October 15th December 7th
December 7th
Discover What Extra Benefit for 2022!
This is your time to make changes! Will your PCP or Specialist remain in-network? Are your PCP and other co-pays increasing? is your time to make changes! Looking for additional benefits? your PCP or Specialist remain Are youin-network? a veteran?
MEDICARE ANNUAL ENROLLMENT PERIOD October 15th December 7th
This Will Are your PCP and other co-pays Callincreasing? today for an appo Discover What Extra Benefits are availabl Looking for additional benefits? review yourforc2022! ur rent pl Are you a veteran? In P e r s o n o r V i r t u tm Call today for an aaplpa op inpto min en t teon
iew your cur rent plan options Benefits are availablerevfor 2022! Steven Smit Discover What Extra Benefits are Savailable teLicensed ven Smith Insurance Pr Call today for an appointment to for 2022! 520-213-9900 TTY:711 520-213-9900 review your currentCplan Options! all today for an appointmesesinsadvocates@out nt to In-person or Virtual appointments available Discover What Extra Benefits are available review your cur rent plan options!
This isDiscover your time to make changes! What Extra Will your PCP or Specialist remain in-network? Are your PCP and other co-pays increasing? Looking for additional benefits? Are you a veteran?
In-Person or Vir tual appointments available
Licensed Insurance Professional
sesinsadvocates@outlook.com www.medicare4tucson.com
for 2022!
In-Per son or Vir tual appointments availawww.medicare4tucso ble
HMOs for Medicare Coverage Call today for an appointmen t to Which Assume Responsibility Steven Smith review your cur rent plan options! Licensed Insurance Professional In-Person or Vir tual appointments availCOMPANY able
Steven Smith
Licensed Insurance Professional Premium or
520-213-9900 TTY:711 Subscription Charges sesinsadvocates@outlook.com
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NOVEMBER 2021
$0 monthly premium
BlueJourney Local PPO (LPPO)
OR Pima County) 520-213-9900(Maricopa TTY:711
sesinsadvocates@outlook.com $59 monthly premium www.medicare4tucson.com
NONE
NONE
Pre-existing Health Conditions
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Costs on Entry to Hospital
$175 per day, Days 1-7 in plan hospital (medical or mental health). Same cost share applies with prior authorization at non-plan hospital.
In Network: $260 per day, Days 1-7 plan hospital (medical or mental health). Out-of- Network: 40% coinsurance at a non-plan hospital.
Maximum Period of Coverage for Any One Benefit
364 days in a calendar year
364 days in a calendar year
Skilled Nursing Facility
$0 copay per day, Days 1-20. $188 copay per day, Days 21-40. $0 copay per day, Days 41-100 in plan skilled nursing facility (SNF). Same cost share applies with prior authorization at non-plan skilled nursing facility. No prior hospitalization required.
In Network: $0 copay per day Days 1-20, $188 copay per day Days 21-40 in plan skilled nursing facility (SNF). Out-of-Network: 40% coinsurance. No prior hospitalization required.
Medical Coverage for Part B
Covered in full after applicable copayments/coinsurance
Covered in full after applicable copayments/coinsurance
Outpatient Care
In Network - $0 Primary Care copay, $40 Specialist copay. $40 Urgent Care, $40 Physical/Speech/Occupational therapy, $0 lab copay, $0 most xrays, $225 ASC.
Physician care for hospital or office services, surgery, anesthesia, X-ray, laboratory, injections, splints, casts, dressings, physical and speech therapy, radiology, ambulance, prosthetics, etc.
$0 Primary Care copay, $30 Specialist copay, $30 Urgent Care, $10 copay Physical /Speech /Occupational therapy $0 lab copay, $0 most xrays, $175 ASC. Medicare coverage limits apply.
Outpatient Prescription Drugs
T1 - Preferred Generic $0; T2 - Generic $7 Extended day supply for T1/T2 provides 100 days for One copay; T3 - Preferred Brand $47; T4 - Non-Preferred Brand $100; T5 - Specialty 33%. Network pharmacies nationwide.
T1 - Preferred Generic $0; T2 - Generic $9 Extended day supply for T1/T2 provides 100 days for One copay; T3 - Preferred Brand $47; T4 - Non-Preferred Brand $100; T5 - Specialty 33%. Network pharmacies nationwide.
Renewability of Contract
Renewable annually
Renewable annually
Travel Restrictions Out of Area
Coverage throughout the United States and its territories for emergency and urgently needed care only
In Network copay and coinsurance apply when using travel benefit in select states with participating providers.
Major Options Available from Company
Silver & Fit, Over-the-Counter allowance, Telehealth, No charge upgrade to rechargeable Hearing aids, Eyewear allowance, 20 visits for Complementary medicine (chiro/acupuncture/therapeutic massage) using preferred network providers, Dental cleaning/exam/xray. Coverage limitations apply.
Silver & Fit, Over-the-Counter allowance, Telehealth, No charge upgrade to rechargeable hearing aids, Eyewear allowance, 20 visits for Complementary medicine (chiro/acupuncture/therapeutic massage) using preferred network providers, Dental cleaning/exam/xray. Preferred network providers. Coverage limitations apply.
A.M. Best Rating
Medicare STAR ratings released in October
Medicare STAR ratings released in October
For More Information
For more information about all of Blue Cross Blue Shield of Arizona Medicare Advantage plans or to register for a seminar please call 1-888-273-4093, TTY:711. Daily 8:00 a.m. - 8:00 p.m. Oct 1 - Mar 31. Mon-Fri 8:00 a.m. - 8:00p.m. April 1 - Sept 30.
For more information about all of Blue Cross Blue Shield of Arizona Medicare Advantage plans or to register for a seminar please call 1-888-273-4093, TTY:711. Daily 8:00 a.m. - 8:00 p.m. Oct 1 - Mar 31. Mon-Fri 8:00 a.m. - 8:00p.m. April 1 - Sept 30.
ACCREDITED BUSINESS ®
(Maricopa OR Pima County)
Registration or Policy Fee
www.medicare4tucson.com
Get your copy today!
BluePathway Plan 2 (HMO)
Out-of-Network: $40 Primary Care copay, $80 Specialist copay. 40% coinsurance for most other covered services when out of network. Medicare coverage limits apply.
www.LovinLife.com
