Blue Medicare HMO Standard Overview
Blue Medicare HMO Standard for Nash County, North Carolina, by Blue Cross and Blue Shield of North Carolina, is a Health Maintenance Organization (HMO) Medicare Advantage plan for seniors on Medicare. It gives you all of the same health insurance benefits as traditional Medicare and offers extras that Medicare does not cover.
The insurance premium is $0.00 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 traditional 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.
Blue Medicare HMO Standard Quality Rating
After its first year on the market, the CMS (Centers for Medicare and Medicaid Services) gives each Medicare Advantage 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, 2013).out of 5 stars. That means Medicare deems this plan
Blue Medicare HMO Standard Out-of-Pocket Expenses
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 $3,400. 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 traditional 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 traditional Medicare benefits, the only way to avoid high medical bills is to purchase Medicare Supplement insurance to supplement your coverage.
Compare Medicare Health Insurance Plans
Make sure you get the best health insurance for your unique situation. Compare Blue Medicare HMO Standard with these Medicare Advantage plans:
- HumanaChoice R5826-063
- HumanaChoice R5826-003
- Blue Medicare PPO Enhanced
- HumanaChoice R5826-079
- Blue Medicare HMO Medical Only
Blue Medicare HMO Standard is available in the following North Carolina cities: Middlesex, Rocky Mount, Bailey, Castalia, Nashville, Red Oak, Sharpsburg, Spring Hope, Whitakers, and all other areas of Nash County.
CMS File Date: January 14, 2014.
This Medicare health insurance catalog is maintained by 9/30/2014.and was last updated on