2022 Blue Medicare Advantage Flex (no Part D) (PPO)

Blue Medicare Advantage Flex (no Part D) (PPO) H6502-003 is a 2022 Medicare Advantage Plan or Part-C by Blue Medicare Advantage available to residents in Missouri and Kansas. This plan does not provide additional prescription drug (Part-D) coverage. The Blue Medicare Advantage Flex (no Part D) (PPO) has a monthly premium of $0 and has an in-network maximum out-of-pocket limit of $4,000 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $4,000 out-of-pocket. This can be a extremely nice safety net.

Blue Medicare Advantage Flex (no Part D) (PPO) is a Local PPO *. A preferred provider organization (PPO) is a Medicare plan that has created contracts with a network of "preferred" providers for you to choose from at reduced rates. You do not need to select a primary care physician and you do not need referrals to see other providers in the network. Offering you a little more flexibility overall. You can get medical attention from a provider outside of the network but you will have to pay the difference between the out-of-network bill and the PPOs discounted rate.

Blue Medicare Advantage works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Blue Medicare Advantage Flex (no Part D) (PPO) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Blue Medicare Advantage and not Original Medicare. With Medicare Advantage you are always covered for urgently needed and emergency care. Plus you receive all the benefits of Original Medicare from Blue Medicare Advantage except hospice care. Original Medicare still provides you with hospice care even if you sign up for Medicare Advantage.

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2022 Blue Medicare Advantage Medicare Advantage Plan Costs

2021 Blue Medicare Advantage Flex (no Part D) (PPO) Summary of Benefits

*This will be updated with 2022 data when available.

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Additional Benefits

No

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Comprehensive Dental

Diagnostic services	0-50% coinsurance (Out-of-Network)
Diagnostic services	50% coinsurance
Endodontics	50% coinsurance
Endodontics	0-50% coinsurance (Out-of-Network)
Extractions	50% coinsurance
Extractions	0-50% coinsurance (Out-of-Network)
Non-routine services	50% coinsurance
Non-routine services	0-50% coinsurance (Out-of-Network)
Periodontics	0-50% coinsurance (Out-of-Network)
Periodontics	50% coinsurance
Prosthodontics, other oral/maxillofacial surgery, other services	Not covered
Restorative services	50% coinsurance
Restorative services	0-50% coinsurance (Out-of-Network)

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Deductible

$0

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Diagnostic Tests and Procedures

Diagnostic radiology services (e.g., MRI)	20% coinsurance (Out-of-Network)
Diagnostic radiology services (e.g., MRI)	$185-285 copay
Diagnostic tests and procedures	$0 copay
Diagnostic tests and procedures	$0 copay (Out-of-Network)
Lab services	$0 copay
Lab services	$0 copay (Out-of-Network)
Outpatient x-rays	$0 copay (Out-of-Network)
Outpatient x-rays	$0 copay

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Doctor Visits

Primary	$5 copay per visit
Primary	$5 copay per visit (Out-of-Network)
Specialist	$20 copay per visit
Specialist	$20 copay per visit (Out-of-Network)

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Emergency care/Urgent Care

Emergency	$90 copay per visit (always covered)
Urgent care	$50 copay per visit (always covered)

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Foot Care (podiatry services)

Foot exams and treatment	$20 copay (Out-of-Network)
Foot exams and treatment	$20 copay
Routine foot care	$20 copay (Out-of-Network)
Routine foot care	$20 copay

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Ground Ambulance

$285 copay
$285 copay or 20% coinsurance (Out-of-Network)

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Hearing

Fitting/evaluation	$0 copay
Fitting/evaluation	$0 copay (Out-of-Network)
Hearing aids	$699-999 copay (Out-of-Network)
Hearing aids	$699-999 copay
Hearing exam	$20 copay
Hearing exam	$20 copay (Out-of-Network)

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Inpatient Hospital Coverage

$285 per day for days 1 through 6 $0 per day for days 7 through 90
$285 per day for days 1 through 6 $0 per day for days 7 through 90 (Out-of-Network)

