Does Ascenion Parish in Louisiana Have Blue Medicare Enhanced Ppo

Medicare Advantage

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Louisiana

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Ascension Parish

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Blue Advantage

This page contains editorial content that is not endorsed or approved by Blue Cross and Blue Shield of Louisiana^[2]. This is not a solicitation of insurance.

Online enrollment by MedicareEnrollment.com^[1].

Medicare Rating:	☆ ☆ ☆ ☆ ☆
Plan ID:	H1248-001
Plan Year:	2022
Premium:	$100.00/mo
Part B Reduction:	NONE
Health Plan Deductible:	NONE
Drug Plan Benefit:	Yes
Rx Deductible:	$0.00/year
Rx Gap Coverage:	Yes
Availability:	Ascension County, LA
Policy Valid:	2022-1-1 to 2022-12-31
Insured By:	Blue Cross and Blue Shield of Louisiana

Blue Advantage is a 2022 Medicare Advantage PPO plan from Blue Cross and Blue Shield of Louisiana that's available to Medicare beneficiaries living in Ascension Parish, Louisiana.

Key Takeaways

1. It is a Preferred Provider Organization (PPO) health plan.
2. It has the same major health insurance benefits as Original Medicare Original Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage. .
3. It offers extra benefits that Medicare Part A Medicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care. and Medicare Part B Medicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services. do not cover.
4. There's a $0 copayment to see your primary care physician ( in-network Doctors, hospitals, pharmacies, and other healthcare providers that agree to health plan members' services and supplies at a set price are in-network providers. With some health plans, your care is only covered if you get... ).
5. The monthly premium is $100.00 (plus your monthly Medicare Part B premium The Medicare Part B premium is the monthly charge paid by beneficiaries for their outpatient medical care, services, and supplies. A beneficiary's premium may be uplifted by an IRMAA surcharge if their income is above... ).
6. The health plan does not have an annual deductible A deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share. .
7. The maximum out-of-pocket cost Out-of-Pocket Costs for Medicare are the remaining costs that are not covered by the beneficiary's health insurance plan. These costs can come from the beneficiary's monthly premiums, deductibles, coinsurance, and copayments. with this plan is $4,000 (in-network).
8. It includes a prescription drug plan ( Medicare Part D Medicare Part D plans are an option Medicare beneficiaries can use to get prescription drug coverage. Part D plans provide cost-sharing on covered medications in four different phases: deductible, initial coverage, coverage gap, and catastrophic. Each... ). The annual Part D deductible is $0.00.

If you qualify for Medicare benefits but don't know where to start, we have licensed Medicare insurance agents^[1] at 1-855-728-0510 (TTY 711) who can answer your questions and help enroll you in Medicare Advantage, Medicare Supplement Insurance, and Prescription Drug Part D plans.

This Blue Cross and Blue Shield of Louisiana PPO plan allows you to choose your own primary care doctor, specialists, and other healthcare providers in Ascension Parish. In most cases healthcare providers in the plan's provider network cost less.

Blue Advantage
2022 Copays in Ascension Parish, LA

Healthcare Service	Member Cost
Primary Care Doctor:	$0 co-pay
Chiropractic Services as a supplemental benefit:	None
Podiatrist Services (Medicare Covered):	None
Telehealth Services:	None
Emergency Room Care:	$90 co-pay (waived if admitted within 72 days)
Urgent Care:	$35 co-pay
Ambulance Services:	$260 co-pay
Hospital Inpatient Stay:	$170 per day for days 1 through 10 $0 per day for days 11 through 90 $0 per day for days 91 and beyond
Outpatient Lab Services:	$0 co-pay
Outpatient Diag Services:	$0-30 co-pay
Routine Eye Exams:	Covered (limited coverage, no additional premium)
Eye Glasses:	Upgrades: Yes Contact lenses: No Eyeglasses (lenses & frames): Yes Eyeglass lenses: Yes Eyeglass frames: No Limits Apply Optional coverage
Hearing Exams:	Routine Exams: Yes (limits & co-pay/insurance apply) Aid Eval/Fitting: Yes (limits & co-pay/insurance apply)
Hearing Aids:	Over the ear: Yes Outer ear: No Inner ear: No (limits & co-pay/insurance apply)

Blue Advantage
Prescription Copays in Ascension Parish, LA

Tier	Preferred	Standard
1 (Preferred Generic)	$3.00 copay	$10.00 copay
2 (Generic)	$12.00 copay	$18.00 copay
3 (Preferred Brand)	$45.00 copay	$47.00 copay
4 (Non-Preferred Drug)	$100.00 copay	$100.00 copay
5 (Specialty Tier)	33%	33%
In addition to the monthly premium and Part D deductible, Blue Advantage has copayments A copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service. (fixed dollar amount) and/or coinsurances (percentage) that you must pay when you pickup your medications. The table above shows you those costs.

