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BlueCare Plus (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for BlueCare Plus (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on BlueCare Plus (HMO D-SNP) in 2025, please refer to our full plan details page.
BlueCare Plus (HMO D-SNP) is a HMO D-SNP plan offered by BlueCross BlueShield of Tennessee available for enrollment in 2025 to people living in Tennessee. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that BlueCare Plus (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
BlueCare Plus (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about BlueCare Plus (HMO D-SNP).
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 BlueCare Plus (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $40.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 Maximum Out-Of-Pocket cost of $9350.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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 BlueCare Plus (HMO D-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000. If you qualify for the low-income subsidy (LIS), you may have a reduced premium. Once your yearly out-of-pocket drug costs reach $2000, you pay nothing for your Part D covered drugs.
Additional Benefits
The BlueCare Plus (HMO D-SNP) plan offers a range of benefits, including inpatient hospital stays with a $2010 copay, and outpatient services with 20% coinsurance. It also covers primary care, preventive services, hearing, vision, and dental services, each with specific coinsurance amounts and limitations. This plan provides coverage for ambulance services, and transportation to health-related locations. Home infusion, dialysis, medical equipment, and diagnostic services are also covered. However, the plan does not cover certain services like cardiac rehabilitation and additional home health care.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered under the BlueCare Plus (HMO D-SNP) plan, with a copay of $2010 for a Medicare-covered stay. Additional days and non-Medicare-covered stays for both Acute and Psychiatric services are not covered.
Outpatient Services See details
Outpatient services, including outpatient hospital services and observation services, are covered with a 20% coinsurance. Ambulatory Surgical Center (ASC) Services and outpatient substance abuse services are covered with a coinsurance between 20% and 20%. Outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the BlueCare Plus (HMO D-SNP) plan, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
The BlueCare Plus (HMO D-SNP) plan covers ambulance and transportation services. Ambulance services have no copay but require a 20% coinsurance for both ground and air ambulance services. Transportation services to a plan-approved health-related location are covered for up to 150 one-way trips per year, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services are covered by BlueCare Plus (HMO D-SNP) with a 20% coinsurance, but no copay. Urgently Needed Services are covered with a 20% coinsurance and no copay. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered. Primary Care Physician Services, Chiropractic Services, Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services, and Additional Telehealth Benefits have a 20% coinsurance. Occupational Therapy Services, Mental Health Specialty Services, Psychiatric Services, and Opioid Treatment Program Services have a minimum and maximum coinsurance of 20%. Routine Foot Care has a 20% coinsurance, and is limited to 6 visits every year.
Preventive Services See details
The BlueCare Plus (HMO D-SNP) plan covers preventive services, including Medicare-covered services with no copay, and additional services like Health Education, Personal Emergency Response Systems, Fitness Benefit, Telemonitoring Services, Remote Access Technologies, and Kidney Disease Education Services. Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKGs following Welcome Visits are covered with a 20% coinsurance. Annual physical exams, In-Home Safety Assessments, Medical Nutrition Therapy, and others are not covered.
Hearing Services See details
Hearing Services includes routine hearing exams with a coinsurance of at most 20% and fitting/evaluation for hearing aids with no coinsurance. Prescription hearing aids are partially covered, but inner ear, outer ear, and over the ear hearing aids are not covered, and OTC hearing aids are also not covered.
Vision Services See details
The BlueCare Plus (HMO D-SNP) plan covers vision services including eye exams and eyewear. Eye exams have a 20% coinsurance, and routine eye exams are limited to one per year. Eyewear, including contact lenses and eyeglasses, is covered with a 20% coinsurance, and has a combined maximum of $500 per year. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The BlueCare Plus (HMO D-SNP) plan covers Medicare Dental Services with 20% coinsurance, and other dental services like oral exams, dental x-rays, and prophylaxis (cleaning). The plan does not cover fluoride treatment. Orthodontic Services has a maximum benefit coverage of $3,000 per year. The plan also covers endodontics, periodontics, prosthodontics (fixed), and oral and maxillofacial surgery. However, this plan does not cover adjunctive general services, prosthodontics (removable), maxillofacial prosthetics, implant services, or orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, 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 these services.
Dialysis Services See details
Dialysis Services are covered by the BlueCare Plus (HMO D-SNP) plan. You will pay 20% coinsurance.
Medical Equipment See details
The BlueCare Plus (HMO D-SNP) plan covers Durable Medical Equipment (DME) with a 20% coinsurance and no copay, and Prosthetics/Medical Supplies with a 20% coinsurance and no copay. Diabetic Equipment is covered with a coinsurance, and also includes Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts, each with a 20% coinsurance and no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the BlueCare Plus (HMO D-SNP) plan. Diagnostic Procedures/Tests and Lab Services have a coinsurance of at most 20%, while Diagnostic and Therapeutic Radiological Services and Outpatient X-Ray Services also have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the BlueCare Plus (HMO D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the BlueCare Plus (HMO D-SNP) plan. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the BlueCare Plus (HMO D-SNP) plan, but require prior authorization. There is no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services are not covered, including acupuncture, over-the-counter items, 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. The plan covers a meal benefit for a chronic illness.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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