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Blue Cross Medicare Advantage Saver Plus (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Blue Cross Medicare Advantage Saver Plus (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Blue Cross Medicare Advantage Saver Plus (PPO) in 2025, please refer to our full plan details page.
Blue Cross Medicare Advantage Saver Plus (PPO) is a PPO plan offered by Health Care Service Corporation available for enrollment in 2025 to people living in New Mexico. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Blue Cross Medicare Advantage Saver Plus (PPO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Blue Cross Medicare Advantage Saver Plus (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 Blue Cross Medicare Advantage Saver Plus (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 $47.00. 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.
This plan has a $590.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $11100.00 (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 $11100.00 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
The Blue Cross Medicare Advantage Saver Plus (PPO) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For generic drugs, you can expect to pay a $10-$20 copay, while brand-name and non-preferred drugs have a 25% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you will pay nothing for covered drugs.
Additional Benefits
The Blue Cross Medicare Advantage Saver Plus (PPO) plan offers comprehensive coverage, including inpatient and outpatient services, with varying copays. You'll find no copay for primary care, preventive services, routine eye exams, and many dental services like oral exams and cleanings. Other services like hearing exams, vision services, and home health services are covered, with some requiring a copay or coinsurance. This plan also includes coverage for ambulance services, emergency services, and specialized services like partial hospitalization and cardiac rehabilitation, with associated copays or coinsurance. Additionally, the plan covers home infusion services, dialysis, and medical equipment with a coinsurance. However, some services like additional hours of care, upgrades, and certain types of hearing aids are not covered by the plan.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you pay a $370 copay for days 1-6, and no copay for days 7-90; for Inpatient Hospital Psychiatric, you pay a $290 copay for days 1-6, and no copay for days 7-90. Additional Days for Inpatient Hospital-Acute are covered, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered. Additional Days for Inpatient Hospital Psychiatric and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services are covered by the Blue Cross Medicare Advantage Saver Plus (PPO) plan, including outpatient hospital services with a $375 copay, observation services with a $370 copay, ambulatory surgical center services with a $300 copay, and outpatient blood services with no copay. Outpatient substance abuse services have a $75 copay for individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered by the Blue Cross Medicare Advantage Saver Plus (PPO) plan with a $55 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Blue Cross Medicare Advantage Saver Plus (PPO) plan, with prior authorization required for all ambulance services. Ground ambulance services have a $250 copay, while air ambulance services have a 20% coinsurance; however, transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage have a copay of $110, $30, and $110 respectively, with no coinsurance. Worldwide Emergency Transportation is not covered.
Primary Care See details
Primary Care services include no copay for Primary Care Physician Services. Chiropractic Services have a $15 copay, but routine care is not covered. Occupational Therapy Services have a $35 copay. Physician Specialist Services have a $45 copay. Mental Health Specialty Services, including individual and group sessions, have a $40 copay. Physical Therapy and Speech-Language Pathology Services have a $40 copay. Additional Telehealth Benefits have no copay. Opioid Treatment Program Services have a $50 copay.
Preventive Services See details
Preventive services, including annual physical exams, are covered with no copay. Other preventive services include Fitness Benefit, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay.
Hearing Services See details
The Blue Cross Medicare Advantage Saver Plus (PPO) plan covers hearing exams with a $40 copay, and routine hearing exams and fitting/evaluation for hearing aids with no copay. Prescription hearing aids (all types) are covered with a copay between $699 and $999, while inner ear, outer ear, and over the ear prescription hearing aids, as well as OTC hearing aids, are not covered.
Vision Services See details
The Blue Cross Medicare Advantage Saver Plus (PPO) plan covers vision services, including routine eye exams, with no copay, and eyewear with a $100 combined maximum benefit. Eyeglasses (lenses and frames) and upgrades are not covered, but contact lenses, eyeglass lenses, and eyeglass frames are covered with no copay.
Dental Services See details
The Blue Cross Medicare Advantage Saver Plus (PPO) plan covers dental services, including oral exams, dental x-rays, and cleanings with no copay. Additionally, restorative services and adjunctive general services have no coinsurance, while periodontics and oral and maxillofacial surgery have 20% coinsurance. Fluoride treatment, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Blue Cross Medicare Advantage Saver Plus (PPO) plan, including Medicare Part B Insulin Drugs with a $35 copay and between 0% and 20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with between 0% and 20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the Blue Cross Medicare Advantage Saver Plus (PPO) plan and require prior authorization. The coinsurance for this service is 20%.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. Durable Medical Equipment has a 20% coinsurance and requires authorization, while Medical Supplies, Medicare-covered Prosthetic Devices, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance, and Diabetic Supplies have a coinsurance between 0% and 20%.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Blue Cross Medicare Advantage Saver Plus (PPO) plan. Diagnostic Procedures/Tests have a copay between $0 and $100, and Lab Services have no copay. Diagnostic Radiological Services have a copay of up to $300, Therapeutic Radiological Services have a copay of $60, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Blue Cross Medicare Advantage Saver Plus (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 by the Blue Cross Medicare Advantage Saver Plus (PPO) plan, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. The plan requires prior authorization, and there is a copay for some services, but the specific amount is not provided.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Blue Cross Medicare Advantage Saver Plus (PPO) plan, with a prior authorization requirement. There is no copay for days 1-20 and days 50-100, but there is a $214 copay for days 21-49, and there is no coinsurance. Additional days beyond Medicare-covered SNF stays and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services are not covered under the Blue Cross Medicare Advantage Saver Plus (PPO) plan, including acupuncture, over-the-counter items, meal benefits, and many other services. No authorization or referral is required for these services.
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