2018 True Blue HMO

2018 True Blue HMO

2018 Benefits

Silver & Fit, VSP, TrueHearing Select

True Blue HMO is a Medicare Advantage Health Maintenance Organization plan offered by Blue Cross of Idaho. True Blue HMO provides comprehensive coverage with affordable premiums and predictable costs. True Blue HMO gives you an all-around approach to good health with healthcare services from local providers you know and trust. You are eligible to enroll in True Blue HMO if you are:

  • Entitled to Medicare benefits under Part A
  • Enrolled in Medicare Part B
  • Reside in the plan's service area

The benefit information provided below is a brief summary, not a comprehensive description of benefits. For more information contact us.

2018 PLAN OVERVIEW

  Premium PCP Office Visit Fitness Options Part D Deductible Specialist Office Visit Inpatient Hospital Care Out-of-Pocket Maximum
True Blue Rx HMO
includes Part D Coverage
(see service area premium table below)
$55 Area 1
or
$70 Area 2
$10 $50
annual gym membership

OR

$10
annually for two at home fitness kits
$0 $40
no referral needed
$300
per day for days 1-6
$6,700
per calendar year includes most plan services
True Blue Rx Option I HMO
includes Part D Coverage
(see service area premium table below)
$139 Area 1 or $146 Area 2 $5 $0 $25
no referral needed
$175
per day for days 1 - 5

$6,700
per calendar year includes most plan services

True Blue Rx Option II HMO
includes Part D Coverage
(see service area premium table below)
$89 $10 $200
(Generic drugs are excluded from deductible)
$40
no referral needed
$275
per day for days 1 - 5
$6,700
per calendar year includes most plan services
True Blue No Rx HMO
without Part D Coverage
$30 $10 N/A $25
no referral needed
$100
per day for days 1 - 5
$3,000
per calendar year includes most plan services
 

TRUE BLUE HMO PLAN PREMIUMS

True Blue Rx Option I (HMO) Plan H1350-015-1 Service Area
Ada, Boise, Bonner, Boundary, Canyon, Clark, Elmore, Gem, Kootenai, Nez Perce, Owyhee, and Payette counties.
$139 monthly plan premium in addition, you must keep paying your Medicare Part B premium.
True Blue Rx Option I (HMO) Plan H1350-015-2 Service Area
Bannock, Bingham, Bonneville, Cassia, Fremont, Jefferson, Madison, Minidoka, Power, and Twin Falls counties.
$146 monthly plan premium in addition, you must keep paying your Medicare Part B premium.
True Blue Rx Option II (HMO) Plan H1350-016-1 Service Area
Ada, Boise, Bonner, Boundary, Canyon, Clark, Elmore, Gem, Kootenai, Nez Perce, Owyhee, and Payette counties.
$89 monthly plan premium in addition, you must keep paying your Medicare Part B premium.
True Blue Rx Option II (HMO) Plan H1350-016-2 Service Area
Bannock, Bingham, Bonneville, Cassia, Fremont, Jefferson, Madison, Minidoka, Power, and Twin Falls counties.
$89 monthly plan premium in addition, you must keep paying your Medicare Part B premium.
True Blue Rx (HMO) Plan H1350-019-1 Service Area
Ada, Boise, Bonner, Boundary, Canyon, Clark, Elmore, Gem, Kootenai, Nez Perce, Owyhee, and Payette counties.
$55 monthly plan premium in addition, you must keep paying your Medicare Part B premium.
True Blue Rx (HMO) Plan H1350-019-2 Service Area
Bannock, Bingham, Bonneville, Cassia, Fremont, Jefferson, Madison, Minidoka, Power, and Twin Falls counties.
$70 monthly plan premium in addition, you must keep paying your Medicare Part B premium.
True Blue No Rx (HMO) Plan H1350-006-0
Ada, Bannock, Bingham, Boise, Bonner, Bonneville, Boundary, Cassia, Canyon, Clark, Elmore, Fremont, Gem, Jefferson, Kootenai, Madison, Minidoka, Nez Perce, Owyhee, Payette, Power, and Twin Falls counties.
$30 monthly plan premium in addition, you must keep paying your Medicare Part B premium.
 

SUMMARY OF BENEFITS

EVIDENCE OF COVERAGE

ANNUAL NOTICE OF CHANGE

Y0010_MK18060 Approved 10/19/2017
Last updated 10/01/2017