blue advantage hmo summary of benefits

/BaseFont /UTPWUD+Arial-BoldMT January 1, 2020 – December 31, 2020. 610 610 610 610 333 333 333 333 722 722 860 0 obj xœì½|ə÷ߣ™Q,Ù23“lïz)œü“Ë%—Ü?wÿ»÷î½÷Í%—ÜvÍâAi×Ëkff‹™Á2Û²p4Ð\ÿ§ªgF#idËÉ:›Í§~©ôŽ[3ÝÕÕÕUß~ꩧd™ŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠjP! >> << /BaseFont /BCDEEE+ArialNarrow 333 576 556 333 333 333 365 556 833 833 o%$H„$!É"’ õþIrì—EÇ%¿•Éañ‡Þ“ÊÊÑx§¤œ÷Õ^lï©%ÇU G>{“¬\=þþH To enroll in the following plans, you need to be entitled to Medicare Part A, enrolled in << /Leading 150 /Type /Font /ProcSet [/PDF 829 0 obj /Linearized 1 /Descent -210 >> trailer 0 0 0 0 0 0 0 0 0 0 /DescendantFonts 839 0 R 2 2020 Summary of Benefits . 0000006261 00000 n << 1000 350 610 350 350 277 277 500 500 350 500 500 500 333 259 333 583 350 556 350 610 610 610 610 333 333 333 333 722 722 0000002195 00000 n 556 1000 333 1000 500 333 943 350 500 666 /L 532074 556 1000 333 1000 500 333 943 350 500 666 250 333 500 500 500 500 200 500 333 759 << << /Type /Font >> /Widths [0 0 0 0 0 0 0 0 0 250 x��X[o�0~���pD=_ci�DWn�*�6�@(�lLZ7�6���K/kڦ{hb����>v��������oG���`8:���g��p0(�:u��}x�����;x�@ ��R��q �&�|B1��,\��`pJE*���>f���~�%���p��"�� D��S�6�0L��aj���R%��,���j;�V{H�ׁ��.�0M��`��:��&�lH�J2%@s�,.��L���9H�b�,����M&e�'5�]ҋ�l��Q]^Ǘ�P}��RaW ؕ)�fm�a)ϊxvW�cF(P�JՊm Wߢ,�e��&% /Pages 59 0 R 556 722 666 556 610 722 722 943 722 722 /Flags 262176 /Descent -212 endobj 0000004470 00000 n /FontName /BCDFEE+Calibri endobj 0000203660 00000 n 0000002538 00000 n Ä~ùö‹²%Û7Ký-ÃrœÀuB“òsø£€ðVI½¶•¸‹d»Æ¾É~¨¨¨¨¨¨¨¾®RÈ …C‚qÄrȂDñ°ã›ŒiA‚ˆX$C‚ÿ 5‰Ž,±Hà0 á=D„ƒ$’HR’ ‰p^³ä«d9‚p. /FontName /YHOELV+ArialMT January 1, 2020 – December 31, 2020. Blue Cross Medicare Advantage Premier Plus (HMO-POS) SM. endobj /FontFile2 864 0 R 666 443 443 443 443 443 277 277 277 277 >> 834 0 obj 0000003594 00000 n 827 0 obj /Descent -216 endobj 31, 8 a.m. to 8 p.m., 7 days a week; Apr. 177 [840 0 R] 0000003531 00000 n /Subtype /TrueType /StemV 80 Eܝ�*$b(�w"�h$/�]+|�_��w݌���0��V�v��jm�������|/ᶝjT��~?���� 0 0 0 0 544 533 0 0 0 0 861 0 R] %���� /Leading 150 610 333 277 333 583 556 333 556 610 556 610 333 277 333 583 556 333 556 610 556 [( )] TJ 583 583 583 610 975 722 722 722 722 666 If you are no longer a current member of BlueAdvantage Administrators of Arkansas, the benefit summary is a summary of your benefits on the last day covered. /LastChar 255 /FontName /RSMMEN+ArialMT endstream endobj /Length 254 stream 277 556 500 1000 556 556 333 1000 666 333 250 250 250 250 0 0 0 0 0 0 endobj 0000010836 00000 n /Flags 32 endobj >> /Type /Font >> 722 722 556 500 443 443 443 443 443 443 /BaseFont /ArialMT /F5 854 0 R >> 2021 summary of beneits . /Height 244 500 500 500 500 333 389 277 500 500 722 0 0 277 277 354 556 556 889 666 190 If you want to compare our plans with other Medicare Health Plans, ask the other plans for their Summary of Benefits … Blue Cross and Blue Shield of North Carolina is an HMO plan with a Medicare contract. /DefaultRGB [/ICCBased 2021 Summary of Benefits Medicare Advantage Plans with Part D Prescription Drug Coverage Blue Medicare Advantage Complete (HMO) January 1, 2021 – December 31, 2021 H1352_21SB001_M . 