Need help? Call the Medicare Sales team at 1-800-505-2583 (TTY:711).
Questions? Call the Medicare Concierge team at (401) 277-2958 or 1-800-267-0439 (TTY: 711).
Come back at the start of the Annual Election Period (October 15) to select and enroll in a plan.
2024

BlueRI for Duals

(HMO D-SNP)

Monthly premium

$0.00

Enroll now
Submit plan change

This plan offers more benefits for $0 to members who are enrolled in both Medicare and Medicaid. A dedicated care team makes accessing high-quality care and services easy!

Questions? Call us at (401) 459-5477 or 1-855-430-9293 (TTY: 711).

Medical

  • $0 monthly premium
  • $0 copay for primary care visits
  • $0 specialist visits
  • $0 labs/X-rays
  • $0 inpatient hospital stay
  • $0 outpatient surgery copay
  • $0 skilled nursing facility
  • $0 virtual doctors' visits 24/7
  • $0 acupuncture benefit

Prescription Drugs

  • $0 prescription drugs

Dental/Hearing/Vision

  • $0 hearing aids
  • $0 preventive and comprehensive dental
  • $0 for routine hearing and vision screenings
  • Get $300/year vision hardware allowance
  • Get $1,500/year allowance for dental and hearing (Flexible Benefit Card)

Extras

  • $160/month for groceries and over-the-counter (OTC) benefit for everyday health items (Flexible Benefit Card)
  • $200 annual wellness reimbursement
  • $0 fitness benefit
  • 72 one-way rides/year
  • 120 hours/year of household help
Qualify for Low-Income Subsidy but not Medicaid?

Coverage
Copays & Details
Outpatient Care and Services1,2

Ambulance

$0

Dental Services

Medicare-covered: $0
Preventive: $0
Comprehensive: $0

$3,000 limit on all covered dental services for preventive and comprehensive dental services. All preventive and comprehensive services must be provided by an in-network plan-contracted dentist.

Diabetes Supplies and Services

In-network: $0

You must use OneTouch plan-designated monitors and test strips.

Diagnostic Tests, Lab and Radiology Services, and X-Rays

$0 for lab services
$0 for diagnostic tests and X-rays
$0 for high-tech radiology services (for example, MRIs)

Emergency Care

$0

Outpatient Hospital/Surgery

$0

Hearing Services

Routine hearing
$0

Non-routine hearing
$0 copay

Hearing aids
$0 per hearing aid (2 aids every year)

Primary Care Physician Visit

$0

Specialist Visit

$0

Vision Visit

Routine vision
$0 

Non-routine vision
$0 

Vision hardware
Our plan offers a $300/year allowance for vision hardware.

Preventive Care

$0

Inpatient Care1,2

Inpatient Hospital Care

$0 Days 1 and beyond

Our plan covers an unlimited number of days for an in-network inpatient hospital stay.

Skilled Nursing Facility

$0 per day for days 1-100

Our plan covers up to 100 days in a skilled nursing facility.

 
Preferred
Standard
Prescription Deductible

No deductible

Initial Coverage (up to 30-day supply)**3

Tier 1 (Preferred Generic)

n/a

$0 copay

Tier 2 (Non-preferred Generic)

n/a

$0 copay

Tier 3 (Preferred Brand)

n/a

$0 copay

Tier 4 (Non-Preferred Drug)

n/a

$0 copay

Tier 5 (Specialty Tier)

n/a

$0 copay

Preferred Insulins (30-day supply)

$0 copay

 

Mail Order (90-day Supply)

n/a

$0 copay for Tiers 1 and 2

Gap Coverage

n/a

$0 copay

Hours: Monday through Friday, 8:00 a.m. to 8:00 p.m. (Open seven days a week, 8:00 a.m. to 8:00 p.m., October 1 – March 31.)You can use our automated answering system outside of these hours.

*Your premium may be higher than this amount depending on your Low Income Subsidy Program (LIS) level. If you are eligible for Medicare cost-sharing assistance under Medicaid, you pay $0 for your deductible, doctor office visits, and inpatient hospital stays. If you lose your Medicaid, you will be responsible to pay copays.  

**You must receive LIS or "Extra Help" to receive  the Over-the-Counter (OTC) + Grocery Food Card as well as $0 Part D drug copays

1 The out-of-pocket maximum includes only Medicare-covered services. This is the most a member would pay for these services during a calendar year. You must receive all routine care from plan providers unless you select the BlueCHiP for Medicare Value (HMO-POS), BlueCHiP for Medicare Extra, BlueCHiP for Medicare Preferred (HMO-POS), or the HealthMate for Medicare (PPO) plan. If you select the BlueCHiP for Medicare Value, BlueCHiP for Medicare Extra, BlueCHiP for Medicare Preferred, or the HealthMate for Medicare plan, with the exception of emergency or urgent care, ambulance, or dialysis services, it may cost more to get care from out-of-network providers.

2 A preauthorization may be required. Review may include but is not limited to pre-authorization and/or continued treatment by the plan and/or plan designee. Contact Plan for details.

3 You must use network pharmacies to access your prescription drug benefit, except under non-routine circumstances, quantity limitations and restrictions may apply. Please refer to the Summary of Benefits or the Evidence of Coverage for prescription drug cost share information in a long-term care setting, mail order and extended day retail supplies as well as detailed benefit information concerning the Initial Coverage stage, Coverage Gap stage and the Catastrophic level stage.