BlueMedicare Preferred (PFFS)

BlueMedicare Preferred (PFFS) is a PFFS plan offered by USAble Mutual Insurance Company available for enrollment in 2025 to people living in Select Counties in Arkansas. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that BlueMedicare Preferred (PFFS) 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 BlueMedicare Preferred (PFFS).

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.

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:

Drug Coverage

The BlueMedicare Preferred (PFFS) plan features a prescription drug deductible of $615.00 under its Basic Alternative drug benefit. After meeting this deductible, standard pharmacy costs during the initial coverage phase include a $12.00 copay for Tier 1 preferred generic drugs, 20% coinsurance for Tier 2 standard generics, 30% coinsurance for Tier 3 preferred brands, and 25% coinsurance for Tier 4 non-preferred drugs. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and will pay nothing for covered Medicare Part D drugs. Individuals who qualify for the low-income subsidy can also see their Part D premium reduced from $48.00 to $39.10.

Additional Benefits

The BlueMedicare Preferred (PFFS) plan offers comprehensive coverage for essential medical needs, featuring no copay for primary care telehealth visits, preventive screenings, and routine home health services. For in-person care, members can expect a $10 copay for primary care visits, a $40 copay for specialist visits, and a $390 daily copay for the first five days of inpatient hospital stays. Emergency care requires a $115 copay, while ground ambulance services are covered with a $325 copay and no coinsurance. This plan also includes valuable supplemental benefits, such as routine dental exams, cleanings, and routine eye exams with no copay or coinsurance. Hearing care features no copay for routine exams, with prescription hearing aids available for copays ranging from $699 to $999. Additionally, members receive a $25 quarterly allowance for over-the-counter items with no copay, alongside a 20% coinsurance for durable medical equipment and dialysis services.