Forever Blue 751 (PPO)*
Our Forever Blue 751 (PPO) Medicare Advantage Plan is designed to make Medicare easy for you. Pay in-network copays for all plan-covered services when you receive care outside of Western New York with BlueCard Travel. It is designed to give you the freedom to see any doctor or hospital that accepts Medicare nationwide.
*Costs may be higher when out-of-network. Emergency services are covered at any hospital, however, routine or scheduled medical services at certain facilities, including Kaleida Health and ECMC will be considered out-of-network when billed by those facilities and result in a higher cost-share.
Not sure if this plan is right for you?
Call us, visit one of our Medicare Centers, or chat online.
|Primary Care Doctor||Specialist|
Use our new Find a Doctor tool to discover if your doctor, specialist, or facility are in-network.
If they are not in-network, you can search to find one that is in our network of providers.
|Medical / Drug Deductibles||$0 / $0 (tiers 3-5)|
|Part D Prescriptions:||Preferred Pharmacy||Standard Pharmacy|
The Medicare Part D Coverage Gap
The 'coverage gap' or 'donut hole' is a Part D drug coverage stage the changes what you pay for prescriptions. You may not end up in the coverage gap each year, but you should be aware of how it works, just in case.
Surgery & Treatment
|Inpatient hospital||$205/day, days 1-7 / $1,435 max per year|
Optional Supplemental Dental Care
Add Dental Care
Optional supplemental benefits (no network - see any dentist)
|Premium||Preventive Services (2 cleanings & 2 oral exams/year)||Diagnostic and Restorative Service Cost||Annual Max Allowance|
|Basic||$17||50% coinsurance||50% coinsurance||$500|
|Enhanced||$35||Full coverage||50% coinsurance||$1,000|
Common Plan Elements
|World coverage for emergency and urgent care||$80/$65|
|Part B diabetes supplies and monitors||$0|
|Skilled nursing facility days 1-20||$0|
|Skilled nursing facility days 21-100||$167.50/day|
|Hearing aid (specific models)*||$699 or $999/unit|
|In-network out-of-pocket maximum||$6,700|
*Our plans cover one routine hearing exam per year with a TruHearing provider. Please call TruHearing™ to verify your benefit and schedule a hearing exam. Coverage is for TruHearing Flyte models only. TruHearing™ is a registered trademark of TruHearing, Inc. TruHearing™ is an independent company that administers the hearing aid benefit.
$0 Preventive Services:
More than 20 services are included at no cost* when you use providers in our network. These services include annual wellness visit, bone density test, cardiovascular screenings, cancer screenings, diabetes self-management training, vaccines, and more.
- Explore services offered at $0 copay
*A $0 copay applies when using an in-network provider.
$0 Gym Membership:
Stay active with access to more than 14,000 fitness locations nationwide with SilverSneakers®. Enjoy amenities including weight machines, cardio equipment, swimming pools, saunas, exercise classes for all fitness levels, and more.
$0 Care Management:
Our nationally accredited care management team works with you and your doctor to help manage your health and meet your unique goals.
- Learn more about our health care services*
*This page links to a non-Medicare page.
$0 In-Home Care:
We've partnered with Landmark Health to create Care at Home℠ -- care and support available 24/7, provided in the comfort of your home.
Contracts & Additional Resources
Looking for another plan?
BlueCross BlueShield of Western New York is a Medicare Advantage plan with a Medicare contract and enrollment depends on contract renewal.This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or coinsurance may change January 1 of each year. The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. You must continue to pay your Medicare Part B Premium. Out-of-network/non-contracted providers are under no obligation to treat BlueCross BlueShield of Western New York members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next. A division of HealthNow New York Inc., an independent licensee of the BlueCross BlueShield Association. A salesperson will be present with information and applications. For accommodations of persons with special needs at sales meetings, please call 1-800-248-9296 (TTY 711). BlueCross BlueShield of Western New York complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-833-202-9524 (TTY: 711).注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-833-202-9524 (TTY: 711).
Content Last Updated June 18, 2018