Blue Advantage
CMS 5-Star Review Ratings

CMS Measure	Star Rating
2022 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	☆ ☆ ☆ ☆ ☆
In this table we show you the quality rating for this Blue Cross and Blue Shield of Louisiana plan. Each year CMS rates health plans (Part C) in five broad categories and drug plans (Part D) in four broad categories. We do not recommend joining a plan with an overall rating less than 3.0.

Monthly Premium

Blue Advantage's monthly premium in Ascension Parish is $100.00. That includes your prescription coverage, as well. Plus, you must continue to pay your monthly Medicare Part B premium. Some Medicare Advantage plans Medicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B). include a monthly Part B premium reduction, also known as the Medicare give back. This plan's Part B premium reduction is NONE.

Co-payments and/or co-insurances also apply with most healthcare services, except preventive care mandated by CMS (see H1248-001 Summary of Benefits).

Although the health plan itself does not have a deductible, the prescription drug plan does. It's $0.00 per year. That means you have first dollar coverage.

IMPORTANT: When evaluating Blue Advantage, look past the monthly premium. Identify the costs of the healthcare services you use most. Only then will you uncover the plan's value for your personal situation.

Maximum Out-of-Pocket (MOOP) Limit

Unlike Original Medicare, Medicare Advantage plans must set an annual Maximum Out-of-Pocket limit on inpatient and outpatient healthcare services. The Blue Advantage plan MOOP is $4,000 . Once you reach this amount of spending on your copayments, all of your Medicare Part A and Part B services will be covered at no additional charge for the remainder of the year.

NOTE: MOOP does not include what you spend on monthly premiums A premium is an amount that an insurance policyholder must pay for coverage. Premiums are typically paid on a monthly basis. In the federal Medicare program, there are four different types of premiums. . It also does not apply to your prescription drugs, Part D deductible, or any other extra benefits bundled in the plan.

CRITICAL: Be sure to evaluate the annual premiums and MOOP of Blue Advantage versus what you might expect to pay for a Medicare Supplement Medicare Supplements are additional insurance policies that Medicare beneficiaries can purchase to cover the gaps in their Original Medicare (Medicare Part A and Medicare Part B) health insurance coverage. in Ascension Parish. Some Medicare Supplements offer less overall financial risk than Medicare Advantage plans with a similar annual cost.

Contact Blue Cross and Blue Shield of Louisiana

For more information about this plan, and other plans on this site, call 1-855-728-0510. You may also contact the plan:

If you qualify for Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program on www.medicare.gov. To learn more about this plan, visit the Blue Cross and Blue Shield of Louisiana Medicare website.

Additional Medicare Plan Options in Ascension Parish

Are you eligible for a Ascension Parish, LA 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:

• Wellcare Dual Pinnacle (Local HMO), for Dual-Eligible beneficiaries
• Humana Gold Plus SNP-DE H1951-056 (Local HMO), for Dual-Eligible beneficiaries
• Wellcare Dual Access Medicare (Local HMO), for Dual-Eligible beneficiaries
• Healthy Blue Dual Advantage (Local HMO), for Dual-Eligible beneficiaries
• Peoples Health Secure Health (Local HMO), for Dual-Eligible beneficiaries

Not qualified for an SNP? Here are some additional plans you might consider:

• HumanaChoice H5216-202 (PPO)
• HumanaChoice H5216-064 (PPO)
• Vantage BASIC (HMO-POS)
• Wellcare Patriot No Premium (HMO)
• Vantage 100 (HMO-POS)

The Medicare Part C information on this page originates from CMS Landscape Source Files, is maintained by David Bynon, and was last updated on April 4, 2022.

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Source: https://medicarewire.com/medicare-advantage/plan/H1248-001-0-LA22005/

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