2014 BlueCHiP for Medicare

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select any 2 plans

Our BlueCHiP for Medicare plans offer a variety of Medicare Advantage options to meet your coverage needs.

* You must continue to pay your Medicare Part B premium.

With BlueCHiP for Medicare Value, you get comprehensive medical, Part D prescription drug, out-of-network coverage and the Living Fit health club benefit for $0 plan premium.
  • No monthly plan premium*
  • Comprehensive medical and prescription drug coverage in one plan
  • Point-of-service benefit allowing you to receive services out-of-network
  • Health and wellness benefits and programs
  • Low copayments on many generic drugs
  • Access to one-on-one coordinated care
  • Coverage from a local company
  • $0 copayment on generic drugs
Monthly Premium:
$0*
Part D Prescription Drug Coverage:
$0 for generic drugs; $100 deductible for tiers 2, 3, 4
In-Network Medical Out-of-Pocket Max:
$4,450
Out-of-Network Medical Out-of-Pocket Max:
$4,450
BlueCHiP for Medicare Standard with Drugs provides comprehensive medical, Part D prescription drug and the Living Fit health club benefit at a low monthly plan premium.
  • Comprehensive medical and prescription drug coverage in one plan
  • Health and wellness benefits and programs
  • Low copayments on many generic drugs
  • Access to one-on-one coordinated care
  • Coverage from a local company
Monthly Premium:
$48*
Part D Prescription Drug Coverage:
$4 for generic drugs; no deductible
In-Network Medical Out-of-Pocket Max:
$4,250
BlueCHiP for Medicare Plus combines low out-of-pocket costs with coverage for Medicare Part D prescription drugs, a vision benefit, and the Living Fit health club benefit.
  • Comprehensive medical and prescription drug coverage in one plan
  • Health and wellness benefits and programs
  • Low copayments on many generic drugs
  • Vision hardware benefit
  • Access to one-on-one coordinated care
  • Coverage from a local company
Monthly Premium:
$171*
Part D Prescription Drug Coverage:
$4 for generic drugs; no deductible
In-Network Medical Out-of-Pocket Max:
$2,950
BlueCHiP for Medicare Preferred is our plan with the lowest cost sharing, and includes Medicare Part D prescription drug coverage, vision and hearing aid benefits, coverage for out-of-network services, and the Living Fit health club benefit.
  • Comprehensive medical and prescription drug coverage in one plan
  • Our lowest plan copayments for doctor and hospital care
  • Point-of-service benefit allowing you to receive services out-of-network
  • Enhanced prescription drug coverage with low copayments and coverage for generics in the coverage gap
  • Additional benefits for hearing aids, vision hardware, and health club membership
  • Health and wellness benefits and programs
  • Low copayments on many generic drugs
  • Access to one-on-one coordinated care
  • Coverage from a local company
Monthly Premium:
$291*
Part D Prescription Drug Coverage:
$4 for generic drugs; no deductible; some gap coverage
In-Network Medical Out-of-Pocket Max:
$2,250
Out-of-Network Medical Out-of-Pocket Max:
$3,000
BlueCHiP for Medicare Core provides comprehensive medical coverage including the Living Fit health club benefit. This plan does not cover Medicare Part D prescription drugs and has no monthly plan premium.
  • No monthly plan premium*
  • Comprehensive medical coverage at an affordable price
  • Health and wellness benefits and programs
  • Vision hardware benefit
  • Access to one-on-one coordinated care
  • Coverage from a local company
Monthly Premium:
$0*
Part D Prescription Drug Coverage:
Part D prescription drug coverage is not available with this plan
In-Network Medical Out-of-Pocket Max:
$3,950

Last updated: 04/20/2014

H4152_2014website697 Approved

Blue Cross & Blue Shield of Rhode Island is an HMO plan with a Medicare contract. Enrollment in Blue Cross & Blue Shield of Rhode Island depends on contract renewal.

The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. Visit Contact Us.

Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1 of each year.

You must continue to pay your Medicare Part B premium.