Blue Cross Medicare Advantage Comfort (PPO) 2025 Plan Details for Todd County, Minnesota Residents
Blue Cross Medicare Advantage Comfort (PPO) 2025 Plan Details for Todd County, Minnesota Residents
Navigating your Medicare Advantage options in Todd County for 2025 can be overwhelming, but we're here to help. With Blue Cross Medicare Advantage Comfort (PPO) included in your plan options, you can evaluate it alongside other plans to make an informed decision. Enroll online quickly, or consult with a licensed agent if you need assistance.
Blue Cross Medicare Advantage Comfort Overview
Plan ID H5959-016-0 Overview | |
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Health Plan ID: | H5959-016-0 |
Medicare Advantage Plan Type: | Local PPO |
Plan Year: | 2024 |
Monthly Premium: | $64.00 Plus your Medicare Part B premium. |
Health Plan Deductible: | $0.00 |
Annual Out-of-Pocket Maximum: | $3,800 |
Part B Give Back: | $0.00/mo |
Part D Drug Plan Benefit: | Enhanced, $350.00 deductible |
Part D Gap Coverage: | No |
Supplemental Benefits: | Vision, Hearing |
Availability: | Todd County, MN |
Insured By: | Blue Cross and Blue Shield of Minnesota |
Explore Blue Cross Medicare Advantage Comfort Benefits
Blue Cross Medicare Advantage Comfort is a Medicare Advantage Prescription Drug (MAPD) Preferred Provider Organization (PPO) plan that offers both flexibility and comprehensive coverage. With a monthly premium of $64.00, this plan includes all the essential benefits of Medicare Part A and Part B, plus additional services like prescription drug coverage. The annual Part D deductible is $350.00. As a PPO plan, you can visit providers both in and out of the network, although staying in-network usually means lower costs.
Blue Cross Medicare Advantage Comfort also provides financial protection with an annual maximum out-of-pocket (MOOP) limit of $3,800. After reaching this limit, the plan covers 100% of your in-network healthcare costs for the remainder of the year. This feature makes Blue Cross Medicare Advantage Comfort an excellent option for those who value both comprehensive coverage and the ability to choose their providers.
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Out-of-Pocket Costs
Blue Cross Medicare Advantage Comfort includes cost-sharing, which refers to the out-of-pocket expenses you'll incur when accessing approved healthcare services. The table below outlines the most common in-network out-of-pocket costs for plan H5959-016-0.
Service | Enrollee Cost |
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Doctor's Office Visit (In-Network) | |
Primary: | $20 Copay |
Specialist: | $45 Copay Prior Authorization Required |
Wellness & Preventive Programs: | None |
Preventive care: | $0 |
Foot Care (In-Network) | |
Foot Exams and Treatments (Medicare-covered): | $45 Copay Prior Authorization Required |
Routine Foot Care: | Not Covered |
Chiropractic Treatment (In-Network) | |
Medicare-covered chiropractic: | $20 Copay Prior Authorization Required |
Routine chiropractic: | Not Covered |
Emergency and Urgent Care | |
Emergency room care: | $90 Copay |
Urgent care: | $45 Copay |
Ground ambulance: | $250 Copay |
Inpatient hospital care: | $400.00 per stay |
Outpatient hospital care: | $275 Copay Prior Authorization Required |
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: | $45 Copay |
Outpatient group therapy: | $45 Copay |
Inpatient psychiatric hospital care: | $400.00 per stay |
Outpatient group therapy: | $45 Copay |
Outpatient individual therapy: | $0 |
Rehabilitation Services (In-Network) | |
Physical therapy and speech and language therapy: | $45 Copay Prior Authorization Required |
Occupational therapy: | $45 Copay Prior Authorization Required |
Medical Equipment and Supplies (In-Network) | |
Diabetes supplies: | $0 |
Durable medical equipment: | 20% Coinsurance Prior Authorization Required |
Prosthetics: | 20% Coinsurance |
Diagnostics, Lab Services, and Imaging (In-Network) | |
Diagnostic radiology services: | $100 Copay Prior Authorization Required |
Lab services: | $0 |
Outpatient x-rays: | $10 Copay Prior Authorization Required |
Diagnostic tests and procedures: | $30 Copay 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 Blue Cross Medicare Advantage Comfort as a Part B benefit.
