Benefits at-a-Glance BlueMedicare Classic (HMO)
BlueMedicare Premier (HMO)
H1035-018
H1035-022
Service Area
Palm Beach
Palm Beach
How much is the monthly premium?
$0 You must continue to pay your Medicare Part B premium.
$0 You must continue to pay your Medicare Part B premium.
How much is the deductible?
This plan does not have a deductible.
This plan does not have a deductible.
Is there any limit on how much I will pay for my covered services?
$4,500 for services you receive from In-Network providers.
$3,400 for services you receive from In-Network providers.
Plan Costs & Details
Medical & Hospital Benefits Doctor’s Office Visits
$0 copay Primary Care Physician
$0 copay Primary Care Physician
$35 copay Specialist
$15 copay Specialist
Preventive Care
$0 copay
$0 copay
Inpatient Hospital Care
Days 1-8: $225 copay per day.
Days 1-8: $75 copay per day.
After the 8th day the plan pays 100% of covered expenses.
After the 8th day the plan pays 100% of covered expenses.
Outpatient Hospital
$175 copay except for Observation Services
$75 copay except for Observation Services
$90 copay for Observation Services
$100 copay for Observation Services
$150 copay in an Ambulatory Surgical Center
$40 copay in an Ambulatory Surgical Center
$175 copay in an Outpatient Hospital Facility
$75 copay for in an Outpatient Hospital Facility
$50 copay at a Convenient Care Center
$10 copay at a Convenient Care Center
$50 copay at an Urgent Care Center
$10 copay at an Urgent Care Center
Emergency Room
$90 copay
$100 copay
Ambulance
$295 copay
$300 copay
Outpatient Surgery
Urgently Needed Services
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