Platinum Blue Core Plan (Cost) H2461-005 is a 2023 Medicare Advantage Plan or Part-C by Blue Cross and Blue Shield of Minnesota available to residents in Minnesota. This plan does not provide extra prescription drug (Part-D) coverage. Blue Cross and Blue Shield of Minnesota Platinum Blue Core Plan (Cost) has a monthly premium of $29.00 and has an in-network maximum out-of-pocket limit of $6,000 (MOOP). This means that if you get sick or need a high-cost procedure the co-pays are capped once you pay $6,000 out-of-pocket. This can be an extremely nice safety net.

Blue Cross and Blue Shield of Minnesota works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Platinum Blue Core Plan (Cost) you still retain Original Medicare. But you will get extra Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Blue Cross and Blue Shield of Minnesota 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 and Blue Shield of Minnesota except hospice care. Original Medicare still provides you with hospice care if you sign up for Medicare Advantage in Minnesota.

2023 Blue Cross and Blue Shield of Minnesota Medicare Advantage Plan Overview

What type of plan is Platinum Blue Core Plan (Cost)

Platinum Blue Core Plan (Cost) is a Cost * plan. A Cost plan is operated by a Health Maintenance Organization (HMO) in accordance with a cost reimbursement contract. A Medicare Cost Plan is a type of HMO. These plans may work in much the same way, and have some of the same rules, as Medicare Advantage Plans. You may use the cost plans network of providers or receive their health care services through Original Medicare. With a Cost Plan, if you go to a non-network provider, the services are covered under Original Medicare. You would pay the Medicare Part A and Part B coinsurance and deductibles.

How much does Platinum Blue Core Plan (Cost) cost?

Part-C Premium

A monthly premium is the fee you pay to the plan in exchange for coverage. Blue Cross and Blue Shield of Minnesota charges a $29.00 premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.

MOOP

The maximum out-of-pocket (MOOP) is a yearly limit on your out-of-pocket costs. Platinum Blue Core Plan (Cost) by Blue Cross and Blue Shield of Minnesota MOOP is $6,000. Once you spend $6,000 you will pay nothing for Part A or Part B covered services. Copayments and coinsurance for Medicare approved services apply toward your out-of-pocket limit. Remember Original Medicare (Parts A and B) doesn’t have a MOOP.

2023 Summary of Benefits

The benefit information provided is a summary of what Platinum Blue Core Plan (Cost) covers and what you pay (such as copayments and coinsurance amounts) for certain common medical events. The Summary of Benefits from Blue Cross and Blue Shield of Minnesota 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.

Wellness programs (e.g., fitness, nursing hotline)	Covered

---

Contact lenses

Vision	Not covered

---

Eyeglass frames

Vision	Not covered

---

Eyeglass lenses

Vision	Not covered

---

Eyeglasses (frames and lenses)

Vision	Not covered

---

Other

Vision	Not covered

---

Routine eye exam

Vision	Not covered

---

Upgrades

Vision	Not covered

---

Transportation	Not covered
Skilled Nursing Facility	$0 per day for days 1 through 20 $196 per day for days 21 through 100

---

Occupational therapy visit

Rehabilitation services	$40 copay

---

Physical therapy and speech and language therapy visit

Rehabilitation services	$20-40 copay

---

Cleaning

Preventive dental	Not covered

---

Dental x-ray(s)

Preventive dental	Not covered

---

Fluoride treatment

Preventive dental	Not covered

---

Oral exam

Preventive dental	Not covered

---

Preventive care	$0 copay
Outpatient hospital coverage	20% coinsurance per visit
In-Network Other health plan deductibles?	No
Optional supplemental benefits	No

---

Inpatient hospital - psychiatric

Mental health services	$600 per stay

---

Outpatient group therapy visit

Mental health services	$40 copay

---

Outpatient group therapy visit with a psychiatrist

Mental health services	$40 copay

---

Outpatient individual therapy visit

Mental health services	$40 copay

---

Outpatient individual therapy visit with a psychiatrist

Mental health services	$40 copay

---

Diabetes supplies

Medical equipment/supplies	$0 copay per item

---

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

Medical equipment/supplies	20% coinsurance per item

---

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

Medical equipment/supplies	20% coinsurance per item

---

Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)	$6,000 In-network
Inpatient hospital coverage	$600 per stay

---

Fitting/evaluation

Hearing	$0 copay

---

Hearing aids

Hearing	$699-999 copay

---

Hearing exam

Hearing	$0 copay

---

Health plan deductible	$0
Ground ambulance	20% coinsurance

---

Foot exams and treatment

Foot care (podiatry services)	$50 copay

---

Routine foot care

Foot care (podiatry services)	Not covered

---

Emergency

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

---

Urgent care

Emergency care/Urgent care	$65 copay per visit (always covered)

---

Primary

Doctor visits	$20 copay per visit

---

Specialist

Doctor visits	$20 copay or 20% coinsurance per visit

---

Diagnostic radiology services (e.g., MRI)

Diagnostic procedures/lab services/imaging	20% coinsurance

---

Diagnostic tests and procedures

Diagnostic procedures/lab services/imaging	20% coinsurance

---

Lab services

Diagnostic procedures/lab services/imaging	$0 copay

---

Outpatient x-rays

Diagnostic procedures/lab services/imaging	$60 copay

---

Diagnostic services

Comprehensive dental	Not covered

---

Endodontics

Comprehensive dental	Not covered

---

Extractions

Comprehensive dental	Not covered

---

Non-routine services

Comprehensive dental	Not covered

---

Periodontics

Comprehensive dental	Not covered

---

Prosthodontics, other oral/maxillofacial surgery, other services

Comprehensive dental	Not covered

---

Restorative services

Comprehensive dental	Not covered

---

In-Network Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?	No

Platinum Blue Core Plan (Cost) Reviews

Is Platinum Blue Core Plan (Cost) a good plan? Platinum Blue Core Plan (Cost) received a 4.5 overall star rating from the CMS. The CMS uses a Star Rating System to measure how well Medicare Advantage and Part D plans perform. Plans are rated on a one-to-five scale, with one star representing poor performance and five stars representing excellent performance. Medicare Advantage with prescription drug (Part D) coverage (MA-PD) contracts are rated on up to 38 unique quality and performance measures. You can use the CMS star rating to compare Platinum Blue Core Plan Reviews among several different plans.

Staying Healthy, Screening, Testing, & Vaccines

Managing Chronic And Long Term Care for Older Adults

Member Experience with H2461-005 Health Plan

Member Complaints and Changes in Plans Performance

Health Plan Customer Service Rating for Blue Cross and Blue Shield of Minnesota

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

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 Platinum Blue Core Plan (Cost) requires you to live in that plan’s service area. The service area is listed below:

Go to top

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.