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Medicare Plus BlueSM PPO

Give your Medicare-eligible employees or retirees the freedom of a PPO plan. This plan offers comprehensive coverage and the flexibility to see a doctor without a referral.

Plan highlights
  • The same medical, emergency and hospital benefits as Original Medicare Part A and B. 
  • This flexible plan replaces Medicare coverage with PPO coverage.
  • Our two plan options give you more choices for your employees.

NETWORK SIZE

Network Size

PREMIUM COST

$$

LEVEL OF CONSUMER ENGAGEMENT

High

INDIVIDUAL DEDUCTIBLE

$0 - $500

How this plan works

What's a PPO plan?

A PPO, or preferred provider organization, offers flexibility. Members don’t need a primary care physician. They can go to any health care professional without a referral.

 

The benefits of Medicare Plus Blue PPO

Medicare Plus Blue PPO is a health plan with a Medicare contract. Members get all medical, emergency and hospital benefits they'd get with Original Medicare Part A and B. Why replace Medicare coverage with our plan? Your employees will receive:

  • Access to a network of more than 52,000 doctors and specialists and 128 hospitals
  • Fitness and preventive benefits to stay healthy and active, so they can enjoy their retirement
  • Telephone and face-to-face support to get the most out of their health care plan

Plan options

Standard Plan A

This is a top-level plan with a $2,000 out-of-pocket maximum.

Monthly premium

Medium

Deductible

$0

Out-of-pocket maximum

$2,000

PCP Copay

$10

Annual deductible

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

Active - In network/ Out of Network

$0 / $100

Passive - In network/ Out of Network

$0 / $0

Coinsurance percentage

Coinsurance percentage

Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.

Active - In network/ Out of Network

0% / 10%

Passive - In network/ Out of Network

0% / 0%

Out-of-pocket maximum

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

Active - In network/ Out of Network

$2,000 / $4,000

Passive - In network/ Out of Network

$2,000 / $2,000

PCP visit copay

PCP office visit copay

This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.

Active - In network/ Out of Network

$10 / 10%

Passive - In network/ Out of Network

$10 / $10

Standard Plan B

This is a top-level plan with a $500 out-of-pocket maximum.

Monthly premium

Medium

Deductible

$500

Out-of-pocket maximum

$3,000

PCP Copay

$15

Annual deductible

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

Active - In network/ Out of Network

$500 / $500

Passive - In network/ Out of Network

$500 / $500

Coinsurance percentage

Coinsurance percentage

Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.

Active - In network/ Out of Network

20% / 30%

Passive - In network/ Out of Network

20% / 20%

Out-of-pocket maximum

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

Active - In network/ Out of Network

$3,000 / $5,000

Passive - In network/ Out of Network

$3,000 / $3,000

PCP visit copay

PCP office visit copay

This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.

Active - In network/ Out of Network

$15 / $30

Passive - In network/ Out of Network

$15/ $15

Frequently asked questions

Our agents can help you set up your plan, enroll your employees and help you determine the easiest way to set up payments. Contact an agent to learn more. 

There are three types of accounts used to pay for medical expenses: a health savings account, or HSA, a health reimbursement arrangement, or HRA, and a flexible spending account, also known as an FSA.

These accounts are part of what's called consumer-directed health care. They offer:

  • Potential tax savings by being tax exempt or tax deductible
  • More control over health care costs
  • Lower health care costs

We can help you decide which is best for your business and employees. Connect with us.

PCP Focus is a custom primary care physician HMO network offered by Blue Care Network. The doctors your employees will choose from this network have shown they can provide quality care and a high level of efficiency that lowers health care costs. We pass those savings on to you: your premiums are up to 8% lower when you choose a plan with the PCP Focus network.

Interested in this plan for your employees?

Let us help you choose the plans that meet your strategic goals.

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