Capital Blue Cross | WellSpan Health AdvantagePlus is a 2022 Medicare Advantage PPO plan from Capital BlueCross that's available to Medicare beneficiaries living in Franklin County, Pennsylvania.
- It is a Preferred Provider Organization (PPO) health plan.
- It has the same major health insurance benefits as Original Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage..
- It offers extra benefits that Medicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care. and Medicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services. do not cover.
- There's a $0 copayment to see your primary care physician (Doctors, hospitals, pharmacies, and other healthcare providers that agree to health plan members' services and supplies at a set price are in-network providers. With some health plans, your care is only covered if you get...).
- The monthly premium is $19.00 (plus your monthly The Medicare Part B premium is the monthly charge paid by beneficiaries for their outpatient medical care, services, and supplies. A beneficiary's premium may be uplifted by an IRMAA surcharge if their income is above...).
- The health plan does not have an annual A deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share..
- The maximum Out-of-Pocket Costs for Medicare are the remaining costs that are not covered by the beneficiary's health insurance plan. These costs can come from the beneficiary's monthly premiums, deductibles, coinsurance, and copayments. with this plan is $5,900 (in-network).
- It includes a prescription drug plan (Medicare Part D plans are an option Medicare beneficiaries can use to get prescription drug coverage. Part D plans provide cost-sharing on covered medications in four different phases: deductible, initial coverage, coverage gap, and catastrophic. Each...). The annual Part D deductible is $0.00.
This Capital BlueCross PPO plan allows you to choose your own primary care doctor, specialists, and other healthcare providers in Franklin County. In most cases healthcare providers in the plan's provider network cost less.
Capital Blue Cross | WellSpan Health AdvantagePlus's monthly premium in Franklin County is $19.00. That includes your prescription coverage, as well. Plus, you must continue to pay your monthly Medicare Part B premium. Some Medicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B). include a monthly Part B premium reduction, also known as the Medicare give back. This plan's Part B premium reduction is NONE.
Co-payments and/or co-insurances also apply with most healthcare services, except preventive care mandated by CMS (see H3923-030 Summary of Benefits).
Although the health plan itself does not have a deductible, the prescription drug plan does. It's $0.00 per year. That means you have first dollar coverage.
IMPORTANT: When evaluating Capital Blue Cross | WellSpan Health AdvantagePlus, look past the monthly premium. Identify the costs of the healthcare services you use most. Only then will you uncover the plan's value for your personal situation.
Maximum Out-of-Pocket (MOOP) Limit
Unlike Original Medicare, Medicare Advantage plans must set an annual Maximum Out-of-Pocket limit on inpatient and outpatient healthcare services. The Capital Blue Cross | WellSpan Health AdvantagePlus plan MOOP is $5,900 . Once you reach this amount of spending on your copayments, all of your Medicare Part A and Part B services will be covered at no additional charge for the remainder of the year.
NOTE: MOOP does not include what you spend on monthly A premium is an amount that an insurance policyholder must pay for coverage. Premiums are typically paid on a monthly basis. In the federal Medicare program, there are four different types of premiums. . It also does not apply to your prescription drugs, Part D deductible, or any other extra benefits bundled in the plan.
CRITICAL: Be sure to evaluate the annual premiums and MOOP of Capital Blue Cross | WellSpan Health AdvantagePlus versus what you might expect to pay for a Medicare Supplements are additional insurance policies that Medicare beneficiaries can purchase to cover the gaps in their Original Medicare (Medicare Part A and Medicare Part B) health insurance coverage. in Franklin County. Some Medicare Supplements offer less overall financial risk than Medicare Advantage plans with a similar annual cost.
Contact Capital BlueCross
If you qualify for Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program on www.medicare.gov. To learn more about this plan, visit the Capital BlueCross Medicare website.
Additional Medicare Plan Options in Franklin County
Are you eligible for a Franklin County, PA Medicare Special Needs Plan (SNP)? SNPs are a special type of Medicare Advantage plan designed to help people with special needs. Here are some of the SNP plans in your area:
- UnitedHealthcare Dual Complete (Local HMO), for Dual-Eligible beneficiaries
- Geisinger Gold Secure Rx (Local HMO), for Dual-Eligible beneficiaries
- UPMC for Life Complete Care (Local HMO), for Dual-Eligible beneficiaries
- Humana Gold Plus SNP-DE H6622-078 (Local HMO), for Dual-Eligible beneficiaries
- UnitedHealthcare Nursing Home Plan 2 (Local PPO), for Institutional beneficiaries
Not qualified for an SNP? Here are some additional plans you might consider:
- Vibra Essential Advocate (PPO)
- HumanaChoice H5525-006 (PPO)
- HumanaChoice R0923-002 (PPO)
- Geisinger Gold Preferred Advantage Rx (PPO)
- Geisinger Gold Classic Advantage Rx (HMO)