Blue Medicare AdvantageSM

Blue Medicare Advantage


Blue Medicare Advantage offers all of the coverage of Original Medicare — plus benefits not covered by Medicare or most Medicare Supplement insurance plans, including built-in prescription drug coverage. Think of it as an all-in-one plan.

Whether you’re new to Medicare or thinking about switching plans, here are some important things to consider before choosing Blue Medicare Advantage.

  • Be sure you are eligible for Medicare. Your primary residence must be in Bernalillo or Sandoval counties to enroll in Blue Medicare Advantage.
  • If you're eligible for Medicare and planning to retire, speak with your benefits administrator at work about your benefit options.
  • Learn how Medicare Advantage works.
  • Review the 2013 Blue Medicare Advantage plan benefits and built-in drug coverage below.
  • If you’d like to enroll in a Medicare Advantage plan, make sure you’re aware of enrollment periods. Members may enroll in the plan only during specific times of the year.

2013 Blue Medicare Advantage plan benefits:
Benefit In-Network
Monthly premium $0.00
Maximum medical out-of-pocket cost $3,000.00
Doctor office visits $5 copay for each Medicare-covered primary care doctor visit
$30 copay for each Medicare-covered specialist visit
Inpatient hospital care Days 1-4: $200 copay per day
Days 5-90: $0 copay per day
Emergency care $65.00

2013 Blue Medicare Advantage built-in drug coverage:
Prescription deductible $325 for tiers 3, 4 & 5 only
Copay Tier 1 Preferred Generic Drugs $3.00
Copay Tier 2 Non-preferred Generic Drugs $12.00
Copay Tier 3 Preferred Brand Drugs $45.00
Copay Tier 4 Non-preferred Brand Drugs $95.00
Coinsurance Tier 5 Specialty Drugs 25%
Copay gap coverage After your total yearly drug costs reach $2,970, you receive limited coverage by the plan on certain drugs. You will also receive a discount on brand name drugs and generally pay no more than 47.5% for the plan’s costs for brand drugs and 79% of the plan’s costs for generic drugs until your yearly out-of-pocket drug costs reach $4,750.

Evidence of Coverage
H3822_BEN_NM_MAPDEOC2013 Accepted 09042012

Evidence of Coverage en Espanol
H3822_BEN_NM_MAPDEOC2013SPA Accepted 09052012

Summary of Benefits
H3822_NM_BEN_BNFTSMRY13 Accepted 09152012

Summary of Benefits en Espanol
H3822_NM_BEN_BNFTSMRY13SPA Accepted 09152012

You must continue to pay your Medicare Part B premium. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1 of each year. Limitations, copayments, and restrictions may apply. Find more information here . If you would like to submit feedback directly to Medicare, please use the Medicare Complaint Form  or contact the Office of the Medicare Ombudsman .