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Forever Blue 770 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Forever Blue 770 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Forever Blue 770 (PPO) in 2026, please refer to our full plan details page.
Forever Blue 770 (PPO) is a PPO plan offered by Highmark Health available for enrollment in 2025 to people living in Northeastern New York. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Forever Blue 770 (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 Forever Blue 770 (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 Forever Blue 770 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $220.00. 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 $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 $10000.00 (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 $10000.00 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 Forever Blue 770 (PPO) Medicare plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at a preferred pharmacy, as well as no copay for a 3-month preferred mail order supply. Tier 2 generic drugs are also highly affordable, with copays starting at just $3 for a 1-month supply at preferred pharmacies. For higher-tier medications, your costs are based on coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 20% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance across all pharmacy and mail order options. Choosing preferred pharmacies and mail-order services is the best way to keep your out-of-pocket costs low under this plan.
Additional Benefits
The Forever Blue 770 (PPO) plan offers robust medical coverage with predictable cost-sharing, featuring no copay to a $5 copay for primary care doctor visits and a $22 copay for specialists. Inpatient hospital stays require daily copays for the first week before transitioning to no copay, while emergency room visits carry a $130 copay that is waived upon admission. Outpatient hospital services and emergency ambulance transportation are also covered with fixed copays and no coinsurance. For routine wellness, this plan provides preventive services, home health care, and routine dental exams with no copay and no coinsurance. Members also receive a $200 annual eyewear allowance with no copay, prescription hearing aid coverage with copays between $499 and $799, and a $40 quarterly over-the-counter allowance. Additionally, skilled nursing facility stays feature no copay for the first 20 days, ensuring affordable recovery support.
Inpatient Hospital See details
Forever Blue 770 (PPO) partially covers inpatient hospital services with no coinsurance, requiring a daily copay of $205 for days 1 to 7 of acute stays and $270 for days 1 to 6 of psychiatric stays, followed by no copay. While unlimited additional acute days are covered, hospital upgrades, additional psychiatric days, and non-Medicare-covered psychiatric stays are not covered.
Outpatient Services See details
Forever Blue 770 (PPO) covers outpatient hospital and observation services for a $275 copay and ambulatory surgical center services for a $175 copay, both with no coinsurance. Outpatient substance abuse sessions have a $40 copay and no coinsurance, while outpatient blood services are covered with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
Forever Blue 770 (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance.
Ambulance and Transportation Services See details
Forever Blue 770 (PPO) covers ground and air ambulance services with a $315 copay and no coinsurance, requiring prior authorization. Some transportation services are covered, but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Forever Blue 770 (PPO) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within one day. Urgently needed services require a $50 copay and no coinsurance, and worldwide emergency, urgent, and transportation services are covered with no coinsurance and copays of $130, $50, and $315 respectively.
Primary Care See details
Forever Blue 770 (PPO) primary care benefits feature no coinsurance for all covered services, with primary care physician visits ranging from no copay to a $5 copay and specialist visits requiring a $22 copay. Therapy services cost a $15 copay, mental health services cost a $40 copay, and chiropractic care is partially covered, offering routine care for a $15 copay (up to 12 visits yearly) while other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by Forever Blue 770 (PPO) with no copay and no coinsurance for covered benefits like annual physical exams, diabetes self-management, and glaucoma screenings. However, the plan does not cover health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, additional smoking cessation, telemonitoring, home safety modifications, and counseling.
Hearing Services See details
Forever Blue 770 (PPO) provides partially covered hearing services, featuring hearing exams with a $22 copay and no coinsurance, and prescription hearing aids with a $499 to $799 copay and no coinsurance. Over-the-counter (OTC) hearing aids, along with inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision Services See details
Forever Blue 770 (PPO) offers partially covered vision services, as other eye exam services are not covered. Covered eye exams carry a $0 to $22 copay (or a $25 copay for routine annual exams) and no coinsurance, while eyewear is covered with no copay, no coinsurance, and a $200 combined annual maximum limit.
Dental Services See details
Forever Blue 770 (PPO) offers partially covered dental services, featuring no copay and no coinsurance for routine exams, cleanings, and x-rays, while Medicare-covered dental services require a $22 copay and no coinsurance. Comprehensive benefits like restorative care, endodontics, periodontics, prosthodontics, and oral surgery have no copay and 0% to 50% coinsurance up to a $2,000 annual limit, though fluoride, implants, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Forever Blue 770 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other Part B drugs have no copay and no coinsurance to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Forever Blue 770 (PPO) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is covered by Forever Blue 770 (PPO) with no copays, though prior authorization is required. Durable medical equipment carries a 0% to 20% coinsurance, prosthetics and medical supplies require a 20% coinsurance, and diabetic equipment is partially covered with no coinsurance, excluding diabetic supplies and therapeutic shoes or inserts which are not covered.
Diagnostic and Radiological Services See details
Forever Blue 770 (PPO) covers diagnostic services with no coinsurance, featuring a $5 copay for lab services and a $40 copay for diagnostic procedures. Radiological services are also covered, requiring a minimum $150 copay for diagnostic radiology, a $40 copay for outpatient X-rays, and a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered under the Forever Blue 770 (PPO) plan with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Forever Blue 770 (PPO) notes that some services are covered under cardiac rehabilitation with no coinsurance, but cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered and require a $15 copay.
Skilled Nursing Facility (SNF) See details
Forever Blue 770 (PPO) 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, a daily copay of $218 for days 21 through 100, and any days beyond the standard 100-day limit are not covered.
Other Services See details
Forever Blue 770 (PPO) partially covers Other Services, offering chronic illness meal benefits and a $40 quarterly over-the-counter (OTC) allowance with no copay and no coinsurance. Acupuncture is not covered under this benefit.
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