BlueMedicare Independence (HMO) 2025 Plan Details for Crawford County, Arkansas Residents
BlueMedicare Independence (HMO) 2025 Plan Details for Crawford County, Arkansas Residents
Choosing the right Medicare Advantage plan in Crawford County is crucial for your healthcare needs in 2025. With BlueMedicare Independence (HMO) as one of the options, you can compare it side-by-side with other available plans to find the best fit. Whether you prefer enrolling online or seeking advice from a licensed agent, we’ve made the process simple and straightforward.
BlueMedicare Independence Overview
Plan ID H6158-003-0 Overview | |
---|---|
Health Plan ID: | H6158-003-0 |
Medicare Advantage Plan Type: | Local HMO |
Plan Year: | 2024 |
Monthly Premium: | $23.40 Plus your Medicare Part B premium. |
Health Plan Deductible: | $0.00 |
Annual Out-of-Pocket Maximum: | $4,000 |
Part B Give Back: | $0.00/mo |
Part D Drug Plan Benefit: | Basic, $545.00 deductible |
Part D Gap Coverage: | No |
Supplemental Benefits: | Vision, Hearing |
Availability: | Crawford County, AR |
Insured By: | Arkansas Blue Medicare |
Why Consider BlueMedicare Independence?
BlueMedicare Independence is a Medicare Advantage Prescription Drug (MAPD) Health Maintenance Organization (HMO) plan that delivers comprehensive healthcare benefits. With a monthly premium of $23.40, it covers the core services of Medicare Part A and Part B, along with additional benefits like prescription drug coverage. The annual Part D deductible is $545.00. As an HMO plan, you’ll generally need to use providers within the plan’s network, except in emergencies.
A key benefit of BlueMedicare Independence is the financial protection it offers, with an annual maximum out-of-pocket (MOOP) limit of $4,000. After reaching this limit, the plan covers 100% of your in-network healthcare costs for the rest of the year. This makes BlueMedicare Independence a dependable option for those seeking a combination of medical and prescription drug coverage with predictable out-of-pocket expenses.
We're Here to Help You Enroll |
---|
Cost-Sharing Overview
BlueMedicare Independence has cost-sharing, meaning you'll have out-of-pocket costs when using approved healthcare services. The table below details the most common in-network out-of-pocket expenses for plan H6158-003-0.
Service | Enrollee Cost |
---|---|
Doctor's Office Visit (In-Network) | |
Primary: | $0 Copay |
Specialist: | $25 Copay |
Wellness & Preventive Programs: | None |
Preventive care: | $0 Copay |
Foot Care (In-Network) | |
Foot Exams and Treatments (Medicare-covered): | $25 Copay |
Routine Foot Care: | $25 Copay |
Chiropractic Treatment (In-Network) | |
Medicare-covered chiropractic: | $20 Copay |
Routine chiropractic: | Not Covered |
Emergency and Urgent Care | |
Emergency room care: | $120 Copay |
Urgent care: | $30 Copay |
Ground ambulance: | $325 Copay |
Inpatient hospital care: | $300.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
Outpatient hospital care: | $250 Copay |
Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $203.00 per day for days 21 and beyond |
Optional supplemental benefits: | |
Mental Health Services (In-Network) | |
Outpatient individual therapy: | $35 Copay |
Outpatient group therapy: | $35 Copay |
Inpatient psychiatric hospital care: | $300.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
Outpatient group therapy: | $35 Copay |
Outpatient individual therapy: | $0 |
Rehabilitation Services (In-Network) | |
Physical therapy and speech and language therapy: | $40 Copay Prior Authorization Required |
Occupational therapy: | $35 Copay Prior Authorization Required |
Medical Equipment and Supplies (In-Network) | |
Diabetes supplies: | $0 Copay Prior Authorization Required |
Durable medical equipment: | 20% Coinsurance Prior Authorization Required |
Prosthetics: | 20% Coinsurance |
Diagnostics, Lab Services, and Imaging (In-Network) | |
Diagnostic radiology services: | $275 Copay Prior Authorization Required |
Lab services: | 20% Coinsurance Prior Authorization Required |
Outpatient x-rays: | $0 Copay Prior Authorization Required |
Diagnostic tests and procedures: | 20% Coinsurance Prior Authorization Required |
Medicare Part B Drugs (In-Network) | |
Chemotherapy: | 20% Coinsurance |
Other Part B drugs (Medicare-covered) | 20% Coinsurance |
Most preventive services are covered 100% by BlueMedicare Independence as a Part B benefit.
Supplemental Benefits
Here’s an overview of the additional benefits that Arkansas Blue Medicare offers with this plan:
Supplemental Healthcare Service | Member Cost |
---|---|
Preventive Dental | |
Oral exam (In-Network) | Not Covered |
Fluoride treatment (In-Network) | Not Covered |
Dental x-ray(s) (In-Network) | Not Covered |
Cleaning (In-Network) | Not Covered |
Comprehensive Dental | |
Periodontics (In-Network) | Not Covered |
Non-routine services (In-Network) | Not Covered |
Diagnostic services (In-Network) | Not Covered |
Extractions (In-Network) | Not Covered |
Endodontics (In-Network) | Not Covered |
Restorative services (In-Network) | Not Covered |
Prosthodontics, other oral/maxillofacial surgery, other services (In-Network) | Not Covered |
Hearing Aids | |
Fitting/evaluation (In-Network) | $0 Copay Limitations Apply |
Hearing aids (In-Network) | Covered Limits may apply |
Hearing exam (In-Network) | $0 Copay |
Vision | Maximum vision benefit: | $150.00 Every year |
Eyeglasses (frames and lenses) (In-Network) | $0 Copay |
Routine eye exam (In-Network) | $0 Copay |
Contact lenses (In-Network) | $0 Copay |
Additional Benefits
None specified.
