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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 2026, 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 3.5 out of 5 stars in 2026.
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 $27.70. 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 $615.00 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 $9250.00 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) Medicare plan features an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are fully covered with no copay for one-month, two-month, and three-month supplies at standard pharmacies and through standard mail order. This provides an affordable option for your everyday generic prescription needs. For other drug tiers, the plan utilizes a coinsurance model for standard pharmacies and standard mail order. Tier 2 preferred brand drugs and Tier 3 non-preferred drugs both require a 25% coinsurance for one-month, two-month, and three-month supplies. Tier 4 specialty medications also carry a 25% coinsurance, which is limited to a one-month supply.
Additional Benefits
The BlueCare Plus (HMO D-SNP) plan offers comprehensive coverage where many routine and outpatient services, including primary care, emergency care, diagnostic tests, and medical equipment, require no copay and a 20% coinsurance. Inpatient hospital stays require a copay of $2,230 per acute stay and $2,080 per psychiatric stay, but carry no coinsurance. Skilled nursing facility care is also available with no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100. For additional care, members can access preventive services, home health, and home infusion with no copay and no coinsurance. The plan also features valuable extras with no copay or coinsurance, including preventive and comprehensive dental up to a $3,000 annual limit, select hearing aids, over-the-counter items, and unlimited transit via bus or subway to plan-approved locations.
Inpatient Hospital See details
BlueCare Plus (HMO D-SNP) offers partially covered inpatient hospital services with no coinsurance, requiring a $2,230 copay per acute stay and a $2,080 copay per psychiatric stay. Prior authorization is required for these services, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
BlueCare Plus (HMO D-SNP) covers outpatient services—including outpatient hospital, observation, ambulatory surgical center, outpatient substance abuse, and blood services—with no copay and a 20% coinsurance. Prior authorization is required for most of these covered services, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
Partial hospitalization is covered by BlueCare Plus (HMO D-SNP) with no copay and a 20% coinsurance, although prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by BlueCare Plus (HMO D-SNP), with ground and air ambulance services requiring a 20% coinsurance and no copay. Transportation benefits are partially covered, providing unlimited one-way trips to plan-approved locations via bus or subway with no copay or coinsurance, but excluding transportation to other health-related locations.
Emergency Services See details
Emergency services are covered by BlueCare Plus (HMO D-SNP) with a 20% coinsurance and no copay, with the coinsurance waived if you are admitted to the hospital within 24 hours. Urgently needed services also require a 20% coinsurance and no copay, while worldwide emergency, urgent, and transportation services are not covered.
Primary Care See details
BlueCare Plus (HMO D-SNP) covers primary care, specialist, therapy, and mental health services with no copay and 20% coinsurance, though prior authorization is required for some services. Chiropractic benefits are partially covered, as routine chiropractic care is covered up to 20 visits per year but other chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by BlueCare Plus (HMO D-SNP), with Medicare-covered zero-dollar services, memory fitness, and remote access technologies requiring no copay and no coinsurance. Other covered services, including kidney disease education and glaucoma screenings, have no copay but require a 20% coinsurance, while annual physical exams, health education, and personal emergency response systems are not covered.
Hearing Services See details
BlueCare Plus (HMO D-SNP) hearing services include one routine hearing exam annually with no copay and 20% coinsurance, alongside unlimited fitting evaluations. Prescription hearing aids are partially covered with no copay and no coinsurance for up to two devices every three years, though OTC hearing aids and inner ear, outer ear, and over the ear prescription aids are not covered.
Vision Services See details
BlueCare Plus (HMO D-SNP) partially covers vision services with no copay, featuring a 20% coinsurance for routine eye exams (one per year) and contact lenses up to a $400 annual maximum. Other eye exam services, individual eyeglass lenses, individual eyeglass frames, and upgrades are not covered under this plan.
Dental Services See details
BlueCare Plus (HMO D-SNP) offers partially covered dental services with no copay and a 20% coinsurance for Medicare-covered dental, and no copay and no coinsurance for preventive and comprehensive services up to a $3,000 annual limit. Non-covered services under this plan include fluoride treatments, implants, orthodontics, removable prosthodontics, maxillofacial prosthetics, adjunctive general services, and other diagnostic or preventive dental services.
Home Infusion bundled Services See details
BlueCare Plus (HMO D-SNP) covers Home Infusion bundled Services with no copay and no coinsurance, although prior authorization and step therapy are required. Associated Medicare Part B chemotherapy, radiation, and other drugs feature no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin drugs carry a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by BlueCare Plus (HMO D-SNP) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
BlueCare Plus (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with no copay and a 20% coinsurance. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
BlueCare Plus (HMO D-SNP) covers diagnostic and radiological services, including lab work, tests, X-rays, and therapeutic radiology, with no copay and a 20% coinsurance. Prior authorization is required for all of these covered services.
Home Health Services See details
BlueCare Plus (HMO D-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under BlueCare Plus (HMO D-SNP) with no copay and require prior authorization. While some services are covered, sub-services such as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered and carry a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by BlueCare Plus (HMO D-SNP) with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and additional days beyond the standard 100-day Medicare benefit are not covered.
Other Services See details
Other services are partially covered by BlueCare Plus (HMO D-SNP), which offers over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture, Naloxone OTC products, and other additional services are not covered, and the meal benefit requires prior authorization.
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