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Medicare Advantage (Part C) plans PPO & HMO
Florida Blue delivers more health solutions for every stage of life. You deserve a Medicare Advantage plan that meets your health needs, and we’re with you every step of the way. Our range of Medicare Advantage health solutions care for you and your budget.
Plans with $0 monthly premiums
All the benefits of Original Medicare (Parts A and B)
Most plans include Part D prescription drug coverage
Extra dental, hearing, and vision benefits at no additional cost
Earn up to $220 in gift cards to your favorite restaurants, retailers, or local gas stations when you complete healthy activities
Low or no copay to see a primary care doctor
SilverSneakers® Fitness program
Comprehensive network of providers
60 hours of help around the house for things like light housekeeping, grocery shopping, and meal preparation
Personalized service and expert guidance
Choosing the right Medicare Advantage plan for your needs
Florida Blue Medicare’s wide range of health solutions ensures that you can find the right Medicare Advantage plan with the right coverage, at the right cost. You have options when it comes to Medicare Advantage (Part C) plans. Many of our Medicare Advantage plans can give you vision, dental, and hearing coverage, help around the house, and low or no copays to see doctors and specialists. Most plans even have a $0 monthly plan premium.
Florida Blue Medicare HMO plans
Looking for a Medicare plan that saves you money? We’re with you. If you prefer having one doctor to coordinate your care with specialists and other health care providers, one of our Medicare Advantage HMO plans could be a great choice for you.
• You choose a trusted primary care physician to coordinate your medical needs.
• With most plans, you need to use in-network doctors, specialists, or hospitals, with a few exceptions, like medical emergencies.
• You can benefit from our rewards programs.
HMO D-SNP: Medicare & Medicaid benefits
Our HMO D-SNP plan provides Dual Eligible Special Needs coverage to people who have both Medicare and Medicaid.
These plans have extra benefits for members that qualify.
• Support services to help you schedule appointments, provide transportation, or explain your benefits
• Monthly over-the-counter allowance for everyday health care items
• Blue Dollars Food Card putting money in your pocket each month for healthy food2
• Post-discharge meals delivered to your home based on your nutritional needs
• 60 hours of help around the house including light housekeeping, grocery shopping, and meal prep
• New for 2023! $0 prescription copays on all Part D prescription costs2 for both generics and brand name for members with Low Income Subsidy (LIS) / Extra Help
2To receive the monthly food card allowance benefit and $0 prescription copays, LIS or Extra Help qualification is required.
Florida Blue Medicare PPO plans
Do you want the freedom to choose any doctor who accepts Medicare and a network of lower cost providers when you travel? 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 needs.
• Our PPO plans give you the freedom to choose any doctor who accepts Medicare
• They also give you the opportunity to save with lower out-of-pocket costs when you use in-network providers.
• With these plans, you have the option to use health care providers out-of-network.
• You don’t need a referral for specialist visits.
• Earn up to $220 in gift cards to your favorite restaurants, retailers, or local gas stations when you complete healthy activities
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 HMO plans offer $0 premiums, low out-of-pocket costs, and low prescription drug costs. While our $0 premium 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 Medicare covered services and you don’t pay anything.
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Deductible – The amount you pay before Florida Blue Medicare begins to pay its share of the cost. Some Medicare Advantage plans have a separate drug deductible before they start to pay for your prescriptions.
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Copay – A flat dollar amount (for example, $10) you pay each time you receive care or fill a prescription
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Coinsurance – A percentage (for example, 10%) you pay for your care or drugs after you meet your deductible
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Premium – A fixed, monthly amount you pay for your Medicare Advantage plan coverage. Many Florida Blue Part C plans have a $0 premium.
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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 2023 Medicare Advantage plan benefits and features
| HMO | HMO DSNP | PPO | |
|---|---|---|---|
|
Monthly plan premiums |
$0 |
$0 to $35.90 |
in select plans |
|
Medical deductible |
(not available) |
(not available) |
in select plans |
|
Limited out-of-pocket costs for care each year |
|
|
|
|
Hospital, ER & urgent care coverage |
|
|
|
|
Preventive care |
|
|
|
|
Non-emergency/non-urgent coverage outside of Florida |
(not available) |
(not available) |
|
|
Dental coverage |
|
|
in select plans |
|
Vision, hearing & prescription drug (Rx) coverage |
|
|
in select plans |
|
Mental health & substance abuse services |
|
|
|
|
Skilled nursing facility & home health agency coverage |
|
|
|
|
Able to see specialists without a referral & not have a Primary Care Physician |
(not available) |
(not available) |
|
|
Able to see providers out-of-network |
(not available) |
(not available) |
|
|
Rx mail-order benefit |
|
|
|
|
Over the counter (OTC) medication allowance |
in select plans |
|
in select plans |
|
Transportation benefit |
in select plans |
|
(not available) |
|
Post discharge meals1 |
(not available) |
|
(not available) |
|
Meals-at-home program |
in select plans |
|
(not available) |
|
Blue Dollars healthy food program2 |
(not available) |
|
(not available) |
|
Fitness benefit – SilverSneakers® |
|
|
|
|
Member Rewards program |
|
|
|
|
Online member portal |
|
|
|
1Available to HMO D-SNP plan members following a hospital discharge.
2To receive the monthly food card allowance benefit and $0 prescription copays, LIS or Extra Help qualification is required.
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