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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 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
Earn reward dollars when you complete certain preventive screenings and health activities between January 1 and December 31
Low or no copay to see a primary care doctor
SilverSneakers® Fitness program2
Comprehensive network of providers
Personalized service and expert guidance
2SilverSneakers is a registered trademark of Tivity Health, Inc. © 2024 Tivity Health, Inc. All rights reserved.
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, and low or no copays to see doctors and specialists. Most plans even have a $0 monthly plan premium.
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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 reward dollars when you complete certain preventive screenings and health activities between January 1 and December 31.Unredeemed rewards earned in 2024 will not carry over to 2025 and will expire if you disenroll from the plan.
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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.
• Over-the-Counter (OTC) Allowance to use towards the purchase of eligible OTC items.
• Healthy Food allowance*+ monthly allowance added to your Blue Dollars Benefits Mastercard® Prepaid Card, for use towards the purchase of healthy foods.
• Post-discharge meals delivered to your home based on your nutritional needs.
• $0 prescription copays on all Part D covered prescription costs2 for both generics and brand name for members with Low Income Subsidy (LIS) / Extra Help.*
Allowance amounts vary by plan. Any unused amounts do not rollover to the next period. Consult the Evidence of Coverage for details.Eligible allowance and rewards amounts cannot be combined. Additional limitations or restrictions may apply. Subscription-type services like Walmart+, Instacart, Shipt, and Amazon are not eligible.
+Non-DSNP Plans: This benefit is part of special supplemental benefits and not all members will qualify. See Special Supplemental Benefits for the Chronically Ill (SSBCI) in your Plan’s Evidence of Coverage for full eligibility requirements.
*Dual Eligible Special Needs (DSNP) Plans: Eligibility for the monthly healthy food allowance and $0 copays for Part D covered drugs will be determined at the time of enrollment, based on LIS also known as “Extra Help”. Unused monthly food allowance does not roll over to the next month.
The Benefits Mastercard® Prepaid Card, is issued by The Bancorp Bank, N.A., Member FDIC, pursuant to license by Mastercard® International Incorporated. Mastercard® and the circles design are registered trademarks of Mastercard® International Incorporated. Card can be used for eligible expenses wherever Mastercard® is accepted. Valid only in the U.S. No cash access.
2Monthly plan premium is $0 for individuals with Medicaid, QMB, or SLMB. Individuals with QI or QWDI qualify for the plan and may have a premium up to $37.70. Sponsored by Florida Blue Medicare, Inc., d/b/a Florida Blue Medicare, and the State of Florida, Agency for Health Care Administration.
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.
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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 prescription 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 2024 Medicare Advantage plan benefits and features
| HMO | HMO DSNP | PPO | |
|---|---|---|---|
|
Monthly plan premiums |
$0 |
$0 to $37.70 |
in select plans |
|
Medical deductible |
(not available) |
(not available) |
in select plans |
|
Limited out-of-pocket costs for care each year |
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|
|
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Hospital, ER & urgent care coverage |
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|
|
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Preventive care |
|
|
|
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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 |
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Skilled nursing facility & home health agency coverage |
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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 |
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|
|
|
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) |
|
Healthy Food Allowance*+ |
in select plans |
|
(not available) |
|
Fitness benefit – SilverSneakers®2 |
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Member Rewards program |
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Online member portal |
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1Available to HMO D-SNP plan members following a hospital discharge.
2SilverSneakers is a registered trademark of Tivity Health, Inc. © 2024 Tivity Health, Inc. All rights reserved.
+Non-DSNP Plans: This benefit is part of special supplemental benefits and not all members will qualify. See Special Supplemental Benefits for the Chronically Ill (SSBCI) in your Plan’s Evidence of Coverage for full eligibility requirements.
*Dual Eligible Special Needs (DSNP) Plans: Eligibility for the monthly healthy food allowance and $0 copays for Part D covered drugs will be determined at the time of enrollment, based on LIS also known as “Extra Help”. Unused monthly food allowance does not roll over to the next month.
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