Supplemental Benefits
Here’s an overview of the additional benefits that Blue Cross and Blue Shield of Minnesota offers with this plan:
Supplemental Healthcare Service | Member Cost |
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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) | Covered Limits may apply |
Hearing aids (In-Network) | Covered Limits may apply |
Hearing exam (In-Network) | Covered Limits may apply |
Vision | Maximum vision benefit: | $125.00 Every year |
Eyeglasses (frames and lenses) (In-Network) | Covered Limits may apply |
Routine eye exam (In-Network) | Covered Limits may apply |
Contact lenses (In-Network) | Covered Limits may apply |
Additional Benefits
None specified.
Part D Prescription Drug Costs & Benefits
Blue Cross Medicare Advantage Comfort includes an enhanced benefit Medicare Part D plan (PDP), which offers greater coverage than basic plans. An enhanced benefit plan has a higher actuarial value, meaning it covers a larger percentage of your healthcare costs.
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: | $13.40 |
Supplemental Part D Premium: | $19.40 |
Total Part D Premium: | $32.80 |
Part D Premium with Full LIS Assistance: | $19.40 |
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 $350.00. You must pay this amount at the pharmacy before Blue Cross and Blue Shield of Minnesota 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, Blue Cross Medicare Advantage Comfort has out-of-pocket costs that you must pay when you pick up your prescriptions.
Drug Tier | Preferred | Standard |
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1 (Preferred Generic) | N/A | $0.00 copay (deductible does not apply) |
2 (Generic) | N/A | $11.00 copay |
3 (Preferred Brand) | N/A | $47.00 copay |
4 (Non-Preferred Drug) | N/A | 42% |
5 (Specialty Tier) | N/A | 27% |
How CMS Star Ratings Guide Your Choice
Each year, the Centers for Medicare & Medicaid Services (CMS) assesses health plans (Part C) and drug plans (Part D) based on a 5-star rating system. These ratings provide an overview of the plan’s performance in areas such as preventive care, managing chronic conditions, and member experience.
Considering a plan’s star rating can be an important part of your decision-making process, as higher ratings often reflect stronger performance in key areas of healthcare and customer service.
CMS Measure | Star Rating |
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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 |
Am I Eligible for Blue Cross Medicare Advantage Comfort?
To enroll in Blue Cross Medicare Advantage Comfort, 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 Blue Cross Medicare Advantage Comfort and benefit from its comprehensive coverage options.
Enrollment Periods for Blue Cross Medicare Advantage Comfort
To ensure you don’t miss your chance to enroll in Blue Cross Medicare Advantage Comfort, 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 Blue Cross Medicare Advantage Comfort
Enrolling in Blue Cross Medicare Advantage Comfort is easy. Choose the option that works best for you:
- Online through MedicareEnrollment.com: Visit the enrollment page and complete your enrollment through their Secure Online Enrollment Form.
- By Phone: Call HealthCompare (our trusted enrollment partner) at 1-877-388-0596 (TTY 711). A licensed insurance agent can assist you with the enrollment process and provide answers to any questions.
- Through Medicare.gov: Go to Medicare.gov, log in or create an account, and follow the instructions to join Blue Cross Medicare Advantage Comfort through the official Medicare website.
- Directly with Blue Cross Medicare Advantage Comfort: You can also enroll directly with the plan. The necessary contact details are provided below in the "Contact" section.
Remember to enroll during the correct enrollment period to ensure your coverage starts on time.
Contact Blue Cross and Blue Shield of Minnesota
Website: | http://www.bluecrossmnonline.com |
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Formulary: | http://www.myprime.com |
Pharmacy: | Blue Cross and Blue Shield of Minnesota Pharmacy Page |
New Members: | (855)579-7658 |
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.
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