Monthly premium
With a $0 monthly premium, this is a sensible option for those who already have prescription drug coverage elsewhere but still want low, predictable out-of-pocket cost sharing on hospital and medical coverage plus built-in dental, vision, and hearing. For example, if you're a veteran of the U.S. military with drug coverage through the VA, Core (HMO) could be a good fit for you.
Not sure what plan you need? Use the plan recommendation tool.
Medical
- $0 copay for PCP visits
- $0 labs/X-rays
- $25 specialist visits
Dental/Hearing/Vision
- $0 preventive and comprehensive dental
- $1,500/year dental benefit maximum
- $0 for routine hearing and vision screenings
- 2 hearing aids, starting at $200, annually
- Get $200/year for dental and hearing (Flexible Benefit Card)
- Get $200/year for eyewear
Extras
- $0 gym and home fitness benefit
- Get $75/quarter over-the-counter (OTC) benefit for everyday health items (Flexible Benefit Card)
Tools to help you choose:
See if your doctor is in the network
Ambulance
$175 copay per trip
Dental Services
Preventive: $0
Comprehensive: $0
$1,500 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
$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
$150 for high-tech radiology services (for example, MRIs)
Emergency Care
$125 copay per visit
If you are admitted to the hospital within 24 hours, you do not have to pay your share of the cost for emergency care.
Hearing Services
Routine hearing
$0
Non-routine hearing
$25 copay per visit
Hearing aids
$200-$1,675 copay per hearing aid (2 aids every year)
Outpatient Hospital/Surgery
In-network: Up to $150 copay per visit for ambulatory surgical center based services.
Up to $200 copay per visit for hospital based services.
Primary Care Provider Visit
In-network: $0 PCP copay per visit
Specialist Visit
$25 copay per visit
Referral is required for specialist visits.
Vision Visit
Routine vision
$0
Non-routine vision
$25 copay per visit
Vision hardware
Our plan offers a $200/year allowance for vision hardware.
Preventive Care
$0
Inpatient Hospital Care
$225 copay per day for days 1-5, $0 Days 6+
Skilled Nursing Facility (SNF)
$0 copay per day for days 1-20
$214 copay per day for days 21-45
$0 copay per day for days 46-100
Our plan covers up to 100 days in a SNF.
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 Enhanced (HMO-POS), BlueCHiP for Medicare Extra (HMO-POS), BlueCHiP for Medicare Preferred (HMO-POS), or the BlueCHiP for Medicare Access (HMO-POS) plan. If you select the BlueCHiP for Medicare Value, BlueCHiP for Medicare Enhanced (HMO-POS), BlueCHiP for Medicare Extra, BlueCHiP for Medicare Preferred, or the BlueCHiP for Medicare Access (HMO-POS) 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.