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BlueMedicare Select (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for BlueMedicare Select (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on BlueMedicare Select (PPO) in 2026, please refer to our full plan details page.
BlueMedicare Select (PPO) is a PPO plan offered by Guidewell Mutual Holding Corporation available for enrollment in 2025 to people living in Select counties in S.FL/ W.FL/C.FL,N.E. FL/N.W FL. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that BlueMedicare Select (PPO) 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 Select (PPO).
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 BlueMedicare Select (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $153.70. 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 has a $1500.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
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 combined Maximum Out-Of-Pocket cost of $10100.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $10100.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 BlueMedicare Select (PPO) plan features an annual prescription drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generics, Tier 2 generics, and Tier 6 select care drugs through standard pharmacies or standard mail order services. For brand-name and specialty medications, cost sharing is based on coinsurance percentages rather than flat copays. You will pay a 20% coinsurance for Tier 3 preferred brands, a 30% coinsurance for Tier 4 non-preferred drugs, and a 25% coinsurance for Tier 5 specialty medications.
Additional Benefits
The BlueMedicare Select (PPO) plan provides comprehensive medical coverage featuring no copay for primary care doctor visits and a $0 to $60 copay for specialist visits. For hospital care, inpatient acute stays require a $350 daily copay for the first seven days and no copay thereafter, while outpatient hospital services range from no copay up to a $325 copay. Emergency room visits carry a $130 copay, which is waived if you are admitted, and urgently needed care requires a $50 copay. Routine vision, hearing exams, and preventive dental care are covered with no copay, though prescription hearing aids require a copay and eyewear is capped at $100 annually. Home health services and diabetic supplies are fully covered with no copay, whereas dialysis services require a 20% coinsurance. Skilled nursing facility stays are also covered with no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
BlueMedicare Select (PPO) partially covers inpatient hospital services with no coinsurance, though upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered. Acute stays require a $350 daily copay for days 1-7 and no copay for days 8 and beyond, while psychiatric stays require a $350 daily copay for days 1-6 and no copay for days 7-90.
Outpatient Services See details
BlueMedicare Select (PPO) covers outpatient services with no coinsurance, featuring costs ranging from no copay to a $325 copay for outpatient hospital services and a $130 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse services require a $40 copay for individual sessions and a $30 copay for group sessions.
Partial Hospitalization See details
Partial hospitalization is covered by BlueMedicare Select (PPO) with a $50 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
BlueMedicare Select (PPO) covers ambulance services with prior authorization, featuring a copay of $0 to $300 and no coinsurance for ground ambulance, and a 20% coinsurance and no copay for air ambulance. For transportation benefits, some services are covered but transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
BlueMedicare Select (PPO) covers emergency services with a $130 copay and no coinsurance (waived if admitted to the hospital within 48 hours), and urgently needed services with a $50 copay and no coinsurance. Worldwide emergency and urgent services are partially covered up to a $25,000 maximum limit with a $130 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
BlueMedicare Select (PPO) covers primary care provider services with no copay and no coinsurance, and specialist visits with a $0 to $60 copay and no coinsurance. Physical, occupational, speech, and mental health therapies have copays ranging from $0 to $40 with no coinsurance, while podiatry is not covered and some chiropractic services are covered but routine and other chiropractic services are not.
Preventive Services See details
BlueMedicare Select (PPO) offers partial coverage for preventive services, providing covered options like kidney disease education, glaucoma screenings, and a memory fitness benefit with no copay and no coinsurance. However, several sub-services are not covered, including annual physical exams, health education, in-home safety assessments, and personal emergency response systems.
Hearing Services See details
BlueMedicare Select (PPO) hearing services are partially covered, offering routine exams and fitting evaluations with no copay and no coinsurance. Up to two prescription hearing aids per year are covered with no coinsurance and a copay ranging from $350 to $1,825, but inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services are partially covered under BlueMedicare Select (PPO), with other eye exam services excluded from coverage. Routine eye exams are covered once yearly with no copay or coinsurance, and eyewear is covered with no copay or coinsurance up to a combined maximum of $100 per year.
Dental Services See details
BlueMedicare Select (PPO) provides partially covered dental services, with Medicare-covered dental requiring a $60 copay and no coinsurance, and covered preventive care, oral surgery, and removable prosthodontics having no copay and no coinsurance. Specific services such as fluoride, restorative treatments, endodontics, periodontics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled services are covered by BlueMedicare Select (PPO) with prior authorization and step therapy, featuring a 0% to 20% coinsurance for chemotherapy, radiation, and other Part B drugs. Covered Part B insulin drugs require a $35 copay and 0% to 20% coinsurance, while other Part B drugs have no copay and a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the BlueMedicare Select (PPO) plan with no copay and a 20% coinsurance.
Medical Equipment See details
BlueMedicare Select (PPO) covers medical equipment with no copay, featuring a 0% to 20% coinsurance for durable medical equipment and prosthetic devices, and a 20% coinsurance for medical supplies. Diabetic equipment, including supplies and therapeutic shoes or inserts, is covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
BlueMedicare Select (PPO) covers diagnostic and radiological services with prior authorization, offering lab services with no copay or coinsurance and diagnostic tests with no coinsurance and a $0 to $10 copay. Diagnostic radiological services require a copay starting at $0 with no coinsurance, while therapeutic radiology has a minimum 20% coinsurance and outpatient X-rays carry a $50 copay with coinsurance.
Home Health Services See details
Home health services are covered by BlueMedicare Select (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by BlueMedicare Select (PPO) with no coinsurance, though only some services are covered as standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by BlueMedicare Select (PPO) with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are not covered under the BlueMedicare Select (PPO) plan, which does not provide coverage or benefits for acupuncture, over-the-counter (OTC) items, or meals.
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