A non-government entity
BlueCare Plus Choice (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for BlueCare Plus Choice (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 Choice (HMO D-SNP) in 2025, please refer to our full plan details page.
BlueCare Plus Choice (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 Choice (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 Choice (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 Choice (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 Choice (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:
Sign up for BlueCare Plus Choice (HMO D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The BlueCare Plus Choice (HMO D-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs for your drugs depending on the specific tier and pharmacy you use. Once your total drug costs reach $2000, you will enter the next coverage phase. After your yearly out-of-pocket drug costs reach $2000, you will pay nothing for Medicare Part D covered drugs.
Additional Benefits
The BlueCare Plus Choice (HMO D-SNP) plan provides coverage for a variety of services with varying cost-sharing structures. Inpatient hospital stays have copays, while outpatient services, partial hospitalization, ambulance, and transportation, as well as many primary care and preventive services, have a 20% coinsurance. The plan also covers hearing, vision, and dental services, with specific limitations on the types of services covered and associated cost-sharing. Additional benefits include coverage for home infusion, dialysis, and medical equipment with coinsurance. Diagnostic and radiological services, along with home health and skilled nursing facility services, are covered with no copay. Cardiac rehabilitation and other services have coinsurance, but specific details may vary.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both requiring prior authorization. For Inpatient Hospital-Acute, the copay for a Medicare-covered stay is $2,185.00, while for Inpatient Hospital Psychiatric, the copay for a Medicare-covered stay is $2,036.00. Additional days, upgrades, and non-Medicare-covered stays for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services and observation services with a 20% coinsurance, Ambulatory Surgical Center (ASC) Services with a 20% coinsurance, and outpatient substance abuse services with a 20% coinsurance. Outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the BlueCare Plus Choice (HMO D-SNP) plan, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the BlueCare Plus Choice (HMO D-SNP) plan. Ground and air ambulance services have a 20% coinsurance, and transportation services to a plan-approved health-related location are covered with a maximum benefit of $280 per month, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services are covered under the BlueCare Plus Choice (HMO D-SNP) plan, with a 20% coinsurance, and no copay. Urgently Needed Services are also 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
The BlueCare Plus Choice (HMO D-SNP) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. 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, individual and group sessions for mental health and psychiatric services, routine foot care, and opioid treatment program services also have a 20% coinsurance. Routine chiropractic care is limited to 20 visits per year.
Preventive Services See details
The BlueCare Plus Choice (HMO D-SNP) plan covers preventive services, but does not cover annual physical exams, in-home safety assessments, personal emergency response systems, medical nutrition therapy, 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 benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, home and bathroom safety devices and modifications, or counseling services. Kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit have a 20% coinsurance.
Hearing Services See details
Hearing Services include routine hearing exams with a coinsurance of at most 20% with one visit per year, and fitting/evaluation for hearing aids. Prescription hearing aids (all types) are covered, with two aids covered every three years, but prescription hearing aids for the inner, outer, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include coverage for eye exams and eyewear. Eye exams have a 20% coinsurance, and routine eye exams are covered once per year. Eyewear, including contact lenses, is covered with a 20% coinsurance up to a combined maximum of $500 per year; however, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The BlueCare Plus Choice (HMO D-SNP) plan covers some Dental Services, while Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, Oral and Maxillofacial Surgery, and Orthodontics are not covered. The plan does cover Medicare Dental Services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%, while the coinsurance for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the BlueCare Plus Choice (HMO D-SNP) plan. You will pay a 20% coinsurance.
Medical Equipment See details
Medical Equipment is covered, with a 20% coinsurance. Durable Medical Equipment has a 20% coinsurance, but equipment for use outside the home is not covered. Prosthetics and medical supplies are covered with a 20% coinsurance, while diabetic equipment is covered with a 20% coinsurance for diabetic supplies and therapeutic shoes/inserts.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the BlueCare Plus Choice (HMO D-SNP) plan. Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have no copay, and a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the BlueCare Plus Choice (HMO D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by BlueCare Plus Choice (HMO D-SNP), but the plan does not cover any of the sub-services including 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. There is a coinsurance for these services, but the exact amount is not specified.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the BlueCare Plus Choice (HMO D-SNP) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
Other Services with the BlueCare Plus Choice (HMO D-SNP) plan do not cover 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, or Self-Directed Personal Assistance Services, and offers a meal benefit for chronic illnesses.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved