2023 Medicare Advantage Plan Details | |||||
---|---|---|---|---|---|
Medicare Plan Name: | BlueMedicare Preferred (PFFS) | ||||
Location: | Benton, Arkansas Click to see other locations | ||||
Plan ID: | H4213 - 017 - 0 Click to see other plans | ||||
Member Services: | |||||
— This plan information is for research purposes only. — Click here to see plans for the current plan year | |||||
Medicare Contact Information: | Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options. TTY users 1-877-486-2048 or contact your local SHIP for assistance |
||||
Email a copy of the BlueMedicare Preferred (PFFS) benefit details | |||||
— Medicare Plan Features — | |||||
Monthly Premium: | $69.00 | ||||
Annual Rx Deductible: | $505 | ||||
Annual Rx Initial Coverage Limit (ICL): | $4,660 | ||||
Health Plan Type: | PFFS | ||||
Maximum Out-of-Pocket Limit for Parts A & B (MOOP): | $0 | ||||
Additional Rx Gap Coverage? | No additional gap coverage, only the Donut Hole Discount | ||||
Total Number of Formulary Drugs: | 3,595 drugs | Browse the BlueMedicare Preferred (PFFS) Formulary | |||
This plan has 6 drug tiers. See cost-sharing for all pharmacies and tiers. | |||||
Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less. | |||||
Formulary Drug Details: | Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 |
• Preferred Pharmacy Cost-Sharing during initial coverage phase: | $15.00 | $20.00 | $47.00 | 32% | 25% |
• Number of Drugs per Tier: | 287 | 857 | 800 | 672 | 772 |
Plan Offers Mail Order? | Yes | ||||
Medicare Plan Pharmacy Numbers: | BIN: 016895 PCN: PFFSAR See BIN/PCNs for all plans | ||||
Number of Members enrolled in this plan in Benton, Arkansas: | 113 members | ||||
Number of Members enrolled in this plan in Arkansas: | 1,687 members | ||||
Number of Members enrolled in this plan in (H4213 - 017): | 1,733 members | ||||
Plan’s Summary Star Rating: | 3.5 out of 5 Stars. | ||||
• Customer Service Rating: | 5 out of 5 Stars. | ||||
• Member Experience Rating: | 3 out of 5 Stars. | ||||
• Drug Cost Accuracy Rating: | 3 out of 5 Stars. |
— Plan Health Benefits — |