A non-government entity
WyoBlue Advantage Enhanced PPO (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for WyoBlue Advantage Enhanced PPO (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on WyoBlue Advantage Enhanced PPO (PPO) in 2026, please refer to our full plan details page.
WyoBlue Advantage Enhanced PPO (PPO) is a PPO plan offered by Blue Cross Blue Shield of Michigan Mutual Ins. Co. available for enrollment in 2026 to people living in Wyoming. The overall rating for this plan is not yet available for 2026.
It's important to know that WyoBlue Advantage Enhanced PPO (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 WyoBlue Advantage Enhanced PPO (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 WyoBlue Advantage Enhanced PPO (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $159.00. 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 $6750.00 (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 $6750.00 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:
Sign up for WyoBlue Advantage Enhanced PPO (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The WyoBlue Advantage Enhanced PPO (PPO) prescription drug coverage features a $615 annual deductible. For Tier 1 preferred generic drugs, you will pay a low $4 copay for a 1-month supply at preferred pharmacies, and there is no copay for a 3-month supply filled through standard mail order. Tier 2 generic medications cost between $9 and $14 for a 1-month supply depending on whether you use a preferred or standard pharmacy. For brand-name and specialty medications, cost-sharing is based on coinsurance rather than flat copays. Tier 3 preferred brands require a 20% coinsurance, Tier 4 non-preferred drugs carry a 35% coinsurance, and Tier 5 specialty drugs have a 25% coinsurance for a 1-month supply. These coinsurance rates remain consistent across preferred, standard, and standard mail-order pharmacy options.
Additional Benefits
The WyoBlue Advantage Enhanced PPO (PPO) plan offers robust coverage for essential medical services with predictable out-of-pocket costs and no coinsurance for many primary benefits. You will pay no copay for primary care doctor visits, annual physicals, and preventive screenings, while specialist visits and outpatient procedures require moderate copays. Emergency care is covered with a $110 copay, and hospital stays feature a $450 daily copay for the first four days followed by no copay for additional days. This plan also includes valuable supplemental benefits like dental, vision, and hearing services, which feature no copay and no coinsurance for routine care up to specified annual limits. You will also receive a $50 quarterly allowance with no copay for over-the-counter items, as well as home health and skilled nursing services designed to support your recovery. Specialized services like medical equipment, dialysis, and certain Part B drugs are covered with a standard 20% coinsurance.
Inpatient Hospital See details
WyoBlue Advantage Enhanced PPO (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $450 daily copay for days 1 through 4 and no copay for days 5 through 90. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services under the WyoBlue Advantage Enhanced PPO (PPO) are covered with no coinsurance, featuring a $350 to $400 copay for outpatient hospital services, a $400 copay per stay for observation services, and a $200 copay for ambulatory surgical center services. Outpatient substance abuse sessions require a $50 copay with no coinsurance, while outpatient blood services are covered with no copay, coinsurance, or deductible.
Partial Hospitalization See details
WyoBlue Advantage Enhanced PPO (PPO) covers partial hospitalization services with a $95.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
WyoBlue Advantage Enhanced PPO (PPO) covers ambulance services with a $400 copay for ground transport and a 20% coinsurance for air transport, both of which require prior authorization. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
WyoBlue Advantage Enhanced PPO (PPO) covers emergency services with a $110 copay (waived if admitted to the hospital within 24 hours) and urgently needed services with a $50 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $50,000 maximum benefit with no coinsurance and copays ranging from $50 to $110.
Primary Care See details
Primary care benefits under the WyoBlue Advantage Enhanced PPO (PPO) are generally covered with no coinsurance, featuring no copay for primary care physician visits and opioid treatment, while podiatry services are not covered. Other covered services like specialist visits, physical therapy, chiropractic care, and mental health services require copays ranging from $15 to $50 and no coinsurance.
Preventive Services See details
Preventive services are covered by WyoBlue Advantage Enhanced PPO (PPO) with no copay and no coinsurance, including annual physical exams, kidney disease education, and routine screenings. Additional preventive services are partially covered with no copay and no coinsurance, but do not cover health education, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, smoking cessation counseling, enhanced disease management, telemonitoring, home and bathroom safety devices, and counseling.
Hearing Services See details
WyoBlue Advantage Enhanced PPO (PPO) covers hearing exams and hearing aids with no copay and no coinsurance. While routine exams and over-the-counter hearing aids (up to $50 per ear every three months in-network) are covered, prescription hearing aids are only partially covered up to $650 per ear annually, as inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision Services are partially covered under the WyoBlue Advantage Enhanced PPO (PPO) plan, with covered routine eye exams costing a $0 to $50 copay and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance up to a combined annual maximum of $650 for both in-network and out-of-network contacts, frames, lenses, and upgrades.
Dental Services See details
Dental Services under the WyoBlue Advantage Enhanced PPO (PPO) are partially covered, offering no copay and no coinsurance for most preventive and comprehensive care up to a combined $650 annual maximum. While Medicare-covered dental services require a $50 copay and no coinsurance, adjunctive general services are not covered.
Home Infusion bundled Services See details
WyoBlue Advantage Enhanced PPO (PPO) covers Home Infusion bundled Services with no copay and no coinsurance, although prior authorization is required. Under this benefit, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require a 0% to 20% coinsurance and no copay.
Dialysis Services See details
Dialysis Services are covered under the WyoBlue Advantage Enhanced PPO (PPO) plan with no copay and a 20% coinsurance.
Medical Equipment See details
WyoBlue Advantage Enhanced PPO (PPO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance, which require prior authorization. Diabetic equipment is partially covered with no copay and a 20% coinsurance for therapeutic shoes and inserts, but diabetic supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the WyoBlue Advantage Enhanced PPO (PPO) with prior authorization, featuring a $20 copay for lab services and a $0 to $200 copay for diagnostic procedures, both with no coinsurance. Radiological services include a $20 copay for outpatient X-rays, no copay for diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiological services.
Home Health Services See details
Home Health Services are covered by the WyoBlue Advantage Enhanced PPO (PPO) with no copay and no coinsurance. Prior authorization is required to access these fully covered services.
Cardiac Rehabilitation Services See details
WyoBlue Advantage Enhanced PPO (PPO) covers Cardiac Rehabilitation Services with no copay and no coinsurance. While some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
WyoBlue Advantage Enhanced PPO (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 1-20 and 56-100, a $200 copay for days 21-55, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
WyoBlue Advantage Enhanced PPO (PPO) provides partial coverage for other services, which includes over-the-counter (OTC) items with no copay and no coinsurance up to a maximum of $50 every three months. Acupuncture, meal benefits, nicotine replacement therapy, and naloxone are not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
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.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved