BlueMedicare Value (PPO)
2021 Summary of Benefits
2021 Summary of Benefits
Summary of Benefits - Pinellas / Hernando, Pasco (PDF)
Summary of Benefits - Escambia, Okaloosa, Santa Rosa / Clay, Duval (PDF)
Summary of Benefits - Manatee, Sarasota / Charlotte, Collier, Lee (PDF)
Summary of Benefits - Broward, Indian River, Martin, Palm Beach, St. Lucie / Miami-Dade (PDF)
Summary of Benefits - Brevard, Orange, Osceola, Seminole / Hillsborough, Polk (PDF)
Summary of Benefits - Lake, Marion, Sumter (PDF)
2021 Evidence of Coverage
Evidence of Coverage - Pinellas (PDF)Evidence of Coverage - Manatee, Sarasota (PDF)
Evidence of Coverage - Escambia, Okaloosa, Santa Rosa (PDF)
Evidence of Coverage - Broward, Indian River, Martin, Palm Beach, St. Lucie (PDF)
Evidence of Coverage - Charlotte, Collier, Lee (PDF)
Evidence of Coverage - Clay, Duval (PDF)
Evidence of Coverage - Miami-Dade (PDF)
Evidence of Coverage - Brevard, Orange, Osceola, Seminole (PDF)
Evidence of Coverage - Hillsborough, Polk (PDF)
Evidence of Coverage - Hernando, Pasco (PDF)
Evidence of Coverage - Lake, Marion, Sumter (PDF)
2021 Annual Notice of Change
Annual Notice of Change - Pinellas (PDF)
Annual Notice of Change - Manatee, Sarasota (PDF)
Annual Notice of Change - Escambia, Okaloosa, Santa Rosa (PDF)
Annual Notice of Change - Broward, Indian River, Martin, Palm Beach, St. Lucie (PDF)
Annual Notice of Change - Charlotte, Collier, Lee (PDF)
Annual Notice of Change - Clay, Duval (PDF)
Annual Notice of Change - Miami-Dade (PDF)
Annual Notice of Change - Brevard, Orange, Osceola, Seminole (PDF)
Annual Notice of Change - Hillsborough, Polk (PDF)
Annual Notice of Change - Hernando, Pasco (PDF)
2021 Comprehensive Formulary
Comprehensive Formulary - Miami-Dade (PDF)
2021 Other Information and Documents
Low-Income Subsidy - Medicare Extra Help Program (PDF)
Prescription Drug Transition Policy (PDF)
FBM FORM BMV PPO 003 NF 102020