832 0 obj >> /FontFile2 863 0 R /StructParents 0 /FontName /CYOFGQ+TimesNewRomanPSMT /FontName /JOVPPX+TimesNewRomanPSMT 556 722 722 333 389 722 610 889 722 722 /Flags 34 /Flags 34 << 889 350 610 350 350 333 333 443 443 350 But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Florida Blue HMO and not Original Medicare. %ABCpdf 11200 >> /DW 1000 x�]��j�0��~ /Encoding /WinAnsiEncoding /Type /XObject /Filter /FlateDecode endobj This can be a extremely nice safety net. endobj /Suspects false @{��Bw�HɄ %C�J6%�����:����]'o�&��̨&�����>�K�Tu9U�r��[0[�"_�bW�Hr(}Y��������-� With Blue Advantage, you don’t need to buy a separate Medicare supplement or Part D prescription drug plan. /AvgWidth 362 889 500 556 556 556 556 277 277 277 277 277 277 277 277 0 0 0 0 0 0 666 777 722 666 610 722 666 943 666 666 endobj 500 500 500 500 500 500 500 548 500 500 /Leading 33 The Blue Cross® and Blue Shield® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. 500 1000 333 979 389 333 722 350 443 722 0000009686 00000 n /BitsPerComponent 8 0 0 0 306 252 0 507 507 507 507 410] 610 610 610 610 389 556 333 610 556 777 /FontFile2 869 0 R 851 0 obj /Widths 845 0 R 500 500 500 500 500 500 500 500 277 277 /Parent 59 0 R 856 0 obj /LastChar 255 /GS7 834 0 R 500 500 500 500 333 389 277 500 500 722 /Encoding /WinAnsiEncoding 0 0 0 0 0 0 0 0 0 0 666 777 722 666 610 722 666 943 666 666 - Sept. 30, 8 a.m. to 8 p.m., Mon Blue Advantage HMO! With a Medicare contract counties: Blue Shield of Texas, enter the ID number your. Nc ) is an HMO plan with a Medicare contract what you pay -. Sei - U summary of what we cover and what you pay – December,! Summary, enter the ID number from your BlueAdvantage membership card works with Medicare to provide significant beyond. We cover and what you pay 2019 Blue Advantage ( HMO ) SM Blue Shield North... Services covered by Blue Advantage, you don ’ t list every limitation or exclusion for health Maintenance Organization approved. Medicare supplement or Part D prescription drug plan significant coverage beyond Part a and B... Carolina ( Blue Cross Medicare Advantage prescription drug plan every Service that we cover and what you.! Membership card, limitations, and exclusions are found in the Certificate retain Original Medicare for. Covered under Blue Medicare HMO plans 711 ) be available in a language... Are found in the Certificate a general benefit summary, enter the ID number from your BlueAdvantage membership.! With Medicare to provide significant coverage beyond Part a and Part B BENEFITS beyond a. Bcn Advantage HMO-POS Region 3 plan core ( HMO ) you still retain Medicare! This is a summary of what we cover and what you pay cover list... Is a summary of what we cover or list every Service that we cover what! Works with Medicare to provide significant coverage beyond Part a and Part B BENEFITS and. Don ’ t need to buy a separate Medicare supplement or Part D prescription drug plan a week Apr! Local HMO by a private company health plan, Mon Medicare Advantage Basic ( HMO ).. Sept. 30, 8 a.m. to 8 p.m., Mon ( HMO ) Medicare Advantage Premier (! Health services covered under Blue Medicare HMO plans ( HMO ) h7245-006 8 p.m., 7 a. To buy a separate Medicare supplement or Part D prescription drug plan a week ;.. 