Products 1
What is the cost of DME under the MA Only West Choice Plan?
20% coinsurance
On our MAPD plans, what is the member responsibility for using a dentist not in-network with UCD (United Concordia Dental)?
The member is responsible for the difference between the dentist's normal charge and what the insurer pays for a given procedure.
How can a member order their items for the OTC benefits?
Purchases must be made through the website, the phone number listed in the catalog, or at designated CVS pharmacies
What is the Rx deductible for MAPD Choice South?
$300 – Tier 3 to 5
What is the copay for a tier 3 prescription at a preferred pharmacy of MedicareBlue Rx Standard?
$29 copay
What is the cost of an Ambulance under the MAPD Metro Complete plan?
Ground and air
$50 copay
What is the eyewear allowance for the MAPD South Core plan?
$90 Copay
What are some of our key in-network healthcare systems for our MAPD West plans?
Altru
Avera
Essentia
Fairview
Mayo Clinics
Sanford
What is the name of the mail order pharmacy for Platinum Blue?
AllianceRx/Walgreens Prime
What is the cost-share for a generic drug in the catastrophic stage?
Generic – The member pays a $3.70 copay or 5% coinsurance, whichever is greater for 2021
What is the travel benefit for Platinum Blue?
Members may travel out of the service area within the U.S. for up to nine months and will only pay the applicable in-network copays and/or coinsurance with any provider who accepts Medicare assignment.
What is the member responsibility for worldwide emergency care or transportation under plan N?
20% coinsurance
What is the dental network for our MAPD plans?
BCBSMN Medicare Dental Network
What is the true out of pocket (TrOOP) for prescription drug coverage?
$6,550 for 2021
For MedicareBlue Rx Premier, what is the member responsibility while in the donut hole at a standard pharmacy?
Tier 1: $15 copay
Tier 2: $20 copay
For drugs in all other tiers:
Generic – 25% of the plan's costs
Brand – 25% of the plan's costs
What is the out of pocket maximum on Medicare Supplement High Deductible?
$2,370
What services can the Supplemental preventive services rider help cover?
non-Medicare covered services (eye exam, hearing screening, and routine physical)
How many acupuncture visits are covered under our MAPD plan benefits?
Medicare covers 20 visits every 12 months for chronic low back pain. No prior authorization is needed.
Blue Cross covers 20 visits per calendar year for any pain diagnosis other than chronic low back pain. Prior authorization may be needed.
What is the benefit for covered insulins on MAPD plans?
The Complete plan offers $0 copay formulary insulins – Members will have $0 copay during the initial and coverage gap phases and will be responsible for 5% during the catastrophic phase.
What is the 90-day supply copay for a tier 2 prescription at a standard pharmacy on MedicareBlue Rx Premier?
$40 copay
What is the over-the-counter benefit for MAPD Metro?
All plan levels include a $50 allowance per quarter for OTC items
What are the preventive services covered at a $0 copay on our platinum blue choice plan?
Annual Medicare-covered wellness visit
Once per year
Physical exam
Once per year
Routine eye exam
Twice per year
Immunizations
flu, pneumonia, and Hepatitis B1 vaccines
Cancer screenings
Original Medicare limits apply
What's the eligibility for MedicareBlue Rx?
To be eligible for a MedicareBlue Rx plan, members must:
Have Medicare Part A and Part B.
Enroll in one Part D plan at a time.
Enroll during specific times of the year.
Be a resident of Minnesota during the enrollment (available in all counties)
What is the member responsibility for Part B prescription drugs on Platinum Blue?
20% coinsurance
What is the donut hole?
This is the amount paid for a 30-day supply after the total yearly covered prescription drug costs reach $4,130.