> /BaseFont /ArialMT << BLUE ADVANTAGE HMO. /Encoding /WinAnsiEncoding >> /MarkInfo << 850 0 obj 0000006261 00000 n 277 333 556 556 556 556 279 556 333 736 /FontName /KKYTOQ+Arial-BoldMT /StemV 80 851 0 obj 610 610 610 556 610 556] January 1, 2019 – December 31, 2019 Blue Advantage from HMO Louisiana, Inc. is an HMO plan with a Medicare contract. >> /ItalicAngle 0 >> 0000006709 00000 n @{��Bw�HɄ %C�J6%�����:����]'o�&��̨&�����>�K�Tu9U�r��[0[�"_�bW�Hr(}Y��������-� 277 556 500 1000 556 556 333 1000 666 333 859 0 obj /ItalicAngle 0 January 1, 2020 – December 31, 2020. 277 277 277 277 0 0 0 0 0 0 >> 583 583 583 610 975 722 722 722 722 666 /F6 838 0 R 0000004266 00000 n >> /Type /Font /Ascent 750 EܝÙ*$b(¯w"h$/ð]+|×_ Âw݌Ñï0ì¸ìVÝv¡½jmÖÀ­ž›¿|/ᶝjT¶Ê~?³™»ï 333 500 443 1000 500 500 333 1000 556 333 /Lang (en-US) 92 SUMMARY OF BENEFITS January 1, 2020 – December 31, 2020 This is a summary of health and drug services covered by Blue Cross ® Blue Shield ® of Arizona Advantage (BCBSAZ Advantage). /Length 135 836 0 obj /BaseFont /BCDFEE+Calibri endobj /Parent 59 0 R /Type /Font 666 777 722 666 610 722 666 943 666 666 /F2 836 0 R 860 0 R] Community Blue Medicare HMO . /ColorSpace << 610 277 277 277 469 556 333 556 556 500 [278] /ToUnicode 848 0 R 831 0 obj 333 576 556 333 333 333 365 556 833 833 0000004816 00000 n 829 0 obj /Type /FontDescriptor This is a summary of drug and health services covered under Blue Medicare HMO Plans . /Suspects false %���� Enrollment in the Plan depends on contract renewal. BT 722 666 666 610 556 556 556 556 556 556 /FontFile2 857 0 R Plan year: January 1, 2018 – December 31, 2018 In this section, you’ll learn about some of the benefits and services we cover and other important details to help you choose the right Medicare Advantage plan for /AvgWidth 441 80 500 500 443 479 200 479 541 350 500 350 Summary of Benefits for . 583 583 583 556 1015 666 666 722 722 666 15 /Root 828 0 R /Length 224 /Length 171684 endobj 0 0 250 333 408 500 500 833 777 180 << ��[|�*�Deh�J�%9Oob� d)��(b�;zL��{�i�Q? [500] Io+ Summary of Benefits . 610 777 722 277 556 722 610 833 722 777 0000003865 00000 n /StemV 36 /Tabs /S >> [556]] 610 277 277 277 469 556 333 556 556 500 333 333 500 563 250 333 250 277 500 500 /ID [ 0000003657 00000 n << /Type /ExtGState << /Flags 32 [833 556] >> 837 0 obj >> /StemV 80 >> 19 stream /FontBBox [-627 -376 2000 1055] This can be a extremely nice safety net. 592 547 501 592 547 774 547 547 0 0 BlueAdvantage HMO Plan on Pathway HMO Network . (PW) NV BA HMO BD NGF $25_$400Ded (15_45_75_30%Rx).s0116 . /Descent -212 /F5 854 0 R stream 8KvVF/K8lfLw/Y8TrTGYASqa04mTaFtTP5w0TMBGEg=) << >> 333 576 453 333 333 299 310 500 750 750 >> • If you want to compare our plan with other Medicare health plans, ask the other plans for their Summary of Benefits … (�a��{/�d �2b�t˨�,&広HYVY�"��X��Ƞ(���n�R&�L��}����z��y�{:��;@wI�m;�"�O!