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Blue Shield Medicare Advantage PPO

Under the Blue Shield Medicare Advantage PPO plan, you have access to a national network of health care providers. You can also see providers out-of-network at the same co-pay as in-network providers, as long as they participate in Medicare and are willing to bill Blue Shield. You must be enrolled in Medicare to participate in this plan. Refer to the Evidence of Coverage for a detailed list of services, exclusions and limitations.

To compare Medicare plan options, click the buttons below. 
 

 

To learn more about the Blue Shield Medicare PPO plan, watch the video below. 

 

Find the Value in Your Benefits

Discover more about the other options available to you by reviewing the Summary of Benefits in the plan documents. Below are some examples:

Inpatient Hospital Care
One copay upon admission (Day 1), then $0 per day thereafter

Skilled Nursing Facility
One copay upon admission (Day 1), then $0 for Days 2–100

Routine Eye Exam
Includes refraction and prescription for eyeglass lenses

Routine Transportation
24 one-way trips per year at $0 copay

Routine Foot Care
$100 allowance per visit, for up to 6 visits per plan year

Acupuncture Services
Up to 24 visits per member, per calendar year; in- and out-of-network covered

Chiropractic Services
Up to 24 visits per member, per calendar year; in- and out-of-network covered

Teladoc
$0 copay

Annual Physical Exam
$0 copay; in- and out-of-network covered

SilverSneakers Fitness
$0 copay

Personal Emergency Response System (PERS)
$0 copay

Hearing Aids
Up to $2,500 per ear, per member, per 36-month period

Routine Hearing Exams
Coverage for routine, non-Medicare-covered hearing exams

Home Meal Delivery
30 meals and 16 snacks per discharge following a hospitalization or skilled nursing facility (SNF) stay

Nutritional Therapy Services
Four additional routine nutritional counseling visits per year, not limited to a specific medical condition

Transgender Benefit
Additional covered services available under the plan

Prescription Drug Benefits
Up to a 100-day supply for prescriptions; up to 90 days for Tier 4 drugs. Enhanced Drug List coverage is also available for certain drugs not covered under Medicare Part D.

NurseHelp 24/7
Access to a registered nurse by phone or online, day or night, seven days a week. Nurses can provide health information, healthcare assistance, self-care tools, and lifestyle counseling.

LifeReferrals 24/7
Confidential consultations with a master’s-level professional, available 24/7, for personal, family, work, relationship, career, grief, legal, and financial concerns.

Wellvolution
A personalized lifestyle medicine platform offering evidence-based programs and tools to support nutrition, sleep, diabetes prevention, chronic condition management, and other health goals. Eligible members can enroll through Wellvolution.

Shield Support
Personalized outreach and care support from nurses, social workers, and specialty clinicians. Services may include short-term care coordination, ongoing case management, health education, self-care resources, and support for members managing cancer, cardiovascular, respiratory, musculoskeletal, digestive, mental health, and other chronic conditions.

Blue Shield Medicare PPO Plan Resources

Blue Shield Medicare Advantage PPO Contact