Medicare Advantage Plans




Blue Cross Medicare AdvantageSM plans can be seen as an all-in-one option and offers:

  • Original Medicare coverage
  • Additional benefits and services not covered by Original Medicare or most Medicare Supplement Insurance Plans
  • Built-in Prescription Drug coverage

Whether you're new to Medicare or making a change, here are some things to consider before choosing your plan.

  • Be sure you are eligible for Medicare.
  • If you'd like to enroll in a Medicare Advantage plan, make sure you're aware of enrollment periods. Members may enroll in the plan only during specific times of the year.
  • You must live in one of the following counties:
    • HMO plans are available in Chambers, Fort Bend, Hardin, Harris, Jefferson, Liberty, Montgomery, and Orange counties.
    • PPO plans are available in Bastrop, Burnet, Caldwell, Collin, Dallas, Denton, Fayette, Fort Bend, Harris, Hays, Lee, Montgomery, Tarrant, Travis, and Williamson counties.
  • Review the 2015 plan benefits and built-in drug coverage below.




Select a plan name below to view 2015 plan information.

TX Medicare Tables
Basic HMO Choice Plus PPO Choice Premier PPO
2015 Blue Cross Medicare Advantage Plans
Blue Cross Medicare Advantage Basic (HMO)SM
Monthly Premium
$0
In-Network
Medical Deductible
$0
Doctors Office Visits

$0 Primary Care
$35 Physician Specialist
Maximum Out-of-Pocket
$3,400
Over-the-Counter Items Monthly Purchase Allowance*
$40
Routine Vision
Covered
Diabetic Test Strips
$0
$0 Other Diabetic Supplies
Outpatient Services/Surgery
$250
Skilled Nursing Facility
$0 copay (days 1-10); $40/day copay (days 11-20); $135 copay (days 21-100)
Gap Coverage
You'll pay $0 / $5 for drugs in Tier 1 and $6 / $11 for drugs in Tier 2. Otherwise, you'll pay 45% of the cost of Brand Name drugs and 65% of the cost of Generic drugs on Tiers 3, 4 and 5.
SilverSneakers® Fitness Program
Covered
Travel Out of Service Area
Covered
Prescription Copays and Coinsurances
Preferred Pharmacy
Standard
Annual Prescription Deductible
$0
$0
Tier 1 - Preferred Generic Drugs
$0
$5
Tier 2 - Standard Generic Drugs
$6
$11
Tier 3 - Preferred Brand Drugs
$39
$44
Tier 4 - Standard Brand Drugs
$85
$95
Tier 5 - Specialty Drugs
33% of the cost
33% of the cost
Evidence of Coverage
Summary of Benefits

2015 Blue Cross Medicare Advantage Plans
Blue Cross Medicare Advantage Premier Choice Plus (PPO)SM
Monthly Premium
$35
In-Network
Out-of-Network
Medical Deductible
$0
$0
Doctors Office Visits
$20 Primary Care
40% Primary Care
$40 Physician Specialist
40% Physician Specialist
Maximum Out-of-Pocket
$3,400
$5,100
Diabetic Test Strips
0%
20% Other Diabetic Supplies
Outpatient Services/Surgery
$225
40%
Skilled Nursing Facility
$0 copay (days 1-10); $40/day copay (days 11-20); $125 copay (days 21-100)
40%
Gap Coverage
You'll pay 45% of the plan's cost for covered Brand Name Drugs and 65% of the plan's cost for Generic Drugs.
SilverSneakers® Fitness Program
Covered
Covered
Travel Out of Service Area
Covered
Covered
Prescription Copays and Coinsurances
Preferred Pharmacy
Standard
Annual Prescription Deductible
$0
$0
Tier 1 - Preferred Generic Drugs
$0
$5
Tier 2 - Standard Generic Drugs
$6
$11
Tier 3 - Preferred Brand Drugs
$39
$44
Tier 4 - Standard Brand Drugs
$85
$95
Tier 5 - Specialty Drugs
33% of the cost
33% of the cost
Annual Notice of Change
Evidence of Coverage
Summary of Benefits

2015 Blue Cross Medicare Advantage Plans
Blue Cross Medicare Advantage Choice Premier (PPO)SM
Monthly Premium
$55
In-Network
Out-of-Network
Medical Deductible
$0
$0
Doctors Office Visits
$15 Primary Care
30% Primary Care
$35 Physician Specialist
30% Physician Specialist
Maximum Out-of-Pocket
$3,400
$5,000
Dental
Preventive - Covered
Comprehensive - Not Covered
Preventive - Covered
Comprehensive - Not Covered
Routine Vision
Covered
Covered
Diabetic Test Strips
0%
20% Other Diabetic Supplies
Outpatient Services/Surgery
$225
30%
Skilled Nursing Facility
$0 copay (days 1-10); $40/day copay (days 11-20); $125 copay (days 21-100)
30%
Gap Coverage
You'll pay 45% of the plan's cost for covered Brand Name Drugs and 65% of the plan's cost for Generic Drugs.
SilverSneakers® Fitness Program
Covered
Covered
Travel Out of Service Area
Covered
Covered
Prescription Copays and Coinsurances
Preferred Pharmacy
Standard
Annual Prescription Deductible
$0
$0
Tier 1 - Preferred Generic Drugs
$0
$5
Tier 2 - Standard Generic Drugs
$6
$11
Tier 3 - Preferred Brand Drugs
$39
$44
Tier 4 - Standard Brand Drugs
$85
$95
Tier 5 - Specialty Drugs
33% of the cost
33% of the cost
Annual Notice of Change
Evidence of Coverage
Summary of Benefits






*If you are a member of a plan with an OTC benefit, you will receive a card with a prefunded monthly benefit allowance. With this allowance, you may purchase eligible OTC and health-related items (i.e. aspirin, cold & flu relief medications, and adhesive bandages) at any participating pharmacy.


Preferred brand diabetic test strips available for pick-up at all pharmacies.

Blue Cross®, 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.


SilverSneakers® is a registered mark of Healthways, Inc.


Healthways SilverSneakers® Fitness Program is a wellness program owned and operated by Healthways, Inc, an independent company.


Thank you for looking at coverage options for Blue Cross Medicare Advantage
We Can Help!

Call 1-866-273-2777 TTY/TDD 711
for personal help finding a plan.


We are open 8 a.m. – 8 p.m., local time, 7 days a week. If you are calling from February 15 through September 30, alternate technologies (for example, voicemail) will be used on weekends and holidays.

To verify your recent enrollment, check the status of a claim or ask questions about your existing coverage, please contact Customer Service at: 1-877-774-8592 TTY/TDD 711

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