| Key features: | A Medicare-approved Cost plan offering three plan options and the SilverSneakers® Fitness Program; our lowest priced plan for medical-only coverage | A Medicare supplement plan providing guaranteed renewable benefits and coverage that moves with you (may reside anywhere in U.S.) | A Medicare-approved PPO plan that provides the convenience of both medical and prescription drug benefits in one plan | A stand-alone prescription drug plan with a Medicare contract that can be paired with a Blue Cross medical plan (or your current medical plan); select the Standard, Enhanced or Premier option |
| Monthly premium: | $29, $79 or $99
(depending on plan option) | $199 (tobacco-free)
$261 (standard)
Includes $5 premium for optional preventive care coverage | $57.30 | $43.70, $37.20 or $96.20 |
| Annual deductible: | $0 | $0 | $0 for medical, $310 for prescriptions | $310, $165 or $0 |
| Doctor’s office visit: | 20% coinsurance, $10 copay or $0 (depending on plan option)
| $0 | $25 copay (primary doctor);
$35 copay (specialist) | Not applicable |
| Emergency care (in the U.S. and worldwide): | $50 copay or $0 (depending on plan option) | $0 in the U.S.
(20% coinsurance worldwide) | $50 copay | Not applicable |
| Travel coverage: | Coverage for up to 9 months
(outside the service area and within the U.S.) | Coverage for unlimited travel
(outside the service area and within the U.S.) | Coverage for up to 6 months
(outside the service area and within the U.S.) | Coverage for unlimited travel
(within the U.S.) |
| Annual out-of-pocket maximum (for covered medical services): | $3,000 | Not applicable | In-network: $3,350 Combined in- and out-of-network: $8,350
Rx: not applicable | Not applicable |
| Prescription drug coverage: | Not included; pair with MedicareBlue Rx | Not included; pair with MedicareBlue Rx | Included with plan | Yes |
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