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In addition to our Medicare HMO Blue (Blue Care®65) plan, we also offer Medicare PPO Blue. Medicare PPO Blue is a preferred provider organization plan, and allows you to use health care services within our network. You can also go to doctors outside of our network, but you may have a higher out of pocket cost if you do.
Medicare PPO Blue is one of our Medicare Advantage plans. This plan provides additional benefits that Medicare doesn't generally cover. These services include preventive dental care, routine physicals, routine hearing exams, eye exams and allowances toward hearing aids and eyewear. There is practically no paperwork and you're covered anytime, anywhere.
Medicare PPO Blue now also offers two options for prescription coverage—basic or enhanced. You can choose to keep one of these options, or you can enroll in Medicare PPO Blue without prescription coverage.
Medicare PPO Blue may be right for you if...
In order to join Medicare PPO Blue, you must have Medicare Part A and Part B, and continue to pay your Medicare Part B premium. A monthly plan premium and copayments apply. Most Medicare beneficiaries are eligible, including those under the age of 65 entitled to Medicare on the basis of a disability.
Medicare PPO Blue has formed a network of doctors, specialists, and hospitals. You can use any doctor who is part of our network. You may choose this doctor to be your Physician of Choice (POC). Your POC can help you coordinate your care. You may also go to doctors outside of our network. The health providers in our network can change at any time. If you're considering enrolling in Medicare PPO Blue and want to learn whether your doctor is part of our network, just call our Physician Selection Service at 1-800-821-1388. You may also visit our main website at www.bluecrossma.com and use our Find A Doctor feature to locate a physician who is part of the network.
You can go to doctors, specialists, or hospitals in- or out-of-network. You may have to pay more for the services you receive outside the network, and you may have to follow special rules prior to getting services in- and/or out-of-network.
Medicare PPO Blue also offers you two options for prescription coverage—basic or enhanced. If you choose to enroll in prescription coverage, it's important that you know Medicare PPO Blue uses a pharmacy formulary. A formulary is a preferred list of medications selected to meet patient needs. Not all medications are included in our formulary. (Our formulary may differ from the Blue Medicare Rx formulary. For more information, please visit the BlueMedicare Rx website.) We may periodically make changes to the formulary. If we remove a medication from the formulary, you will be notified, in writing, before the change is made. To learn more about our formulary, click here.
The service area for this plan includes the following counties: Bristol, Barnstable, Essex, Franklin, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester You must live in one of these places to join the plan.
Medicare Advantage plans like Medicare PPO Blue are contracts between the federal government and managed care organizations and are valid for one year. Therefore, the benefits, premiums, copayments, deductibles and service areas offered by Medicare PPO Blue may change on an annual basis.
Our contract with the federal government may be terminated. In the event of termination we will provide you ample notice and assist you in continuing your Medicare coverage.
You have many options for coverage, and we want to help you choose the best Medicare plan for your unique situation. To learn more about Medicare PPO Blue:
To help you learn more about your health plan coverage options under Medicare, use these helpful tools. To learn more, just click on the links below.
