• Choosing a Medicare Advantage Plan

  • Find a Plan That Best Fits Your Needs

    Medicare Advantage HMO
    (Health Maintenance Organization)
    Medicare Advantage HMO-POS
    (HMO with Point-of-Service)
    If you want a $0 PREMIUM* ...If you want MORE PROVIDER FREEDOM ...
    Except for emergencies, all of your healthcare must be coordinated by your Primary Care Physician (PCP) and you are required to use network providers.
    • $0 premium* plan includes doctor, hospital, prescriptions and more
    • $10 copay for PCP office visits
    • $40 copay for in-network Specialist visits
    • $0 copay for Healthways SilverSneakers® Fitness Program benefit
    • Generic prescriptions as low as $4
    • Enhanced plan options with lower copays available
     
    Your share of costs will be lowest when you use network providers, but you have the freedom to seek care outside the network, too.
    • $34 premium* plan includes doctor and hospital benefits, prescriptions and more
    • $15 copay for PCP office visits
    • $40 copay for in-network Specialist visits; Out-of-network benefits available
    • $0 copay for Healthways SilverSneakers® Fitness Program benefit
    • Generic prescriptions as low as $4
    • Enhanced benefit/lower copay option available
     

    *You must continue to pay your Medicare Part B premium. 

    Compare HMO Plans

    BenefitsMedicare Advantage (HMO)Medicare Advantage Plus (HMO)
    Monthly plan premium*$0 $82
    Annual out-of-pocket maximum$5,900$4,000
    Primary care physician visit$10 copay$10 copay
    Specialist visit$40 copay$35 copay
    Inpatient hospital care$360/day copay for days 1-4;
    $0 copay for days 5+
    $220/day copay for days 1-6;
    $0 copay for days 7+
    Outpatient services20% coinsurance$200 copay/visit
    Emergency room$65 copay (waived if admitted)$65 copay (waived if admitted)
    Ambulance$225 copay/trip$150 copay/trip
    Preventive care$0 copay$0 copay
    Routine chiropractic servicesnot covered$20 copay (up to 12 visits)
    Routine foot care$40 copay (up to 6 visits)$35 copay (up to 6 visits)
    Annual routine vision and hearing examsnot covered$35 copay
    $0 Fitness ProgramHealthways SilverSneakers® Fitness ProgramHealthways SilverSneakers® Fitness Program
    Prescription drugs (30-day supply at preferred pharmacy)
    Deductible$0$0

    Preferred generic

    Non-preferred generic

    Preferred brand

    Non-preferred brand

    Specialty

    $4 copay

    $9 copay

    $45 copay

    $90 copay

    33% coinsurance

    $3 copay

    $8 copay

    $35 copay

    $80 copay

    33% coinsurance

    *You must continue to pay your Medicare Part B premium. 
      enroll now  enroll now 

    Compare HMO-POS Plans

    Benefits Premera Blue Cross Medicare Advantage (HMO-POS) Premera Blue Cross Medicare Advantage Plus (HMO-POS) 
    In-NetworkOut-of-NetworkIn-NetworkOut-of-Network
    Monthly plan premium*$34$122
    Annual out-of-pocket maximum$5,000$2,800
    Primary care provider visit$15 copay$30 copay$10 copay$30 copay
    Specialist visit$40 copay$45 copay$30 copay$40 copay
    Inpatient hospital care$280/day copay for days 1-5;
    $0 copay for days 6+
    $350/day copay for days 1-14;
    $0 copay for days 15+
    $200/day copay for days 1-7;
    $0 copay for days 8+
    $300/day copay for days 1-14;
    $0 copay for days 15+
    Outpatient services20% coinsurance$250 copay/visit20% coinsurance
    Emergency room$65 copay (waived if admitted)$65 copay (waived if admitted)
    Ambulance$150 copay/trip$150 copay/trip
    Preventive care$0 copay20% coinsurance$0 copay20% coinsurance
    Routine chiropractic servicesnot coverednot covered

    $20 copay

    (up to 12 visits)

    $20 copay

    (up to 12 visits)

    Routine foot care

    $40 copay

    (up to 6 visits)

    $45 copay

    (up to 6 visits)

    $20 copay

    (up to 12 visits)

    $40 copay

    (up to 6 visits)

    Annual routine vision and hearing exams$40 copay$45 copay$30 copay$40 copay
    $0 Fitness ProgramHealthways SilverSneakers® Fitness ProgramHealthways SilverSneakers® Fitness Program
    Prescription drugs (30-day supply at preferred pharmacy) 
    Deductible$0$0

    Preferred generic

    Non-preferred generic

    Preferred brand

    Non-preferred brand

    Specialty

    $4 copay

    $9 copay

    $45 copay

    $90 copay

    33% coinsurance

    $3 copay

    $8 copay

    $35 copay

    $80 copay

    33% coinsurance

    These charts show you our HMO-POS plan options and can help you determine which is the best fit for you.

     

    * You must continue to pay your Medicare Part B premium. 

      enroll-now  enroll-now 
  • Contact Us

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    More contact info 

    Customer Service

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    TTY/TDD 711