Platinum Blue Core Plan with Rx (Cost) 2024 Benefit Details for Plan H2461-008-0 by Blue Cross and Blue Shield of Minnesota
Platinum Blue Core Plan with Rx is a 2024 Cost Medicare Advantage plan {with_without_pdp} Part D.
This Blue Cross and Blue Shield of Minnesota option offers the same basic benefits as Original Medicare, but out-of-pocket costs are different. It may also include additional, valuable benefits not covered by Part A or Part B.
This plan is rated 4.5 (Good+) stars by CMS making it a top-rated plan.
Plan Basics | |
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Plan ID: | H2461 008 0 |
Plan Type: | Cost |
Plan Year: | 2024 |
Premium: | $58.50/mo Plus your Medicare Part B premium. |
Health Plan Deductible: | $0.00 |
Out-of-Pocket Maximum: | $6,000/yr |
Part B Reduction: | $0.00/mo |
Drug Plan Benefit: | Basic, $545.00 deductible |
Rx Gap Coverage: | No |
Supplemental Benefits: | Hearing |
Availability: | See List |
Insured By: | Blue Cross and Blue Shield of Minnesota |
Summary of Benefits |
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Health Plan Cost Sharing
This Blue Cross and Blue Shield of Minnesota Medicare Advantage plan has cost-sharing. These are costs you must pay out-of-pocket when you use approved health services.
NOTE: Most preventive services are covered 100% by the plan as a Part B benefit.
The following table summarizes the most common out-of-pocket costs you will incur if you join this plan unless you go out-of-network:
Healthcare Service | Member Cost |
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Doctor Visits (In-Network) | |
Primary: | $20 Copay |
Specialist: | 20% Coinsurance Authorization Required |
Wellness programs (e.g., fitness, nursing hotline): | None |
Preventive care: | $0 |
Foot Care (In-Network) | |
Foot exams and treatment (Medicare-covered): | $50 Copay |
Routine foot care: | Not Covered |
Chiropractic Care (In-Network) | |
Medicare-covered chiropractic care: | $20 Copay Authorization Required |
Routine chiropractic care: | Not Covered |
Emergency Care / Urgent Care | |
Emergency room care: | $95 Copay |
Urgent care: | $60 Copay |
Ground ambulance: | 20% Coinsurance |
Inpatient hospital coverage: | $600.00 per stay |
Outpatient hospital coverage: | $0 |
Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $203.00 per day for days 21 and beyond |
Optional supplemental benefits: | |
Mental Health Services (In-Network) | |
Outpatient individual therapy visit with a psychiatrist: | $40 Copay |
Outpatient group therapy visit with a psychiatrist: | $40 Copay |
Inpatient hospital - psychiatric: | $600.00 per stay |
Outpatient group therapy visit: | $40 Copay |
Outpatient individual therapy visit: | $0 |
Rehabilitation Services (In-Network) | |
Physical therapy and speech and language therapy visit: | $40 Copay |
Occupational therapy visit: | $40 Copay |
Medical Equipment / Supplies (In-Network) | |
Diabetes supplies: | $0 |
Durable medical equipment (e.g., wheelchairs, oxygen): | 20% Coinsurance Authorization Required |
Prosthetics (e.g., braces, artificial limbs): | 20% Coinsurance |
Diagnostic Procedures / Lab Services / Imaging (In-Network) | |
Diagnostic radiology services (e.g., MRI): | 20% Coinsurance |
Lab services: | $0 |
Outpatient x-rays: | $60 Copay |
Diagnostic tests and procedures: | 20% Coinsurance |
Medicare Part B Drugs (In-Network) | |
Chemotherapy: | 20% Coinsurance |
Other Part B drugs (Medicare-covered) | 20% Coinsurance |
Feel free to download our Platinum Blue Core Plan with Rx Summary of Benefits information.
Supplemental Benefits
The following is a summary of the supplemental benefits Blue Cross and Blue Shield of Minnesota includes with this plan:
Supplemental Healthcare Service | Member Cost |
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Preventive Dental | |
Oral exam (In-Network) | Not Covered |
Fluoride treatment (In-Network) | Not Covered |
Dental x-ray(s) (In-Network) | Not Covered |
Cleaning (In-Network) | Not Covered |
Comprehensive Dental | |
Periodontics (In-Network) | Not Covered |
Non-routine services (In-Network) | Not Covered |
Diagnostic services (In-Network) | Not Covered |
Extractions (In-Network) | Not Covered |
Endodontics (In-Network) | Not Covered |
Restorative services (In-Network) | Not Covered |
Prosthodontics, other oral/maxillofacial surgery, other services (In-Network) | Not Covered |
Hearing Aids | |
Fitting/evaluation (In-Network) | Covered Limits may apply |
Hearing aids (In-Network) | Covered Limits may apply |
Hearing exam (In-Network) | Covered Limits may apply |
Vision | |
Eyeglasses (frames and lenses) (In-Network) | Not Covered |
Routine eye exam (In-Network) | Not Covered |
Contact lenses (In-Network) | Not Covered |
Additional Benefits
None specified.
Prescription Drug Plan Costs & Benefits
Platinum Blue Core Plan with Rx includes an basic benefit Medicare Part D plan (PDP). This simply means that the plan covers the minimum amount required by the Centers for Medicare & Medicaid Services, whereas enhanced benefit plans cover more.
