What is BlueJourney Alliance Lung Care (Local HMO C-SNP)?
BlueJourney Alliance Lung Care is a 2020 C-SNP Medicare Special Needs Plan, from Capital BlueCross, available in Berks County, Pennsylvania.
- It's a Local HMO health plan.
- It includes prescription drug coverage (Medicare Part D).
- It offers the same basic health insurance benefits as Original Medicare and additional benefits for special needs.
- It helps coordinate care for chronic conditions.
- Most of the costs of joining this Medicare Special Needs Plan will be covered for you.
How to Qualify to Enroll in BlueJourney Alliance Lung Care
If you qualify and enroll, this Local HMO plan replaces your Original Medicare coverage. To qualify, you must meet the following criteria:
- You have Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance).
- You live in the plan's service area.
- You have one or more of these severe or disabling chronic conditions:
- Chronic alcohol and other dependence
- Autoimmune disorders
- Cancer (excluding pre-cancer conditions)
- Cardiovascular disorders
- Chronic heart failure
- Diabetes mellitus
- End-stage liver disease
- End-Stage Renal Disease (ESRD) requiring dialysis (any mode of dialysis)
- Severe hematologic disorders
- Chronic lung disorders
- Chronic and disabling mental health conditions
- Neurologic disorders
If you don't qualify to join this plan, be sure to compare Medicare Advantage plans available in Berks County, PA. A second option is to keep your original Medicare benefits and add a Pennsylvania Medigap plan and a stand-alone Pennsylvania Medicare Part D plan.
Before Joining BlueJourney Alliance Lung Care, Consider These Questions:
- If dual-eligible, does the plan coordinate my Medicare and Medicaid benefits to make them easily accessible?
- What costs should I expect for my coverage (premiums, deductibles, copayments)?
- Is there an annual limit on my out-of-pocket expenses?
- Will I be able to use my doctors? Are they in the plan's network?
- Are the plan's in-network providers and facilities in convenient locations?
- Does the plan provide coverage for services I receive from out-of-network providers?
- Do I need a referral to see a specialist?
- Are my medications on the plan's formulary?
- What special accommodations does the plan make for persons with disabilities?
- What special language and cultural accommodations does the plan make?
How Much Does BlueJourney Alliance Lung Care Cost?
The premium on this plan is $33.00 per month. That includes your prescription drugs, as well. Plus, you must continue to pay your monthly Medicare Part B premium. Co-payments and/or co-insurances also apply with most healthcare services, except preventive care mandated by CMS (see H3962-018 Summary of Benefits below).
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.
Medicare 5-Star Ratings
In this section we show you the quality rating for this Capital BlueCross plan. Each year CMS rates health plans (Part C) in five broad categories and drug plans (Part D) in four broad categories. We do not recommend joining a plan with an overall rating less than 3.0. The following marks will give you an idea of the level of care you will receive if you join this health plan.
BlueJourney Alliance Lung Care Medicare Part D Co-Pays
This SNP plan includes prescription drug coverage (Medicare Part D). If you have regular prescriptions, it's critical that you evaluate your costs using the plan's formulary.
In addition to the monthly premium and Part D deductible, the drug plan has copayments (fixed dollar amount) and/or coinsurances (percentage) that you must pay when you pickup your medications. Here's the drug coverage schedule for this plan:
|1 (Preferred Generic)||$3.00 copay||$10.00 copay|
|2 (Generic)||$15.00 copay||$20.00 copay|
|3 (Preferred Brand)||$42.00 copay||$47.00 copay|
|4 (Non-Preferred Drug)||$95.00 copay||$100.00 copay|
|5 (Specialty Tier)||33%||33%|
How Much are the Copays & Co-Insurance?
Co-pay data coming soon. For assistance call: 1-855-266-4865.
Contact Capital BlueCross
For more information about this plan, call the Enrollment Assistance line, or visit the Enrollment Website or the plan website:
For assistance 24 hours a day, call 800-633-4227. TTY users should call 877-486-2048. 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.
BlueJourney Alliance Lung Care is available to beneficiaries living in Hereford, Bally, Barto, Bechtelsville, Bernville, Bethel, Birdsboro, Blandon, Bowers, Boyertown, Centerport, Douglassville, Earlville, Fleetwood, Geigertown, Hamburg, Kempton, Kutztown, Leesport, Lenhartsville, Limekiln, Lyon Station, Maxatawny, Mertztown, Mohnton, Mohrsville, Monocacy Station, Morgantown, Mount Aetna, New Berlinville, Oley, Pine Forge, Rehrersburg, Robesonia, Shartlesville, Shoemakersville, Strausstown, Temple, Topton, Virginville, Wernersville, Womelsdorf, Reading, and all other areas of Berks County, Pennsylvania; Medicare plans are the same throughout the County.