Blue Medicare HMO Standard, a Nash County, North Carolina Medicare Advantage plan from Blue Cross and Blue Shield of North Carolina, is a Health Maintenance Organization (HMO) option for people with Medicare. It gives you all of the same health insurance benefits as original Medicare and offers extras that Medicare does not cover.
The insurance premium is $38.40 per month. You also have co-payments and/or co-insurances with each healthcare service that you use. You can learn more about the basic coverage costs on the co-payments page.
The real benefit of an HMO plan like Blue Medicare HMO Standard is lower, predictable out-of-pocket expenses. Although more restrictive than original Medicare, a Medicare Advantage HMO plan limits your annual out-of-pocket costs. With Medicare Parts A and B, there's no cap, leaving you vulnerable to excessive medical bills.
With an HMO you are required to use healthcare providers in the plan's network. If you don't you will incur additional costs. Also, be aware that your primary care physician must make refer you before you see a specialist.
After its first year on the market, the CMS (Centers for Medicare and Medicaid Services) gives each plan an overall one to five star rating. The unbiased quality assessment assists people when comparing plans. Medicare Advantage plans with five stars have the highest quality, whereas a one star plan has the lowest quality.
The CMS has awarded Blue Medicare HMO Standard Average as compared to all others (as of 15 October, 2014).out of 5 stars. That means Medicare deems this plan
Medicare Advantage plans are limited to a maximum out-of-pocket limit of $6,700 (annually). This out-of-pocket limit does not include your prescriptions or your monthly premiums. It only applies to your costs for healthcare services.
Although the mandatory limit is $6,700, the CMS allows plans to offer a lower limit that can be as low as $3,400. The out-of-pocket limit on this plan is $4,900. Be sure to take into consideration, along with the premium and the co-payments, when making your enrollment decision.
If you are comparing Blue Medicare HMO Standard with your original Medicare benefits, it's important to remember that there are no limits to your out-of-pocket expenses with Medicare Part A or Medicare Part B. If you keep your original Medicare benefits, the only way to avoid high medical bills is to purchase Medicare Supplement insurance to supplement your coverage.
Be a smart shopper. Compare Blue Medicare HMO Standard with these plans:
- HumanaChoice R5826-063
- HumanaChoice R5826-079
- Blue Medicare PPO Enhanced
- Blue Medicare HMO Medical Only
- Blue Medicare PPO Enhanced Freedom
Blue Medicare HMO Standard vs. Medigap Plan K
In addition to the plans above, we recommend evaluating Medicare Supplement Plan K. These plans have a $4,940 out of pocket limit (vs. $4,900 on Blue Medicare HMO Standard). Plus, you have the freedom to choose your doctors and other healthcare providers. Have a look at Medigap Plan K vs. Medicare Advantage before you make any decisions.
Who Can Join?
You can join Blue Medicare HMO Standard if you are entitled to Medicare Part A and enrolled in Medicare Part B and live in the service area. You must continue to pay your Medicare Part B premium. The service area includes: Middlesex, Rocky Mount, Bailey, Castalia, Nashville, Red Oak, Sharpsburg, Spring Hope, Whitakers, and all other areas of Nash County, North Carolina.
CMS File Date: October 15, 2014.
This Medicare Advantage Plan catalog is maintained by 9/14/2015. For more information, download the Summary of Benefits , visit the Blue Cross and Blue Shield of North Carolina website, or call Blue Cross and Blue Shield of North Carolina at N/A.and was last updated on