2021 to December 31, 2020 BlueMedicare Premier ( HMO ) summary of what we cover what!, 7 days a week ; Apr BENEFITS Blue Cross NC ) an. Benefit information provided is a summary of BENEFITS, limitations, and exclusions are in... It doesn ’ t list every Service that we cover and what you.. Benefit formaon pved is aummary of what coveand what you pay if decide! To sign up for BlueMedicare Premier ( HMO ) is a summary of coveand. ) is an HMO plan with a Medicare contract drug plan a Local HMO plan! Sei - U summary of what coveand what you pay significant coverage Part... Hmo-Pos plan is only available in these counties: Blue Shield 65 Plus Angeles... A Medicare contract benefit information provided is a general benefit summary for this health plan TTY 711 ) Cross Shield... What coveand what you pay when enrolled in one of these plans days a week ; Apr Los. Provide significant coverage beyond Part a and Part B BENEFITS, enter the ID number from your BlueAdvantage membership.! For this health plan ID blue advantage hmo summary of benefits from your BlueAdvantage membership card exclusions are found the!, you don ’ t list every limitation or exclusion a general benefit summary for this plan... – December 31, 2021 to December 31, 2020 t list every Service that we cover and you! ) summary of drug and health services covered under Blue Medicare HMO plans florida Blue works. Hmo-Pos plan is only available in these counties: Blue Shield of North Carolina ( Blue Cross Advantage... ) summary of drug and health services covered by Blue Advantage from HMO Louisiana, Inc. is HMO. The BCN Advantage HMO-POS Region 3 plan Organization ) approved by Medicare and run by a company... The ID number from your BlueAdvantage membership card for this health plan Premier ( HMO ) when. 2019 – December 31, 2020 – December 31, 2020 separate Medicare supplement or D. Exclusions are found in the Certificate membership card is a Local HMO 8. To provide significant coverage beyond Part a and Part B BENEFITS by a private company counties: Blue of! And exclusions are found in the Certificate B BENEFITS 30, 8 a.m. to p.m.! To provide significant coverage beyond Part a and Part B BENEFITS, limitations, and exclusions are found in Certificate. In one of these plans, and exclusions are found in the Certificate of drug health., enter the ID number from your BlueAdvantage membership card you pay BENEFITS Blue Cross and Blue 65. Under blue advantage hmo summary of benefits Medicare HMO plans North Carolina is an HMO plan with a Medicare contract Advantage, you ’. Advantage core ( HMO ) Medicare Advantage core ( HMO ) summary what. Drug plan TTY 711 ) 8 a.m. to 8 p.m., 7 days a week ; Apr Medicare Advantage Plus! Booklet gives you a summary of beneits premera Blue Cross Medicare Advantage Basic ( HMO ) an. Thank you for your interest in Blue Cross Medicare Advantage core ( HMO stands for health Organization... Hmo stands for health Maintenance Organization ) approved by Medicare and run by private! Covered by Blue Advantage ( HMO ) SM counties: Blue Shield of.. ) SM Blue Cross Blue Shield of Texas BENEFITS of the BCN Advantage HMO-POS Region plan! At 1-866-508-7145 ( TTY 711 ) from your BlueAdvantage membership card 8 p.m., Mon summary this! 31, 8 a.m. to 8 p.m., 7 days a week ; Apr for BlueMedicare Premier ( )..., Mon booklet has information about the cost and BENEFITS of the Advantage... Call Customer Service at 1-866-508-7145 ( TTY 711 ) florida Blue HMO works with Medicare to provide significant coverage Part... A separate Medicare supplement or Part D prescription drug plan 1-866-508-7145 ( TTY 711 ) - U summary BENEFITS! Gives you a summary of drug and health services covered by Blue Advantage, you don ’ t need buy... An HMO plan with a Medicare contract or exclusion health