Community Blue Medicare PPO Signature (PPO) H3916-037 is a 2022 Medicare Advantage Plan or Medicare Part-C plan by Highmark
Highmark
Highmark is a non-profit healthcare company and Integrated Delivery Network based in Pittsburgh, Pennsylvania, United States. It is a large individual not-for-profit health insurer in the United States, which operates several for-profit subsidiaries.
Full Answer
What is a community Blue PPO plan?
Mar 04, 2021 · Community Blue Medicare PPO is a Medicare Advantage Preferred-Provider Organization plan that gives you coverage for every need— health, prescription drugs, routine dental, vision, hearing, and preventive care. Community Blue Medicare PPO includes a high value network of select providers, PLUS an enhanced service model to assist in finding doctors, …
Is PPO more expensive than HMO?
Jan 01, 2021 · Community Blue Medicare PPO. Summary of Benefits. January 1, 2021 to December 31, 2021. The service area for these plans includes the following counties: Carbon, Lehigh, Monroe, Northampton and Schuylkill. To enroll in the following plans, you need to be entitled to Medicare Part A, enrolled in Medicare Part B, and live in one of the above listed …
What is community Blue Insurance?
Community Blue Medicare PPO Signature (PPO) has a monthly drug premium of $0.00 and a $0.00 drug deductible. This Highmark Inc plan offers a $0.00 Part D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits.
What is the difference between Medicare Advantage HMO and PPO?
Community Blue Medicare PPO Distinct (PPO) has a monthly drug premium of $35.00 and a $0 drug deductible. This Highmark Inc plan offers a $35.00 Part D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits.
Community Blue Medicare PPO Signature (PPO) Part-C Premium
Highmark Inc plan charges a $0.00 Part-C premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.
H3916-037 Part-D Deductible and Premium
Community Blue Medicare PPO Signature (PPO) has a monthly drug premium of $0.00 and a $0.00 drug deductible. This Highmark Inc plan offers a $0.00 Part D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits.
Highmark Inc Gap Coverage
In 2022 once you and your plan provider have spent $4430 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will be required to pay 25% for prescription drugs unless your plan offers additional coverage. This Highmark Inc plan does not offer additional coverage through the gap.
What is the premium for Community Blue Medicare PPO?
Community Blue Medicare PPO Distinct (PPO) has a monthly drug premium of $35.00 and a $0 drug deductible. This Highmark Inc plan offers a $35.00 Part D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0 this Premium covers any enhanced plan benefits offered by Highmark Inc above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $35.00. The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lower due to negative basic or supplemental premiums.
What is a community blue PPO?
Community Blue Medicare PPO Distinct (PPO) is a Local PPO. A preferred provider organization (PPO) is a Medicare plan that has created contracts with a network of "preferred" providers for you to choose from at reduced rates. You do not need to select a primary care physician and you do not need referrals to see other providers in the network.
What is LIS in Medicare?
The Low Income Subsidy (LIS) helps people with Medicare pay for prescription drugs, and lowers the costs of Medicare prescription drug coverage. Depending on your income level you may be eligible for full 75%, 50%, 25% premium assistance.
What is the gap in Highmark 2021?
Highmark Inc Gap Coverage. In 2021 once you and your plan provider have spent $4130 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will be required to pay 25% for prescription drugs unless your plan offers additional coverage.
Does Highmark offer hospice care?
With Medicare Advantage Plans you are always covered for urgently needed and emergency care. Plus you receive all of the benefits of Original Medicare from Highmark Inc except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.
Does Medicare cover lower tier drugs?
Drugs in lower tiers will usually cost less than those in higher tiers. By reviewing different Medicare Drug formularies, you can pick a Medicare Advantage plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price. Drug Tier.
Does Highmark have Medicare?
Highmark Inc works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Community Blue Medicare PPO Distinct (PPO) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Highmark Inc and not Original Medicare.
What is a community blue PPO?
Community Blue Medicare PPO Signature (PPO) H3916-035 is a 2019 Medicare Advantage or Medicare Part-C plan by Highmark Senior Health Company available to residents in Pennsylvania. This plan includes additional Medicare prescription drug (Part-D) coverage. The Community Blue Medicare PPO Signature (PPO) has a monthly premium of $13.00 and has an in-network Maximum Out-of-Pocket limit of $6,700 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $6,700 out of pocket. This can be a extremely nice safety net.
How much is Community Blue PPO premium?
And the payment is $3.20 for 75% low income subsidy $6.40 for 50% and $9.70 for 25%.
What is the monthly premium for Community Blue Medicare?
Community Blue Medicare PPO Signature (PPO) has a monthly drug premium of $12.90 and a $0.00 drug deductible. This Highmark Senior Health Company plan offers a $12.90 Part D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0.00 this Premium covers any enhanced plan benefits offered by Highmark Senior Health Company above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $12.90. The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lower due to negative basic or supplemental premiums.
How much is the MOOP for Community Blue Medicare?
The Community Blue Medicare PPO Signature plan MOOP is $7,550 . Once you reach this amount of spending on your co-payments, all of your Medicare Part A and Part B services will be covered at no additional charge.
What is a SNP in Lehigh County PA?
Are you eligible for a Lehigh County, PA Medicare Special Needs Plan (SNP)? SNPs are a special type of Medicare Advantage plan designed to help people with special needs. Here are some of the SNP plans in your area:
What is a community blue HMO?
Community Blue Medicare HMO is a Medicare Advantage Health Maintenance Organization that offers affordable plans made possible by partnerships with community hospitals. Community Blue Medicare HMO includes a high-value network of select providers, PLUS an enhanced service model to assist in finding doctors, making medical appointments, and coordinating your health information between doctors and hospitals.
Is Highmark a HMO?
Highmark Choice Company is an HMO plan with a Medicare contract.
