Update
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

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.

View all programs

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.

View all programs

Easy, Useful, Personal Coverage

Blue Cross Coordinated Care for employees

Learn how this program can improve your employees' health with personalized care.

Online member account

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

View all programs

Interested in this plan for your employees?

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

CONNECT WITH US

Explore health care insights

Read about the latest news and innovations from the experts themselves.

See all insights
A woman holds her baby while looking at her plan
WEBINAR Series

Blue Cross Master Class

Join a live presentation with our health care experts, examining topics you've told us mean the most to your business.

Reserve your seat
A woman looks over her benefits on her smartphone
Resources

Pharmacy benefit manager changes

We're moving to a pharmacy benefits management system to keep costs more stable for our group customers and members.

Read more about the changes
An employer prints out documents for their employees
TOOLKITS

Resources to share with your employees

Browse brochures, videos and posters designed to help your employees get the most out of their Blue Cross coverage.

View toolkits

More plans you may be interested in

BCN Advantage℠ HMO-POS

This plan offers you all the benefits of a Medicare plan with added extras.

Prescription Drug Plan

These prescription drug plans can be customized to save you and your employees money.