Platinum Blue Choice Plan With Rx Cost H246100901

2017 Platinum Blue Choice Plan with Rx (Cost) in Beltrami, Minnesota

Medicare Advantage Plan Benefit Details in Plain Text

The following Medicare Advantage plan benefits apply to the Platinum Blue Choice Plan with Rx (Cost) (H2461 - 009) in Beltrami, Minnesota . This plan is administered by BLUE CROSS AND BLUE SHIELD OF MINNESOTA.  To switch to a different Medicare Advantage plan or to change your location, click here.

Click here to see the Platinum Blue Choice Plan with Rx (Cost) health and prescription benefit details in chart format or email and view benefits chart

Plan Premium

The Platinum Blue Choice Plan with Rx (Cost) has a monthly premium of $110.70. That is $1,328.40 for 12 months. There are a few factors that can increase or decrease this premium. If you qualify for full or partial extra help, your premium will be lower. If you have a premium penalty, your premium will be higher. Please remember that the $110.70 montly premium is in addition to your Medicare Part B premium. If you have a premium penalty, your premium will be higher. Or if you have a higher income you would be subject to the Income Related Adjustment Amount (IRMAA).

This Medicare Advantage Plan with Prescription Drug Coverage is a Cost plan.

Plan Membership and Plan Ratings

The Platinum Blue Choice Plan with Rx (Cost) (H2461 - 009) currently has 23,749 members. , and 12,441 members in Minnesota.

The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 4.5 stars. The detail CMS plan carrier ratings are as follows: Customer Service Rating of 4 out of 5 stars Member Experience Rating not available Drug Cost Information Accuracy Rating of 4 out of 5 stars

Prescription Drug Coverage: Deductible, Cost-sharing, Formulary

This plan has a $400 deductible. However, formulary drugs on Tier 1, 2 and 6 are excluded from the $400 deductible and have first dollar coverage (or a $0 deductible). So, you are 100% responsible for the first $400 in medication costs for drugs not on the excluded tiers. After you have met the deductible, the Platinum Blue Choice Plan with Rx (Cost) will share the costs of your medications with you -- see cost-sharing below. $400 is the maximum deductible for 2017. There are other plans with a lower deductible or even a $0 deductible for all formulary drugs. Click here to review plans with a $0 deductible.

The following information is about the Platinum Blue Choice Plan with Rx (Cost) formulary (or drug list). There are 3247 drugs on the Platinum Blue Choice Plan with Rx (Cost) formulary. Click here to browse the Platinum Blue Choice Plan with Rx (Cost) Formulary.

The Initial Coverage Phase (ICP) can be thought of as the cost-sharing phase of the plan. During this phase, you and the insurance company share your prescription costs. Once you have spent $400, your initial coverage phase will start. All medication are divided into tiers within the plans formulary. This helps the plan to organize and manage the prescription cost-sharing. The Platinum Blue Choice Plan with Rx (Cost)'s formulary is divided into 6 tiers. Every plan can name their tiers differently, and can place medications on any tier. The cost-sharing for this plan is divided as follows: Tier 1 (Preferred Generic) contains 243 drugs and has a co-payment of $6.00. Tier 2 (Generic) contains 1,538 drugs and has a co-payment of $12.00. Tier 3 (Preferred Brand) contains 262 drugs and has a co-insurance of 20% of the drug cost. Tier 4 (Non-Preferred Brand) contains 528 drugs and has a co-insurance of 45% of the drug cost. Tier 5 (Specialty Tier) contains 615 drugs and has a co-insurance of 25% of the drug cost. Tier 6 (Select Care Drugs) contains drugs and has a co-payment of $0.00. Click here to browse the Platinum Blue Choice Plan with Rx (Cost) Formulary.

The Coverage Gap, which is also known as the Donut (Doughnut) Hole is the phase of your Medicare Part D plan where you are responsible for 100% of your medication costs. Healthcare Reform mandates that the insurance carrier pay 49% of your generic drug prescription costs in the donut hole on your behalf. The brand-name drug manufacturer will pay 50% and your plan will pay an additional 10% of the cost of your brand-name drugs purchased in the Donut Hole, for a total of 60% discount. The 50% paid by the brand-name drug manufacturer is paid on your behalf and therefore counts toward your TrOOP (or True Out-of-Pocket) costs. The portion paid by your plan, does not count toward TrOOP. Some Medicare Part D plans offer coverage during the Coverage Gap that is beyond the mandated discounts. Any drug not covered by the plan's Gap Coverage will still receive the discounts noted above -- even if the plan has "No Gap Coverage". This plan (Platinum Blue Choice Plan with Rx (Cost)) offers No Coverage during the Coverage Gap phase.

The Platinum Blue Choice Plan with Rx (Cost) offers many Health and Prescription Drug Coverage Benefits. The following section will describe these benefits in detail.

** General Plan Information ** Choice of Doctors?:  Plan Doctors for Most Services ** Cost ** Monthly Health Plan Premium:  $74.00 Monthly Drug Plan Premium:  $36.70 Health Plan Deductible:  $0 Other Health Plan Deductibles?:  No Maximum Out-of-Pocket Enrollee Responsibility (does not include prescription drugs) :  $3,000 In-network ** Extra Benefits ** Prescription Drugs Covered?:  Yes Optional Supplemental Benefits?:  No ** Outpatient Care and Services ** Ambulance:  $25 Doctor's office visits: Primary Physician $15 per visit Sepcialist $15 per visit Durable medical equipment (wheelchairs, oxygen, etc.):  20% per item Emergency care:  $50 per visit (always covered) Home health care:  You pay nothing Mental health care:  $100 per stay Outpatient hospital:  $0-50 per visit Renal dialysis:  $15 per visit ** Inpatient Care ** Inpatient hospital care:  $100 per stay Optional Supplemental Benefits?:  No Skilled Nursing Facility (SNF):  You pay nothing Prescription Drugs Covered?:  Yes ** Additional Benefits ** Optional Supplemental Benefits?:  No

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Source: https://q1medicare.com/MedicareAdvantage-2017CHealthPlanBenefitsPlainText.php?state=MN&ZIP=&countyCode=27007&contractId=H2461&planId=009&segmentId=0&plan=Platinum%20Blue%20Choice%20Plan%20with%20Rx%20(Cost)%20-%20H2461-009-0

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