The True Blue Special Needs Plan (HMO SNP) is a healthcare plan designed to meet the needs of Idahoans who are eligible for Medicare and full Medicaid benefits, are at least 21 years old, and live in our service area.
True Blue Special Needs Plan members receive the same benefits available to them in Medicaid and Medicare, including prescription coverage, plus a few more, including:
- Care Coordination
- 24-7 live Nurse Line
- Gym Membership at a reduced rate (just $50 for the year)
- Access to Idaho's largest provider network
- Local Customer Service
- Membership in Idaho's Highest Star Rated Medicare Advantage Plan in 2018
True Blue Special Needs Plan members have financial peace of mind knowing there are enrolled in a $0 premium plan. That's right. You don't pay anything for this plan, and Medicaid will continue to pay your Medicare Part B premium. It is a $0 monthly premium, and no deductible. The only expense is what you probably already pay for your prescriptions, which are typically $0 to $3 per fill. Your level of "extra help" determines how much you pay for prescriptions.
This plan combines most of your Medicare and Medicaid benefits into one card, a Blue Cross of Idaho Card. So whether you're at the doctor, hospital, behavioral health center, or pharmacy, you show just one card. This makes it easier for you, your family and caretakers, and your providers.
The benefit information provided below is a brief summary, not a comprehensive description of benefits.
2018 HEALTH PLAN OVERVIEW
|Premium||PCP Office Visit||Part D Deductible||Specialist Office Visit||Inpatient Hospital Care||Out-of-Pocket Maximum||Fitness Options|
|True Blue Special Needs Plan (HMO SNP) Includes Part D Prescription Coverage||$0*||$0*||$0*||$0*||$0*||$3000 per calendar year includes all plan services||$50 annual gym membership
$10 annually for two at home fitness kits
*All cost sharing on this plan is based on the particiant's level of Medicaid eligibility.
|$0 copay for:||$0 copay for:||$0 copay for:||Supplemental Eyewear Coverage|
|True Blue Special Needs (HMO SNP) In-Network Vision Services||Medicare-covered diagnosis and treatment for diseases and conditions of the eye, including an annual glaucoma screening for people at risk||Up to 1 supplemental routine eye exam(s) every year||
||$100 plan coverage limit for supplemental eyewear every year|
- DSNP Enrollee Handbook (spanish version)
- Summary of Benefits (spanish version)
- Evidence of Coverage (spanish version)
- Annual Notice of Change (spanish version)
- Essentials Formulary (Printable Drug List) (spanish version)
National Coverage Determinations (NCD)
Centers for Medicare and Medicaid Services (CMS) occasionally makes a change or revision in Medicare coverage. We are required to notify you in our member newsletter when a National Coverage Determination (NCD) occurs.
You can review decisions using Medicare's Coverage Database. Visit www.cms.gov/medicare-coverage-database to get started.
Medicare beneficiaries may enroll in Blue Cross of Idaho Medicare Advantage plans through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
Blue Cross of Idaho Care Plus is a HMO SNP health plan with a Medicare and Idaho Medicaid contract. Enrollment in Blue Cross of Idaho Care Plus depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year. The pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Idaho Medicaid pays the Medicare Part B premium for Full-Benefit Dual-Eligible members. Each member’s cost share may vary based on the level of extra help you receive. This plan is available to full-benefit dual-eligible beneficiaries who are at least 21 years of age, live in our service area, and receive medical assistance from Medicare and Idaho Medicaid. Please contact the plan for further details.
Esta informacion esta disponible sin costo alguno en otros idomas. Para informacion adicional, por favor marque a nuestro numero de servicio al cliente 1-888-495-2583 de 8 a.m. a 8 p.m. Usuarios de TTY llamar al 1-800-377-1363.
Y0010_MK19182_M Accepted 10/1/2018
Last updated 12/13/2018