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Special Needs Plan (SNP)




A Dual-Eligible Special Needs Plan is a Medicare Advantage plan that is offered to beneficiaries who qualify both for Medicare and Medicaid. A Medicare Advantage Plan (like an HMO) is sometimes called "Part C" or "an MA Plan," and is offered by private insurance companies approved by Medicare.

Whether you're new to Medicare or thinking about switching plans, here are some important things to consider before choosing Blue Cross Medicare Advantage Dual Care (HMO SNP)SM.

  • Be sure you are eligible for Medicaid benefits with the State of Texas.
  • You should be enrolled in a Blue Cross and Blue Shield of Texas (BCBSTX) Medicaid plan in the same county a Blue Cross Medicare Advantage Dual Care (HMO SNP) plan is offered.
  • Have a primary residence in a county Blue Cross Medicare Advantage Dual Care (HMO SNP) plan is offered. These counties include: Bastrop, Burnet, Caldwell, Hays, Lee, Williamson.
  • Depending on your level of Medicaid eligibility, you may not have any cost-sharing responsibility for Original Medicare services, including premium.
  • Review the 2018 Blue Cross Medicare Advantage Dual Care (HMO SNP) plan benefits and built-in drug coverage below.
  • 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.
NM Medicare Tables
HMO SNP
2018 Blue Cross Medicare Advantage Plans
Blue Cross Medicare Advantage Dual Care (HMO SNP)
Monthly Premium
$24.50*
In-Network
Medical Deductible
$0 or $183
Over-the-Counter Items Monthly Purchase Allowance
$50
Doctors Office Visits
0%-20% Primary Care
0%-20% of the cost Physician Specialist
Dental
Not Covered
Routine Vision
Not Covered
Outpatient Services/Surgery
0%-20% of the cost
SilverSneakers® Fitness Program**
Not Covered
Prescription Copays and Coinsurances
For Generic Drugs
(depending on your Extra Help)
$0 copay; or
$1.25 copay; or
$3.35 copay; or
15%
For All Other Drugs
(depending on your Extra Help)
$0 copay; or
$3.70 copay; or
$8.35 copay; or
15%
HMO SNP
2017 Blue Cross Medicare Advantage Plans
Blue Cross Medicare Advantage Dual Care (HMO SNP)
Monthly Premium
$26.40*
In-Network
Medical Deductible
$0
Over-the-Counter Items Monthly Purchase Allowance
$50
Doctors Office Visits
0%-20% Primary Care
0%-20% of the cost Physician Specialist
Dental
Not Covered
Routine Vision
Not Covered
Diabetic Test Strips
0%-20%
0%-20% Other Diabetic Supplies
Outpatient Services/Surgery
0%-20% of the cost
SilverSneakers® Fitness Program**
Not Covered
Prescription Copays and Coinsurances
For Generic Drugs
(depending on your Extra Help)
$0 copay; or
$1.20 copay; or
$3.70 copay
For All Other Drugs
(depending on your Extra Help)
$0 copay; or
$3.30 copay; or
$8.25 copay


*Dependent on members Medicaid eligibility.


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.

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 wellness program owned and operated by Tivity Health, Inc., an independent company.


Tivity Health and SilverSneakers® are registered trademarks or trademarks of Tivity Health, Inc., and/or its subsidiaries and/or affiliates in the USA and/or other countries.

This plan is available to anyone who has both Medical Assistance from the State and Medicare.