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Blue Cross Medicare Advantage Saver Plus (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Blue Cross Medicare Advantage Saver Plus (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Blue Cross Medicare Advantage Saver Plus (PPO) in 2025, please refer to our full plan details page.
Blue Cross Medicare Advantage Saver Plus (PPO) is a PPO plan offered by Health Care Service Corporation available for enrollment in 2025 to people living in Rockford, Springfield, & St. Louis Markets. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Blue Cross Medicare Advantage Saver Plus (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 Blue Cross Medicare Advantage Saver Plus (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 Blue Cross Medicare Advantage Saver Plus (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $40.00. You must continue to pay paying your reduced 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 combined Maximum Out-Of-Pocket cost of $13300.00 (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 $13300.00 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 Blue Cross Medicare Advantage Saver Plus (PPO) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For preferred generic drugs, the copay is $10 at preferred pharmacies and $20 at standard pharmacies. For standard generic drugs, the copay is $47, regardless of the pharmacy. For preferred brand and non-preferred drugs, you will pay 25% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The Blue Cross Medicare Advantage Saver Plus (PPO) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have copays, while outpatient services have copays for services like hospital visits and substance abuse treatment. Primary care, vision, and dental services offer some coverage with copays, and hearing exams and hearing aids are covered with a copay. This plan also covers emergency services, ambulance services, and home health services, with some services like ambulance requiring a copay or coinsurance. Other benefits include coverage for prescription hearing aids, eyewear, and various therapies. However, some services like certain dental, vision, and other services are not covered by this plan.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you pay a $370 copay for days 1-6, and no copay for days 7-90, and for Inpatient Hospital Psychiatric, you pay a $290 copay for days 1-6, and no copay for days 7-90. Additional days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered under the Blue Cross Medicare Advantage Saver Plus (PPO) plan. Outpatient Hospital Services have a $375 copay, and Observation Services have a $370 copay per stay. Ambulatory Surgical Center (ASC) Services have a $325 copay, and Outpatient Blood Services have no copay. Outpatient Substance Abuse Services have a copay of $75 for both Individual and Group Sessions.
Partial Hospitalization See details
Partial Hospitalization is covered by the Blue Cross Medicare Advantage Saver Plus (PPO) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Blue Cross Medicare Advantage Saver Plus (PPO) plan. Ground Ambulance Services have a $225 copay, while Air Ambulance Services have a 20% coinsurance. Transportation Services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered by the Blue Cross Medicare Advantage Saver Plus (PPO) plan. Emergency Services and Worldwide Emergency Coverage have a $110 copay, while Urgently Needed Services have a $45 copay, and all have no coinsurance. Worldwide Emergency Transportation is not covered.
Primary Care See details
Primary Care Physician Services have no copay. Chiropractic Services have a $15 copay for routine care, but other chiropractic services are not covered. Occupational Therapy Services have a $35 copay. Physician Specialist Services have a $30 copay. Individual and Group Sessions for Mental Health and Psychiatric Services have a $40 copay. Physical Therapy and Speech-Language Pathology Services have a $40 copay. Additional Telehealth Benefits have no copay. Opioid Treatment Program Services have a $50 copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and other services like Fitness Benefit and Remote Access Technologies with no copay. The plan does not cover Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), 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 Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Home and Bathroom Safety Devices and Modifications, or Counseling Services.
Hearing Services See details
The Blue Cross Medicare Advantage Saver Plus (PPO) plan covers hearing exams with a $40 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids (all types) are covered with a copay between $699 and $999, while inner ear, outer ear, and over the ear prescription hearing aids, and OTC hearing aids are not covered.
Vision Services See details
The Blue Cross Medicare Advantage Saver Plus (PPO) plan covers vision services, including routine eye exams with no copay, and eyewear. Eyewear coverage includes contact lenses, eyeglass lenses, and eyeglass frames with no copay, but eyeglass frames are limited to one pair per year, and eyeglass lenses are limited to one pair per year. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services include coverage for Medicare dental services with a $35 copay, oral exams with no copay, dental x-rays with no copay, and prophylaxis (cleaning) with no copay. Fluoride treatment, implant services, and orthodontics are not covered. Endodontics, Prosthodontics (removable and fixed), and Maxillofacial Prosthetics are optional supplemental benefits. Restorative services are covered with no coinsurance, Adjunctive General Services have 50% coinsurance, Periodontics and Oral and Maxillofacial Surgery have 20% coinsurance.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but prior authorization is required. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0% and 20%, and for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Blue Cross Medicare Advantage Saver Plus (PPO) plan, but require prior authorization. The coinsurance for these services is 20%.
Medical Equipment See details
Medical equipment is covered, including durable medical equipment with 20% coinsurance and no copay, though durable medical equipment for use outside the home is not covered. Prosthetics and medical supplies are covered with no copay, but with coinsurance for Medicare-covered devices and supplies. Diabetic equipment is covered, with coinsurance for diabetic supplies and therapeutic shoes/inserts.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with copays applying to diagnostic procedures/tests, and radiological services. Diagnostic Procedures/Tests have a copay between $0 and $100, while Lab Services have a $5 copay. Diagnostic Radiological Services have a copay of up to $300, Therapeutic Radiological Services have a $60 copay, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Blue Cross Medicare Advantage Saver Plus (PPO) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Blue Cross Medicare Advantage Saver Plus (PPO) plan. For days 1-20 and 60-100, there is no copay, while days 21-59 have a $214 copay.
Other Services See details
Other Services are not covered under the Blue Cross Medicare Advantage Saver Plus (PPO) plan. Specifically, acupuncture, over-the-counter items, meal benefits, 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, and self-directed personal assistance services are not covered.
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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.
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