Prescription Drug Plan Premium
Although the prescription drug plan (Part D) premium is bundled with the total plan cost, some plans have supplemental costs and/or offer low-income subsidy (LIS) assistance. LIS, also known as Extra Help, is a Social Security program that helps people with limited income and resources lower or cut Part D costs.
The following table outlines the prescription drug plan premium details of this plan.
Basic Part D Premium: | $24.50 |
Supplemental Part D Premium: | $0.00 |
Total Part D Premium: | $24.50 |
Part D Premium with Full LIS Assistance: | $0.00 |
If you would like more information about the Extra Help program, you can refer to the Social Security Extra Help page.
Prescription Drug Plan Deductible
The Medicare Part D annual deductible with this plan is $545.00. This is the amount you must pay at the pharmacy before Blue Cross and Blue Shield of Minnesota begins paying its share.
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Platinum Blue Core Plan with Rx has out-of-pocket costs that you must pay when you pick up your prescriptions.
Drug Tier | Preferred | Standard |
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1 (Preferred Generic) | N/A | $0.00 copay |
2 (Generic) | N/A | $11.00 copay |
3 (Preferred Brand) | N/A | 22% |
4 (Non-Preferred Drug) | N/A | 44% |
5 (Specialty Tier) | N/A | 25% |
CMS 5-Star Rating Marks
Each year Medicare rates health plans (Part C) and drug plans (Part D) in several major categories based on a 5-star rating system. These ratings are designed to help you understand the quality of care and service you can expect if you join this Blue Cross and Blue Shield of Minnesota plan.
CMS Measure | Star Rating |
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2024 Overall Rating | |
Staying Healthy: Screenings, Tests, Vaccines | |
Managing Chronic (Long Term) Conditions | |
Member Experience with Health Plan | |
Complaints and Changes in Plans Performance | |
Health Plan Customer Service | |
Drug Plan Customer Service | Not enough data available |
Complaints and Changes in the Drug Plan | |
Member Experience with the Drug Plan | Not enough data available |
Drug Safety and Accuracy of Drug Pricing |
This Medicare Advantage Cost plan is one of the top performers in the areas served (see list below). Staying healthy is the best way to save money on health care, and Platinum Blue Core Plan with Rx does a good job keeping its members in top health through preventive care, including screenings, tests, and vaccines. When it comes to helping members manage their chronic health conditions, this plan does an average job.
Overall, members say their experience with this Blue Cross and Blue Shield of Minnesota Cost plan is excellent. When it comes to complaints and changes in performance, this plan gets the highest marks. The plan shines at customer service with an overall excellent mark on this important metric.
Platinum Blue Core Plan with Rx does not offer any additional popular benefits, like dental, vision, or hearing.
Prospective members should carefully evaluate plan costs and benefits to understand if the plan's $58.50 dollar per month premium makes sense. Potential members should carefully factor in the maximum out-of-pocket limit of $6,000 per year. In most cases, a plan limit this high will cost members more than Original Medicare for a 5-day hospital stay. With no annual deductible, members of this health plan have first dollar coverage, which is comforting on a fixed budget.
Plan Availability
Platinum Blue Core Plan with Rx (H2461-008-0) is available in the following locations (click to open):
Additional Medicare Advantage Plan Options
The Medicare Advantage program offers a myriad of options, including these plans:
- H2461-010-0: Platinum Blue Complete Plan with Rx (Cost)
- H2461-007-0: Platinum Blue Complete Plan (Cost)
- H2461-009-0: Platinum Blue Choice Plan with Rx (Cost)
- H2461-005-0: Platinum Blue Core Plan (Cost)
- H2461-008-0: Platinum Blue Core Plan with Rx (Cost)
Contact Blue Cross and Blue Shield of Minnesota
Plan Website: | http://www.bluecrossmnonline.com |
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Formulary Information: | http://www.myprime.com |
Pharmacy Information: | Blue Cross and Blue Shield of Minnesota Pharmacy Page |
Prospective Members: | (877)662-2583 |
TTY Users: | 711 |
If you qualify for Medicare benefits 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.
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna Healthcare, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, UnitedHealthcare(R), and Wellcare.
Citations & References
- Blue Cross and Blue Shield of Minnesota, http://www.bluecrossmnonline.com, Last Accessed February 20, 2024
- Medicare.gov, "Understanding Medicare Advantage Plans", Last Accessed January 21, 2024
- Medicare.gov, "Your Medicare coverage choices", Last Accessed February 19, 2024
- Medicare.gov, "Medicare & You Handbook", Last Accessed February 19, 2024
- Medicare.gov, "Your Medicare Coverage", Last Accessed April 11, 2023
- CMS.gov, Landscape Source Files, Last Accessed February 21, 2024
- CMS.gov, Medicare Part C & D Performance, Last Accessed February 21, 2024
- CMS.gov, Plan Benefits Package, Last Accessed February 21, 2024
About This H2461-008-0 Plan Detail Page
The data on this Platinum Blue Core Plan with Rx plan detail page is derived from the 2024 Landscape Source Files, Plan Benefit Package, and Medicare Part C and Part D Performance Data published by CMS.
The author interprets these files, and their associated data dictionary, with great care, making every attempt to communicate the data submitted by Blue Cross and Blue Shield of Minnesota to CMS as clearly and accurately as possible. Given the complexity of the data, the author recommends that all potential enrollees request an official Summary of Benefits from Blue Cross and Blue Shield of Minnesota, at (877)662-2583, prior to enrollment.