2023 Blue Medicare Advantage (Medicare-Medicaid Plan)

Blue Medicare Advantage (Medicare-Medicaid Plan) H0927-001 is a 2023 Medicare Advantage Plan or Part-C by Blue Cross Community MMAI available to residents in Illinois. This plan includes extra prescription drug (Part-D) coverage. Blue Cross Community MMAI Blue Medicare Advantage (Medicare-Medicaid Plan) has a monthly premium of $0 and has an in-network maximum out-of-pocket limit of $- (MOOP). This means that if you get sick or need a high-cost procedure the co-pays are capped once you pay $- out-of-pocket. This can be an extremely nice safety net.

Blue Cross Community MMAI works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Blue Medicare Advantage (Medicare-Medicaid Plan) you still retain Original Medicare. But you will get extra Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Blue Cross Community MMAI and not Original Medicare. With 2023 Medicare Advantage Plan you are always covered for urgently needed and emergency care. Plus, you receive all the benefits of Original Medicare from Blue Cross Community MMAI except hospice care. Original Medicare still provides you with hospice care if you sign up for Medicare Advantage in Illinois.

2023 Blue Cross Community MMAI Medicare Advantage Plan Overview

What type of plan is Blue Medicare Advantage (Medicare-Medicaid Plan)

How much does Blue Medicare Advantage (Medicare-Medicaid Plan) cost?

Monthly Premium

A monthly premium is the fee you pay to the plan in exchange for coverage. Blue Cross Community MMAI charges a $0 consolidated premium. The Part C premium is this charge covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.

Part-D Deductible and Premium

An annual deductible is the amount you pay out-of-pocket for your prescription drugs before your plan begins to pay. Blue Medicare Advantage (Medicare-Medicaid Plan) has a monthly drug premium of $0 and a $0 drug deductible. This Blue Cross Community MMAI plan offers a $0 Part-D Basic Premium that is Not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0. This Premium covers any enhanced plan benefits offered by Blue Cross Community MMAI above and beyond the standard PDP benefits. This can include extra coverage in the gap, lower co-payments, and coverage of non-Part D drugs. The Part D Total Premium is $0. The Part D Total Premium is the addition of supplemental and basic premiums for some plans this amount can be lowered due to negative basic or supplemental premiums.

Blue Cross Community MMAI Gap Coverage

In 2023 once you and your plan provider have spent $4660 on covered drugs. (Combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will be required to pay 25% for prescription drugs unless your plan offers extra coverage. This Blue Cross Community MMAI plan does offer extra coverage through the gap.

Formulary and Drug Coverage

Blue Medicare Advantage (Medicare-Medicaid Plan) formulary is divided into tiers or levels of coverage based on usage and according to the medication costs. Each tier will have a defined copay that you must pay to receive the drug. Drugs in lower tiers will usually cost less than those in higher tiers. By reviewing different Medicare Drug formularies, you can pick a Medicare Advantage plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price.

2023 Summary of Benefits

The benefit information provided is a summary of what Blue Medicare Advantage (Medicare-Medicaid Plan) covers and what you pay (such as copayments and coinsurance amounts) for certain common medical events. The Summary of Benefits from Blue Cross Community MMAI helps get an idea of how much financial protection the plan is generally expected to provide for common health conditions. This section also contains information on coverage for in-network and out-of-network providers.

Contact lenses

Eyeglass frames

Eyeglass lenses

Eyeglasses (frames and lenses)

Other

Routine eye exam

Upgrades

Occupational therapy visit

Physical therapy and speech and language therapy visit

Cleaning

Dental x-ray(s)

Fluoride treatment

Oral exam

Inpatient hospital - psychiatric

Outpatient group therapy visit

Outpatient group therapy visit with a psychiatrist

Outpatient individual therapy visit

Outpatient individual therapy visit with a psychiatrist

Chemotherapy

Other Part B drugs

Diabetes supplies

Durable medical equipment (e.g., wheelchairs, oxygen)

Prosthetics (e.g., braces, artificial limbs)

Fitting/evaluation

Hearing aids

Hearing exam

Foot exams and treatment

Routine foot care

Emergency

Urgent care

Primary

Specialist

Diagnostic radiology services (e.g., MRI)

Diagnostic tests and procedures

Lab services

Outpatient x-rays

Diagnostic services

Endodontics

Extractions

Non-routine services

Periodontics

Prosthodontics, other oral/maxillofacial surgery, other services

Restorative services

Coverage Area

(Click county or state to compare all available Advantage plans)

The availability of Medicare Advantage Plans will vary according to your region. This is why the Coverage Area matters in terms of Medicare eligibility. You will always be eligible for Original Medicare, but eligibility for Blue Medicare Advantage (Medicare-Medicaid Plan) requires you to live in that plan’s service area. The service area is listed below:

Source:CMS. Data as of Oct 1, 2022.

Last updated on December 03, 2022

Notes: Data are subject to change as contracts are finalized. For 2023, enhanced alternative may offer extra cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit. Includes 2023 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.