Part D Prescription Drug Costs & Benefits
BlueMedicare Independence offers a basic benefit Medicare Part D plan (PDP), meaning it meets the minimum coverage requirements set by the Centers for Medicare & Medicaid Services. In contrast, enhanced benefit plans provide additional coverage beyond the basics.
Part D Plan Premium
While the prescription drug plan (Part D) premium is included in the overall plan cost, some plans may have additional costs or provide assistance through the Low-Income Subsidy (LIS) program. Also known as Extra Help, LIS is a Social Security program that assists individuals with limited income and resources in reducing or eliminating Part D expenses.
The following table outlines the prescription drug plan premium details of this plan.
Basic Part D Premium: | $23.40 |
Supplemental Part D Premium: | $0.00 |
Total Part D Premium: | $23.40 |
Part D Premium with Full LIS Assistance: | $0.00 |
If you would like more information about the Extra Help program, you can refer to the Social Security Extra Help page.
Prescription Drug Plan Deductible
The Medicare Part D annual deductible with this plan is $545.00. You must pay this amount at the pharmacy before Arkansas Blue Medicare begins paying its share.
NOTE: The deductible does not apply to one or more drug tiers in this plan (see "Prescription Drug Plan Out-of-Pocket Costs" below).
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, BlueMedicare Independence has out-of-pocket costs that you must pay when you pick up your prescriptions.
Drug Tier | Preferred | Standard |
---|---|---|
1 (Preferred Generic) | N/A | $7.00 copay (deductible does not apply) |
2 (Generic) | N/A | $20.00 copay |
3 (Preferred Brand) | N/A | $47.00 copay |
4 (Non-Preferred Drug) | N/A | $100.00 copay |
5 (Specialty Tier) | N/A | 25% |
6 (Select Care Drugs) | N/A | $0.00 copay |
How CMS Star Ratings Guide Your Choice
The Centers for Medicare & Medicaid Services (CMS) reviews and rates Medicare Advantage (Part C) and drug plans (Part D) annually, using a 5-star system to measure aspects such as member satisfaction, preventive services, and management of chronic conditions.
Higher star ratings generally indicate better plan performance, which can be a useful factor to consider when deciding on a plan that aligns with your healthcare goals and preferences.
CMS Measure | Star Rating |
---|---|
2024 Overall Rating | |
Staying Healthy: Screenings, Tests, Vaccines | |
Managing Chronic (Long Term) Conditions | |
Member Experience with Health Plan | |
Complaints and Changes in Plans Performance | |
Health Plan Customer Service | |
Drug Plan Customer Service | |
Complaints and Changes in the Drug Plan | |
Member Experience with the Drug Plan | |
Drug Safety and Accuracy of Drug Pricing |
Eligibility Requirements for BlueMedicare Independence
To enroll in BlueMedicare Independence, you must meet the following criteria:
- Be eligible for Medicare Part A and Part B.
- Reside in the plan’s service area.
- Not have End-Stage Renal Disease (ESRD), with some exceptions.
If you meet these requirements, you are eligible to enroll in BlueMedicare Independence and benefit from its comprehensive coverage options.
When Can I Enroll in BlueMedicare Independence?
To ensure you don’t miss your chance to enroll in BlueMedicare Independence, be aware of these important enrollment periods:
- Initial Enrollment Period (IEP): Your IEP offers a seven-month window around your 65th birthday to sign up for Medicare.
- Annual Enrollment Period (AEP): The AEP, occurring from October 15 to December 7 each year, allows you to enroll in or make changes to your Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31, the MA OEP provides an opportunity to switch Medicare Advantage plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Certain life changes, like moving or losing insurance coverage, may qualify you for a SEP, giving you a chance to make adjustments outside the standard periods.
Need help figuring out the right time to enroll? Call HealthCompare (our trusted enrollment partner) at 1-877-388-0596 (TTY 711) to get assistance from a licensed insurance agent.
How to Enroll in BlueMedicare Independence
Joining BlueMedicare Independence is straightforward. Here are the steps you can take:
- Online: Use our online enrollment partner's Secure Online Enrollment Form to sign up.
- By Phone: Reach out to HealthCompare (our trusted enrollment partner) at 1-877-388-0596 (TTY 711). A licensed insurance agent will help you with the enrollment process and answer any questions you might have.
- Through Medicare.gov: Enroll directly through the official Medicare website. Visit Medicare.gov, log in or create an account, and follow the steps to join BlueMedicare Independence.
- Direct Enrollment: You can also choose to enroll directly with BlueMedicare Independence. The contact information can be found below in the "Contact" section.
Make sure you enroll during the appropriate period to activate your coverage as soon as possible.
Contact Arkansas Blue Medicare
Website: | http://www.arkansasbluecross.com/medicare |
---|---|
Formulary: | http://www.arkansasbluecross.com/medicare |
Pharmacy: | Arkansas Blue Medicare Pharmacy Page |
New Members: | (888)605-0322 |
TTY Users: | 711 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, you can do so on the Social Security Administration website. For more information about the Medicare Part C program, visit the official Medicare website or call 1-800-MEDICARE.
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna Healthcare, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, UnitedHealthcare(R), and Wellcare.
This page was last updated on .