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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 2026, 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 3.5 out of 5 stars in 2026.
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 $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 Choice (HMO D-SNP) prescription drug plan has an annual drug deductible of $615. For Tier 1 preferred generic drugs, members pay no copay for one-month, two-month, or three-month supplies filled at standard pharmacies or through standard mail order. For other drug tiers, coverage is subject to a flat 25% coinsurance at standard pharmacies and standard mail order. This 25% coinsurance applies to Tier 2 preferred brand drugs and Tier 3 non-preferred drugs for one-month, two-month, and three-month supplies, as well as Tier 4 specialty drugs for a one-month supply.
Additional Benefits
BlueCare Plus Choice (HMO D-SNP) offers a cost-effective structure for many outpatient, specialist, and diagnostic services, featuring no copays and a standard 20% coinsurance. For inpatient care, members pay a $2,034 copay per hospital stay with no coinsurance, while skilled nursing facility stays charge no copay for the first 20 days. Essential services such as home health care, select preventive services, and chronic illness meals are fully covered with no copays and no coinsurance. The plan also provides valuable extras like unlimited public transit rides to approved health locations and up to $400 annually for eyewear with no copays.
Inpatient Hospital See details
BlueCare Plus Choice (HMO D-SNP) offers partial coverage for inpatient acute and psychiatric hospital stays, which require prior authorization and carry a $2,034 copayment per Medicare-covered stay and no coinsurance. Additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by BlueCare Plus Choice (HMO D-SNP) with no copayments, though a 20% coinsurance applies to outpatient hospital, ambulatory surgical center, outpatient substance abuse, and outpatient blood services. Prior authorization is also required for outpatient hospital, ambulatory surgical center, and outpatient substance abuse services.
Partial Hospitalization See details
BlueCare Plus Choice (HMO D-SNP) covers partial hospitalization benefits with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Ambulance and Transportation Services See details
BlueCare Plus Choice (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services are partially covered, offering unlimited one-way bus or subway rides to plan-approved health-related locations with no copay and no coinsurance, but transportation to any health-related location is not covered.
Emergency Services See details
BlueCare Plus Choice (HMO D-SNP) covers emergency and urgently needed services with a 20% coinsurance and no copay, which do not apply to the plan-level deductible. The emergency coinsurance is waived if you are admitted to the hospital within 24 hours, though worldwide emergency, urgent, and transportation services are not covered.
Primary Care See details
BlueCare Plus Choice (HMO D-SNP) covers primary care, specialist, therapy, and telehealth services with no copay and a 20% coinsurance, though prior authorization is required for some services. Chiropractic benefits are partially covered, providing up to 20 routine visits per year with no copay and a 20% coinsurance, while other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by BlueCare Plus Choice (HMO D-SNP), featuring Medicare-covered zero-dollar services, memory fitness, and remote access technologies with no copay and no coinsurance. Kidney disease education, glaucoma screenings, diabetes self-management training, digital rectal exams, and post-welcome visit EKGs are covered with no copay and a 20% coinsurance. Sub-services not covered include annual physical exams, health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, readmission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation counseling, enhanced disease management, telemonitoring, home safety modifications, and counseling.
Hearing Services See details
BlueCare Plus Choice (HMO D-SNP) covers hearing exams with no copay, though routine exams require a 20% coinsurance and have no deductible. Prescription hearing aids are partially covered with no copay or coinsurance for up to two devices every three years, but inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
BlueCare Plus Choice (HMO D-SNP) provides partially covered vision services with no copays, featuring a 20% coinsurance for annual routine eye exams and contact lenses. Covered eyewear, including contact lenses and complete eyeglasses, has a combined maximum benefit of $400 per year, though other eye exams, individual frames, individual lenses, and upgrades are not covered.
Dental Services See details
BlueCare Plus Choice (HMO D-SNP) partially covers dental services, providing Medicare-covered dental care with no copay and a 20% coinsurance, subject to prior authorization. However, other dental services—including routine exams, cleanings, x-rays, restorative care, endodontics, periodontics, prosthodontics, and orthodontics—are not covered.
Home Infusion bundled Services See details
BlueCare Plus Choice (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have no copay and coinsurance ranging from no coinsurance to 20%, while Medicare Part B insulin has a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
BlueCare Plus Choice (HMO D-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered by BlueCare Plus Choice (HMO D-SNP) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic equipment. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by BlueCare Plus Choice (HMO D-SNP) with no copay and a 20% coinsurance, subject to prior authorization. This coverage includes outpatient diagnostic tests, lab services, diagnostic and therapeutic radiological services, and outpatient X-rays.
Home Health Services See details
BlueCare Plus Choice (HMO D-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive these benefits.
Cardiac Rehabilitation Services See details
BlueCare Plus Choice (HMO D-SNP) offers cardiac rehabilitation benefits where some services are covered with no copay and no coinsurance, subject to prior authorization. However, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered and instead carry a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
BlueCare Plus Choice (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services under BlueCare Plus Choice (HMO D-SNP) are partially covered, offering over-the-counter (OTC) items and chronic illness meal benefits with no copays and no coinsurance. However, acupuncture, naloxone, and certain standard OTC drugs are not covered.
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