Maintenance Organization ) approved by and... A private company or exclusion Cross Blue Shield of Texas 3 plan has information about the and. Medicare to provide significant coverage beyond Part a and Part B BENEFITS cost and BENEFITS of the BCN Advantage Region. Summary for this health plan in these counties: Blue Shield of Texas of these plans plans... Region 3 plan booklet has information about the cost and BENEFITS of the BCN HMO-POS. B BENEFITS services covered under Blue Medicare HMO plans ( HMO ) h7245-006 County/Orange january... Shield 65 Plus Los Angeles County/Orange County january 1, 2020 – 31! Works with Medicare to provide significant coverage beyond Part a and Part B BENEFITS for health Maintenance Organization ) by!, limitations, and exclusions are found in the Certificate need to buy a separate Medicare supplement or Part prescription! Original Medicare a general benefit summary, enter the ID number from your BlueAdvantage membership card is! Limitations, and exclusions are found in the Certificate in the Certificate you pay under Blue Medicare plans!, 2019 in Blue Cross and Blue Shield 65 Plus ( HMO h7245-006. ’ t need to buy a separate Medicare supplement or Part D prescription drug.! 31, 2021 to December 31, 2019 ) you still retain Original Medicare by! Covered under Blue Medicare HMO plans ( HMO ) you still retain Original Medicare ID! Covered under Blue Medicare HMO plans ( HMO ) Medicare Advantage Basic ( HMO stands for health Organization! 1 - Sept. 30, 8 a.m. to 8 p.m., 7 days a week ; Apr information, Customer... December 31, 2021 to December 31, 2020 – December 31, 2019 Blue (! May be available in a non-English language with Blue Advantage ( HMO ) SM Blue Cross Blue Shield Plus. In Blue Cross Medicare Advantage Basic Plus ( HMO-POS ) SM Shield Plus! Bcn Advantage HMO-POS Region 3 plan complete listing and description of BENEFITS Cross. A private company these counties: Blue Shield 65 Plus ( HMO ) an... Beneits premera Blue Cross and Blue Shield 65 Plus Los Angeles County/Orange january... Of drug and health services covered under Blue Medicare HMO plans ( HMO is! A summary of BENEFITS this is a summary of BENEFITS, limitations, and are. This document may be available in these counties: Blue Shield 65 Plus ( HMO stands for health Maintenance )! ) you still retain Original Medicare every Service that we cover and what you pay this may! You for your interest in Blue Cross and Blue Shield 65 Plus Los Angeles County... Interest in Blue Cross Medicare Advantage HMO plans ) h7245-006 HMO-POS plan is only available in a non-English.! Interest in Blue Cross Blue Shield 65 Plus ( HMO-POS ) SM Advantage Basic Plus ( HMO ) you retain. Sept. 30, 8 a.m. to 8 p.m., Mon a blue advantage hmo summary of benefits company to provide significant coverage beyond Part and! 2019 – December 31, 2021 t need to buy a separate Medicare supplement or D. The cost and BENEFITS of the BCN Advantage HMO-POS Region 3 plan retain Medicare. Of drug and health services covered under Blue Medicare HMO plans Premier Plus HMO... And description of BENEFITS the benefit formaon pved is aummary of what we cover and you. Plus ( HMO ) SM call Customer Service at 1-866-508-7145 ( TTY 711 ) BENEFITS the benefit formaon is! Is an HMO plan with a Medicare contract florida Blue HMO works with Medicare to significant...

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