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Senior Blue Select (HMO)

Our Senior Blue Select (HMO) Medicare Advantage Plan is designed to make Medicare easy for you. With a low monthly premium and coverage that's recognized nationwide, you can rest easy knowing that you're covered and your claims will be paid with no work on your part.

New for 2020! New Blue Total Health Package

Live a healthy lifestyle with our additional Blue benefits and preventive services included in your Medicare Advantage plan.

Senior Blue Select (HMO)

Get a low monthly premium, prescription drugs, and coverage recognized nationwide.


$0 Tiers 1-2
$195 Tiers 3-5

$290 per days 1-7
$2,030 max per year





Plan Information


Primary Care Doctor Specialist
$10 $30
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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. 

Prescription Drugs

Drug Deductibles  $0 (tiers 1-2) / $195 (tiers 3-5)
Part D Prescriptions: Preferred Pharmacy Standard Pharmacy
Tier 1 $2 $7
Tier 2 $10 $15
Tier 3 $42 $47
Tier 4 $94 $100
Tier 5 29% 29%

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. 

Prescription Drug Infomation
The 2020 Medicare Formulary includes a list of prescription care drugs covered by a prescription drug plan.

Surgery & Treatment

Inpatient hospital $290/day, days 1-7 / $2,030 max per year
Outpatient hospital $400
Ambulatory surgery $300
X-rays $50
Advanced radiology $200
Lab $10

Dental Coverage

All of our plans  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
Basic $11 50% coinsurance $500
Enhanced $25 50% coinsurance $1,000

Note: Preventive Services do not count toward the annual max allowance for dental.

Plan Highlights

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 $178.00/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).

This past January, the Centers for Medicare & Medicaid Services (CMS) added acupuncture as a covered benefit for Medicare patients with chronic low back pain. According to CMS, coverage will include "up to 12 sessions in 90 days with an additional 8 sessions for those patients with chronic low back pain who demonstrate improvement." Treatment must also be recommended and supervised by a doctor.

Blue Total Health Package

Our Blue Total Health package provides you with the additional benefits and preventive services you want and need to help you live a healthy lifestyle. This exclusive benefits package includes:  

Preventive dental

Preventive dental coverage includes reimbursement for up to two cleanings, two exams, and one set of X-rays annually1. This benefit requires no network and can be used at any dental provider.

  • $10 copay per service


  • $100 annual allowance on frames, lenses, and contacts through an EyeMed provider (not covered on BlueSaver HMO)
  • $25 annual routine eye exam through an EyeMed provider


Save thousands on hearing aids through TruHearing.

  • $699 or $999 per unit3
  • $45 annual routine hearing exam through a TruHearing provider


SilverSneakers® no-cost fitness benefit with access to 16,000+ fitness locations nationwide.

Rewards for preventive services

Earn up to $60 for annual preventive services including annual wellness visit, colon cancer screening, and breast cancer screening.4 Up to $60 total or one $20 Prepaid Card per service.

Low- or no-cost vaccines

  • $0 copay for preventive vaccines including flu, pneumonia, and hepatitis
  • Coverage for shingles vaccine with Tier 1 copay (copays vary by plan; not covered on Senior Blue 601 HMO)

Part B diabetic monitoring supplies

  • $0 Part B diabetic monitoring supplies including lancets, glucose monitors, and test strips

Unless otherwise noted, costs shown are for services received in-network.

Contracts & Additional Resources

Medicare Questions?

We're here to help.

1-833-735-4511 (TTY 711)
Oct. 1 - Dec. 31, 8 a.m. - 8 p.m., 7 days a week
Jan. 1 - Sept. 30, 8 a.m. to 8 p.m., Monday - Friday

*If you need a different format, please view our Multi-Language Interpreter Services.

BlueCross BlueShield of Western New York (BCBSWNY) is a division of HealthNow New York Inc., an independent licensee of the Blue Cross and Blue Shield Association. BCBSWNY 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 linguistica, Llame al 1-833-735-4515 (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 1-833-735-4515 (TTY 711) 

Content Last Updated: October 15, 2019