Medicare Advantage Plans

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Medicare Advantage (Part C) PPO Plans and Highest-Rated HMO Plans

5-Star Commitment to Quality

To rate healthcare and Rx drug plans, Medicare uses a 5-star quality system, with five stars being the highest rating possible. Florida Blue Medicare HMO plans have received a 5-star rating two years in a row – and that means quality.

Florida Blue Medicare has Medicare Advantage plans with a complete approach to your health.

  • Plans with $0 monthly premiums
  • All the benefits of Original Medicare (Parts A and B)
  • Usually includes Part D prescription drug coverage
  • Extra dental, hearing and vision benefits at no additional cost
  • Low or no copay to see a primary care doctor
  • SilverSneakers® Fitness program
  • Comprehensive network of providers
  • Personalized service and expert guidance

Choosing the Right Medicare Advantage Plan for Your Needs

You have options when it comes to Medicare Part C plans. Our Medicare Advantage (MA) plans can give you prescription drug coverage and extra benefits, like transportation services to doctor appointments and discount and reward programs. Many plans even have a $0 monthly plan premium.

Florida Blue Medicare 5-star HMO Plans

Looking for a plan with Medicare’s highest rating that saves you money? If you prefer having one doctor to coordinate your care with specialists and other healthcare providers, one of our Medicare Advantage HMO plans could be a great choice for you.

  • You choose a trusted primary care physician (PCP) to coordinate your medical needs.
  • With most plans, you must use in-network doctors, specialists or hospitals, with a few exceptions, like medical emergencies.
  • Our HMO Dual Eligible Special Needs Plan (DSNP) is available to people who have both Medicare and Medicaid.
  • You can benefit from our rewards programs.

Florida Blue Medicare PPO Plans

Do you want the savings of a provider network and the flexibility to see doctors and specialists outside the network? If you do not like to wait for a primary care doctor referral to go to a specialist, one of our Medicare Advantage PPO plans may be a better fit for your unique needs.

  • Our PPO plans give you the opportunity to save with low out-of-pocket costs when you use in-network providers.
  • With these plans, you have the option to use healthcare providers out-of-network.
  • You don’t need a referral for specialist visits.
  • Taking care of your health can help earn you rewards.

What Does a Medicare Advantage Plan Cost?

Like Original Medicare, Medicare Advantage (Part C) plans share the cost of care through deductibles, co-payments (copays) and co-insurance. These costs vary by plan. Our 5-Star HMO plans offer zero dollar premiums, low out-of-pocket costs, and low prescription drug costs. While our PPO plans cost a bit more for the opportunity to go out-of-network and see specialists without a referral, they still offer low out-of-pocket costs for in-network visits.

Medicare Advantage plans also have an out-of-pocket-maximum. Once you reach the maximum, your Medicare Advantage plan pays 100% toward covered services and you don’t pay anything.

Factors that play into your Medicare Advantage plan costs:

  • Deductible - The amount you pay before Florida Blue Medicare begins to pay its share of the cost. Some MA plans have a separate drug deductible before they start to pay for your prescriptions.

  • Copay - A flat dollar amount (for example, $10) you pay each time you receive care or fill a drug.

  • Coinsurance - A percentage (for example, 10%) you pay for your care or drugs after you meet your deductible.

  • Premium - A fixed, monthly amount you pay for your MA plan coverage. Many Florida Blue Part C plans have a $0 premium.

  • Out-of-pocket maximum - The most you pay for covered health care services during your plan’s calendar year. All of your Medicare-covered expenses go toward this maximum.

Compare Medicare Advantage Plan Benefits and Features

  HMO HMO DSNP PPO
Monthly Plan Premiums 0 $0-$28.50, depending on your level of assistance Varies by plan
Medical deductible - - Varies by plan
Limited out-of-pocket costs for care each year
Hospital, ER & urgent care coverage
Preventive Care
Non-Emergency/Non-Urgent Coverage Outside of Florida - -
Dental Coverage In Select Plans
Vision, Hearing & Prescription Drug (Rx) Coverage
Rehabilitation & Mental Health coverage
Skilled Nursing Facility & Home Health coverage
Able to see specialists without a referral & not have a Primary Care Physician - -
Able to use out-of-network providers - -
Rx mail-order benefit
Over the Counter (OTC) medication allowance In Select Plans In Select Plans
Transportation benefit In Select Plans -
Meals-at-home program - -
Fitness benefit – Silver Sneakers
Member Rewards program
Florida Blue Medicare Health Management Portal

Compare Medicare Advantage Plan Benefits and Features

Monthly Plan Premiums

HMO: 0

HMO DSNP: $0-$28.50, depending on your level of assistance

PPO: Varies by plan

Medical deductible

HMO: -

HMO DSNP: -

PPO: Varies by plan

Limited out-of-pocket costs for care each year

HMO:

HMO DSNP:

PPO:

Hospital, ER & urgent care coverage

HMO:

HMO DSNP:

PPO:

Preventive Care

HMO:

HMO DSNP:

PPO:

Non-Emergency/Non-Urgent Coverage Outside of Florida

HMO: -

HMO DSNP: -

PPO:

Dental Coverage

HMO:

HMO DSNP:

PPO: In Select Plans

Vision, Hearing & Prescription Drug (Rx) Coverage

HMO:

HMO DSNP:

PPO:

Rehabilitation & Mental Health coverage

HMO:

HMO DSNP:

PPO:

Skilled Nursing Facility & Home Health coverage

HMO:

HMO DSNP:

PPO:

Able to see specialists without a referral & not have a Primary Care Physician

HMO: -

HMO DSNP: -

PPO:

Able to use out-of-network providers

HMO: -

HMO DSNP: -

PPO:

Rx mail-order benefit

HMO:

HMO DSNP:

PPO:

Over the Counter (OTC) medication allowance

HMO: In Select Plans

HMO DSNP:

PPO: In Select Plans

Transportation benefit

HMO: In Select Plans

HMO DSNP:

PPO: -

Meals-at-home program

HMO: -

HMO DSNP:

PPO: -

Fitness benefit – Silver Sneakers

HMO:

HMO DSNP:

PPO:

Member Rewards program

HMO:

HMO DSNP:

PPO:

Florida Blue Medicare Health Management Portal

HMO:

HMO DSNP:

PPO:

We're always happy to help

Just a Phone Call Away

Just a Phone Call Away

Reach out to us for help or any questions you have about your Part C insurance plan needs.

Call Us at: 1-877-465-1125

Friendly Agents

Friendly Agents

Let one of our many bilingual agents guide you through your Florida Medicare Advantage plan options.

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Florida Blue Centers

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FBM PROD 002 NF 092019
Last Updated: 07.01.2020
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