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BlueMedicare Value (PPO)

2023 Service  Area

  • H5434-023 - Pinellas

  • H5434-024 - Highlands, Manatee, Sarasota

  • H5434-025 - Bay, Calhoun, Escambia, Franklin, Gadsden, Jefferson, Leon, Liberty, Okaloosa, Santa Rosa, Wakulla, Walton

  • H5434-026 - Broward, Indian River, Martin, Palm Beach, St. Lucie 

  • H5434-030 - Charlotte, Collier, Lee

  • H5434-031 - Clay, Duval,  Nassau, St. Johns, Flagler, Volusia

  • H5434-032 - Miami-Dade

  • H5434-033 - Brevard, Orange, Osceola, Seminole

  • H5434-034 - Polk, Hillsborough

  • H5434-035 - Hernando, Pasco

  • H5434-036 - Lake, Sumter, Marion

  • H5434-039 - Alachua, Citrus

Important 2023 benefit information, last updated 2/14/2023

BlueMedicare Value (PPO)

2023 Plan Documents

View and download important forms and documents about your BlueMedicare plan from Florida Blue.

2023 Annual Notice of Changes

Plan Document Last Updated
2023 Annual Notice of Changes - Pinellas last updated 9/19/2022
2023 Annual Notice of Changes - Highlands, Manatee, Sarasota last updated 9/19/2022
2023 Annual Notice of Changes - Bay, Escambia, Leon, Okaloosa, Santa Rosa and Walton last updated 9/19/2022
2023 Annual Notice of Changes - Broward, Indian River, Martin, Palm Beach, St. Lucie last updated 9/19/2022
2023 Annual Notice of Changes - Charlotte, Collier, Lee last updated 9/19/2022
2023 Annual Notice of Changes - Clay, Duval, Flagler, Nassau, St. Johns, Volusia last updated 9/19/2022
2023 Annual Notice of Changes - Miami-Dade last updated 9/19/2022
2023 Annual Notice of Changes - Brevard, Orange, Osceola, Seminole last updated 9/19/2022
2023 Annual Notice of Changes - Hillsborough, Polk last updated 9/19/2022
2023 Annual Notice of Changes - Hernando, Pasco last updated 9/19/2022
2023 Annual Notice of Changes - Lake, Marion, Sumter last updated 9/19/2022
2023 Annual Notice of Changes - Alachua, Citrus last updated 9/19/2022
   

2023 Evidence of Coverage

Plan Document Last Updated
2023 Evidence of Coverage - Pinellas last updated 9/20/2022
2023 Evidence of Coverage - Highlands, Manatee, Sarasota last updated 9/20/2022
2023 Evidence of Coverage - Bay, Calhoun, Escambia, Franklin, Gadsden, Jefferson, Leon, Liberty, Okaloosa, Santa Rosa, Wakulla, Walton last updated 9/20/2022
2023 Evidence of Coverage - Broward, Indian River, Martin, Palm Beach, St. Lucie last updated 9/20/2022
2023 Evidence of Coverage - Charlotte, Collier, Lee last updated 9/20/2022
2023 Evidence of Coverage - Clay, Duval, Flagler, Nassau, St Johns, Volusia last updated 9/20/2022
2023 Evidence of Coverage - Miami-Dade last updated 9/20/2022
2023 Evidence of Coverage - Brevard, Orange, Osceola, Seminole last updated 9/20/2022
2023 Evidence of Coverage - Hillsborough, Polk last updated 9/20/2022
2023 Evidence of Coverage - Hernando, Pasco last updated 9/20/2022
2023 Evidence of Coverage - Lake, Marion, Sumter last updated 9/20/2022
2023 Evidence of Coverage - Alachua, Citrus last updated 9/20/2022
   

2023 Summary of Benefits

Plan Document Last Updated
2023 Summary of Benefits - Pinellas last updated 9/12/2022
2023 Summary of Benefits - Hernando, Pasco last updated 9/12/2022
2023 Summary of Benefits - Bay, Calhoun, Escambia, Franklin, Gadsden, Jefferson, Leon, Liberty, Okaloosa, Santa Rosa, Wakulla, Walton last updated 9/12/2022
2023 Summary of Benefits - Clay, Duval, Flagler, Nassau, St. Johns, Volusia last updated 9/12/2022
2023 Summary of Benefits - Broward, Indian River, Martin, Palm Beach, St. Lucie, Miami-Dade last updated 9/12/2022
2023 Summary of Benefits - Highlands, Manatee, Sarasota, Charlotte, Collier, Lee last updated 9/12/2022
2023 Summary of Benefits - Brevard, Orange, Osceola, Seminole last updated 9/12/2022
2023 Summary of Benefits - Hillsborough, Polk last updated 9/12/2022
2023 Summary of Benefits - Lake, Marion, Sumter last updated 9/12/2022
2023 Summary of Benefits - Alachua, Citrus last updated 9/12/2022
   

2023 Comprehensive Formulary

Plan Document Last Updated
2023 Comprehensive Formulary last updated 5/18/2023
   

2023 Enrollment Form

Plan Document Last Updated
2023 Enrollment Form last updated 8/11/2022
   

2023 Medicare Star Rating

Plan Document Last Updated
2023 Medicare Star Rating last updated 10/12/2022
   

2023 Prescription Drug Transition Policy

Plan Document Last Updated
2023 Prescription Drug Transition Policy last updated 7/1/2022
   

2023 Low-Income Subsidy - Extra Help Program

Plan Document Last Updated
2023 Low-Income Subsidy - Extra Help Program last updated 9/23/2022
   
FBM FORM NF
Disclaimers
Last Updated: 10.01.2022
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