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 or shop for a 2014 plan .

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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