueMedicare Freedom Giveback (PPO) 2025 Summary of Benefits
Plan DocumentsBlueMedicare Freedom Giveback (PPO) Plan Documents

 

Preferences

Plan: H3554-011

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.
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