͡���W4E�P?��qڶ�����UZ7L� �ZcF����>�S�WFӖ��ϙ�م|HO�L^d%�ّay�_��j������{�S��:�����d �a���`�V��E(>�)����ɐ��N�cm�Z����,�D��w@�w-2"�U�a��5~#�/ /ExtGState << 610 610 610 610 389 556 333 610 556 777 856 0 obj /BaseFont /BCDEEE+ArialNarrow /Source (WeJXFxNO4fJduyUMetTcP9+oaONfINN4+d7I7rDsCXgfwEC9G0HBPukfA0p1hkF5B9khgm8VtCFmyd8gIrwOjQRAIjPsWhM4vgMCV\ 500 443 333 500 500 277 277 500 277 777 847 0 obj >> [840 0 R] /FirstChar 0 stream /Type /Font << >> 556 1000 333 1000 556 333 943 350 500 666 1 0 0 1 -0.24 -8.6774 Tm /S 196 /Subtype /TrueType 0000203660 00000 n ±1®Gʐn¸i€ÎGt–èѹ] PdŠ"Y€¹«È 838 0 obj 0000002195 00000 n SEI - U SUMMARY OF BENEFITS The benefit formaon pved is aummary of what coveand what you pay. /LastChar 255 556 556 556 556 556 556 556 556 333 333 /Type /FontDescriptor Y0079_8823_M CMS Accepted 08302019 U5047, 8/19 1 . The benefit information provided is a summary of what we cover and what you pay when enrolled in one of these plans. [556] 0000183741 00000 n You pay ; What you should know . /StemV 80 277 277 277 277 0 0 0 0 0 0 /Widths [0 0 0 0 0 0 0 0 0 277 610 610 610 610 610 610 610 548 610 610 endobj 841 0 obj 0.498 G endobj /MaxWidth 1743 845 0 obj 722 722 722 722 722 563 722 722 722 722 /OutputConditionIdentifier (CGATS TR 001) 0000009686 00000 n Y0132_21-025_ENLA_M This is a summary of drug and health services covered by Blue Advantage (HMO) | Blue Advantage (PPO) from January 1, 2021 – December 31, 2021. /ToUnicode 846 0 R /BBox [0 0 578.09 2.3626] /Descent -216 >> /FontBBox [-627 -376 2000 1055] %ABCpdf 11200 << endstream /Ascent 905 /Descent -212 /Descent -212 >> 777 777 777 777 777 583 777 722 722 722 /ColorSpace /DeviceRGB endobj endstream endobj /W [1 4 2] << 556 1000 333 1000 556 333 943 350 500 666 722 666 666 610 556 556 556 556 556 556 556 556 556 556 333 500 277 556 500 722 250 250 250 250 0 0 0 0 0 0 If you decide to sign up for BlueMedicare Premier (HMO) you still retain Original Medicare. /Type /FontDescriptor /Filter /FlateDecode /CapHeight 716 0000008088 00000 n endstream 563 563 563 443 920 722 666 666 722 610 /LastChar 255 /Info 826 0 R 0000002145 00000 n /Encoding /Identity-H Medicare HMO Blue FlexRx also offers Medicare Part D prescription drug coverage—making it easy for you to get your medical and prescription benefits from one plan. 45 >> endobj 556 556 556 556 556 556 556 556 277 277 0 0 0 0 544 533 0 0 0 0 /Metadata 787 0 R /FontWeight 400 /FontName /ArialMT 275 500 563 333 759 500 399 548 299 299 /Length 254 /FontDescriptor 858 0 R [228 0 291 0 456 729 0 157 273 273 Florida Blue and Florida Blue HMO do not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of their plans, including enrollment and benefit determinations. 0000011875 00000 n 0000328797 00000 n Premiums and benefits . 