Forever Blue Value (PPO)
Our Forever Blue Value (PPO) Medicare Advantage Plan is designed to make Medicare easy for you. Pay a lower premium and have the freedom to see any doctor or hospital that accepts Medicare nationwide. Costs may be higher out-of-network. New for 2019, this plan includes preventive dental coverage.
Want to learn more about this plan?
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.
|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||$250/day, days 1-7 / $1,750 max per year|
NEW Preventive Dental:
All of our plans now include preventive dental coverage:
- Routine cleanings/oral exams - twice per year ($10 copay per service).
- X-rays - four bitewing or one full-month X-ray per year ($10 copay per service).
Optional Supplemental Dental is also available:
You may add dental care with the following optional supplemental benefits (no network - see any dentist):
|Premium||Diagnostic and Restorative Service Cost||Annual Max Allowance|
Note: Preventive services do not count toward the annual max allowance for dental.
|World coverage for emergency and urgent care||$90/$65|
|Part B diabetes supplies and monitors||$0|
|Skilled nursing facility days 1-20||$0|
|Skilled nursing facility days 21-100||$172.00/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. Hearing aid $699 or $999/unit (one per ear, per year, specific models).
New! Up to $60 in Rewards:
Members get a $20 reward card (up to $60) each after receiving certain preventive services, including their annual wellness visit, colorectal cancer screening, and breast cancer screening (subject to medical necessity).
Free 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.
Free 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.
Medicare Advantage members now have access to Telemedicine, hosted by Doctor On Demand. Connect with a doctor 24/7 from your mobile device, tablet, or computer for only $5 more than your primary doctor cost-share.
$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.
Care at Home:
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?
A division of HealthNow New York Inc., an independent licensee of the Blue Cross and Blue Shield Association. 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. Call 1-800-329-2792 for more information. Out-of-network/non-contracted providers are under no obligation to treat BlueCross BlueShield of Western New York members; except in emergency situations. 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. 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 October 1, 2018.