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Secure Blue Courage (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Secure Blue Courage (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Secure Blue Courage (PPO) in 2025, please refer to our full plan details page.
Secure Blue Courage (PPO) is a PPO plan offered by Gemstone Holdings, Inc. available for enrollment in 2025 to people living in Select Counties in Idaho. This plan received an overall rating of 2.5 out of 5 stars in 2025.
It's important to know that Secure Blue Courage (PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Secure Blue Courage (PPO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Secure Blue Courage (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $50.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $7000.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $7000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
Prescription drugs are not covered by Secure Blue Courage (PPO).
Additional Benefits
The Secure Blue Courage (PPO) plan offers a range of benefits with varying costs. You'll pay a $350 copay for inpatient hospital stays for the first five days, but no copay for days 6-90. Outpatient services have copays ranging from $0 to $325, while primary care visits and many mental health services have no copay. The plan also covers emergency services with a $100 copay, and hearing exams with a $40 copay. Vision benefits include eye exams and eyewear with no copay, and prescription hearing aids with copays between $499 and $999. Dental services, home infusion, dialysis, and medical equipment have coinsurance costs, while other services like OTC items and some preventive services are covered with no copay.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both of which require prior authorization. For Inpatient Hospital-Acute, there is a $350 copay for days 1-5, and no copay for days 6-90. For Inpatient Hospital Psychiatric, there is a $350 copay for days 1-5, and no copay for days 6-90. Additional Days for Inpatient Hospital-Acute are covered, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered. Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are also not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with copays ranging from $0 to $325, observation services with a $325 copay, ambulatory surgical center services with no copay, and outpatient substance abuse services with no copay for both individual and group sessions. Additionally, outpatient blood services are covered, including services not usually covered by Medicare plans.
Partial Hospitalization See details
Partial Hospitalization is covered by the Secure Blue Courage (PPO) plan, with a $40 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Secure Blue Courage (PPO). Ground and air ambulance services have a $275 copay, and there is no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency services, urgently needed services, and worldwide emergency services are covered. Emergency services have a $100 copay, and urgently needed services have a $40 copay; worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation have no copay.
Primary Care See details
The Secure Blue Courage (PPO) plan covers primary care physician services with no copay, and chiropractic services with a $20 copay. Occupational therapy services have a $40 copay, and physician specialist services have a $40 copay. Mental health and psychiatric services have no copay for individual and group sessions. Other healthcare professionals have a copay between $0 and $40. Physical therapy and speech-language pathology services have a $40 copay. Additional telehealth benefits have a copay between $0 and $40. Opioid treatment program services have no copay.
Preventive Services See details
Preventive Services, including Medicare-covered services and annual physical exams, are covered by the Secure Blue Courage (PPO) plan. Some additional preventive services have a copay, and the Fitness Benefit has no copay. In-Home Safety Assessments, Personal Emergency Response Systems (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
Hearing Services include Hearing Exams and Prescription Hearing Aids. Hearing Exams have a $40 copay, and Routine Hearing Exams and Fitting/Evaluation for Hearing Aids are covered. Prescription Hearing Aids (all types) have a copay between $499 and $999, while Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered. OTC Hearing Aids are not covered.
Vision Services See details
Vision services include eye exams, eyewear, and upgrades. Eye exams have no copay for routine exams, which are limited to one per year, but other eye exams have a $20 copay. Eyewear has no copay, and contact lenses have a copay between $0 and $35. Eyeglasses (lenses and frames) have a $35 copay, with a maximum benefit of $50 every two years. Eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
The Secure Blue Courage (PPO) plan covers Medicare Dental Services with 10% coinsurance. Other Dental Services have no copay, and include Dental X-Rays, Other Diagnostic Dental Services, Fluoride Treatment, and Other Preventive Dental Services, with a maximum benefit of $500 per year. The plan also covers Oral Exams, Dental X-Rays, Prophylaxis (Cleaning), Fluoride Treatment, Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics, removable, Implant Services, Prosthodontics, fixed, and Oral and Maxillofacial Surgery, but does not cover Maxillofacial Prosthetics and Orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Secure Blue Courage (PPO) plan, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for this benefit.
Dialysis Services See details
Dialysis Services are covered under the Secure Blue Courage (PPO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. DME has a 20% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including Diagnostic Procedures/Tests and Therapeutic Radiological Services, are covered with a coinsurance of at most 10%, and Diagnostic Radiological Services have a maximum copay of $200.00, while Lab Services have no copay and Outpatient X-Ray Services have a copay of $15.00.
Home Health Services See details
Home Health Services are covered by the Secure Blue Courage (PPO) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the specific services of Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are not covered. There is a copay for some Cardiac and Pulmonary Rehabilitation Services, but the exact amount is not specified.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Secure Blue Courage (PPO) plan, but require prior authorization. For days 1-20 and 56-100, there is no copay, but for days 21-55, the copay is $203. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes Over-the-Counter (OTC) Items with a maximum plan benefit of $60.00 every three months, and nicotine replacement therapy (NRT) and Naloxone coverage as a Part C OTC benefit. Acupuncture, Meal Benefit, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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