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Health Plans

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

an image

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

Individual annual deductible

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

 $0 / $100 $0 / $0

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.

 0% / 10% 0% / 0%

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.

 $2,000 / $4,000 $2,000 / $2,000

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.

 $10 / 10% $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

Individual annual deductible

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

 $500 / $500 $500 / $500

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.

 20% / 30% 20% / 20%

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.

 $3,000 / $5,000 $3,000 / $3,000

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.

 $15 / $30 $15/ $15
THE BLUE CROSS DIFFERENCE

See how Smarter, Better, Personalized Health Care tackles your business challenges

Whole Person Health

Health & Well-Being

Encourage a culture of well-being with tools and resources to help your employees improve their whole health.

Blue Cross Rewards

Incentivizing employees with PPO plans to use cost-effective providers by using our Find Care tools.

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Comprehensive Provider and Network Choices

Choices for care

Helping your employees avoid costly ER visits and get the care they need quickly and conveniently.

Value-based care

Elevating the quality of care by rewarding physicians for better patient health outcomes.

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Easy, Useful, Personal Coverage

Blue Cross Coordinated Care Core

A care management program for your employees and their family members who face complex health issues.

Online member account

Your employees will get the tools, information and support they need all under one secure online account.

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Resources

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TOOLKITS

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