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Medical Equipment/Supplies

Diabetes supplies	0-20% coinsurance per item (Out-of-Network)
Diabetes supplies	0-20% coinsurance per item
Durable medical equipment (e.g., wheelchairs, oxygen)	20% coinsurance per item
Durable medical equipment (e.g., wheelchairs, oxygen)	0-20% coinsurance per item (Out-of-Network)
Prosthetics (e.g., braces, artificial limbs)	20% coinsurance per item
Prosthetics (e.g., braces, artificial limbs)	0-20% coinsurance per item (Out-of-Network)

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Medicare Part B Drugs

Chemotherapy	20% coinsurance
Chemotherapy	$285 copay or 20% coinsurance (Out-of-Network)
Other Part B drugs	0-20% coinsurance
Other Part B drugs	$285 copay or 20% coinsurance (Out-of-Network)

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Mental Health Services

Inpatient hospital - psychiatric	$285 per day for days 1 through 6 $0 per day for days 7 through 90
Inpatient hospital - psychiatric	$285 per day for days 1 through 6 $0 per day for days 7 through 90 (Out-of-Network)
Outpatient group therapy visit	$20 copay
Outpatient group therapy visit	$20 copay (Out-of-Network)
Outpatient group therapy visit with a psychiatrist	$20 copay
Outpatient group therapy visit with a psychiatrist	$20 copay (Out-of-Network)
Outpatient individual therapy visit	$20 copay (Out-of-Network)
Outpatient individual therapy visit	$20 copay
Outpatient individual therapy visit with a psychiatrist	$20 copay
Outpatient individual therapy visit with a psychiatrist	$20 copay (Out-of-Network)

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MOOP

$4,000 In and Out-of-network $4,000 In-network

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Option

Yes, contact plan for further details

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Optional supplemental benefits

No

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Outpatient Hospital Coverage

$285 copay or 20% coinsurance per visit (Out-of-Network)
$285 copay or 20% coinsurance per visit

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Preventive Care

$0 copay (Out-of-Network)
$0 copay

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Preventive Dental

Cleaning	$0 copay
Cleaning	0-50% coinsurance (Out-of-Network)
Dental x-ray(s)	0-50% coinsurance (Out-of-Network)
Dental x-ray(s)	$0 copay
Fluoride treatment	0-50% coinsurance (Out-of-Network)
Fluoride treatment	$0 copay
Oral exam	0-50% coinsurance (Out-of-Network)
Oral exam	$0 copay

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Rehabilitation Services

Occupational therapy visit	$20 copay (Out-of-Network)
Occupational therapy visit	$20 copay
Physical therapy and speech and language therapy visit	$20 copay
Physical therapy and speech and language therapy visit	$20 copay (Out-of-Network)

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Skilled Nursing Facility

$0 per day for days 1 through 20 $184 per day for days 21 through 100 (Out-of-Network)
$0 per day for days 1 through 20 $184 per day for days 21 through 100

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Transportation

Not covered

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Vision

Contact lenses	$0 copay
Contact lenses	$0 copay (Out-of-Network)
Eyeglass frames	Not covered
Eyeglass lenses	Not covered
Eyeglasses (frames and lenses)	$0 copay
Eyeglasses (frames and lenses)	$0 copay (Out-of-Network)
Other	Not covered
Routine eye exam	$0 copay
Routine eye exam	$0 copay (Out-of-Network)
Upgrades	Not covered

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Wellness Programs (e.g. fitness nursing hotline)

Covered

CMS Star Ratings for Blue Medicare Advantage Flex (no Part D) (PPO) H6502

Staying Healthy, Screening, Testing, & Vaccines

Managing Chronic And Long Term Care for Older Adults

Member Experience with Health Plan

Member Complaints and Changes in Blue Medicare Advantage Flex (no Part D) (PPO) Plans Performance

Health Plan Customer Service Rating for Blue Medicare Advantage Flex (no Part D) (PPO)

Blue Medicare Advantage Flex (no Part D) (PPO) Drug Plan Customer Service Ratings

Ratings For Member Complaints and Changes in the Drug Plans Performance

Member Experience with the Drug Plan

Drug Safety and Accuracy of Drug Pricing

Ready to Enroll?

Click Here

Or Call
1-855-778-4180
Mon-Fri 8am-8pm EST
Sat 8am-8pm EST

Coverage Area for Blue Medicare Advantage Flex (no Part D) (PPO)

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Source: CMS.
Data as of September 1, 2021.
Notes: Data are subject to change as contracts are finalized. For 2022, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit. Includes 2022 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.