500 500 500 333 259 333 583 350 556 350 /Encoding /WinAnsiEncoding /Font << /Subtype /Image 610 556 333 610 610 277 277 556 277 889 >> /MaxWidth 1182 0 0 250 333 408 500 500 833 777 180 556 556 500 389 279 389 583 350 556 350 623 0 0 0 0 855 0 0 0 0 /FontFile2 869 0 R 889 556 556 556 556 556 277 277 277 277 576.76 1.4826 l 333 333 389 583 277 333 277 277 556 556 /Type /ExtGState 556 722 666 556 610 722 722 943 722 722 0000003042 00000 n /Subtype /TrueType 0 0 277 333 474 556 556 889 722 237 840 0 obj 610 610 610 556 610 556] 333 576 537 333 333 333 365 556 833 833 /Widths [0 0 0 0 0 0 0 0 0 277 stream << /F2 836 0 R [333] 0000008314 00000 n /Name /F2 /S /Transparency << /Text >> /FontName /UTPWUD+Arial-BoldMT /StemV 44 This booklet has information about the cost and benefits of the BCN Advantage HMO-POS Region 3 plan. /FontName /RSMMEN+ArialMT [556] /DW 1000 - Fri. /S /GTS_PDFA1 610 333 277 333 469 500 333 443 500 443 >> 333 333 500 563 250 333 250 277 500 500 << 0 0 0 0 0 0 0 0 0 0 /Subtype /TrueType /Widths [0 0 0 0 0 0 0 0 0 250 563 563 563 443 920 722 666 666 722 610 xref /Type /Group /DefaultRGB [/ICCBased 0 G /FontFile2 867 0 R 583 583 583 556 1015 666 666 722 722 666 This Summary of Benefits booklet gives you a summary of what Blue Cross Medicare Advantage Basic (HMO), Blue Cross Medicare Advantage Basic Plus (HMO-POS), or Blue Cross Medicare Advantage Premier Plus (HMO-POS) covers and what you pay. /Subtype /Type0 /Leading 150 666 777 722 666 610 722 666 943 666 666 But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Florida Blue HMO and not Original Medicare. >> 830 0 obj o%$H„$!É"’ õþIrì—EÇ%¿•Éañ‡Þ“ÊÊÑx§¤œ÷Õ^lï©%ÇU G>{“¬\=þþH /Type /Font << January 1, 2019 – December 31, 2019. >> endobj /FontWeight 400 Enrollment in Blue Advantage depends on contract renewal. 500 1000 333 979 389 333 722 350 443 722 /FontBBox [-568 -306 2045 1039] xœì½|ə÷ߣ™Q,Ù23“lïz)œü“Ë%—Ü?wÿ»÷î½÷Í%—ÜvÍâAi×Ëkff‹™Á2Û²p4Ð\ÿ§ªgF#idËÉ:›Í§~©ôŽ[3ÝÕÕÕUß~ꩧd™ŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠŠjP! Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is an HMO plan with a Medicare contract. /Descent -210 /BitsPerComponent 8 This booklet gives you a summary of what we cover and what you pay. /Encoding /WinAnsiEncoding 2020 Summary of Benefits Capital Health Plan Advantage Plus (HMO) and Capital Health Plan Preferred Advantage (HMO) This is a summary of drug and health services covered by Capital Health Plan Advantage Plus (HMO) and Capital Health Plan Preferred Advantage (HMO) January 1, 2020 – December 31, 2020. With Blue Advantage, you don’t need to buy a separate Medicare supplement or Part D prescription drug plan. Blue Cross Medicare Advantage Premier Plus (HMO-POS) SM. /Filter /FlateDecode /CapHeight 715 /BaseFont /RSMMEN+ArialMT x�]R�n�0��>��۔MBH��C5����!B*�2����������,o�=�����L�W=�'�I�K�a��r�K/=Ɖ��yE����|S|Z��Zv��e�3�i��b����(O��J}� r&��s"�3DO�zn �+�����yٛ�-�}Q@��Ŵ��I5-�F^�˨99�*sr��gkٹ�ϧ4>:c�uƕCI��όS� �(�Y+lKWt�X�Y�$B��Ț$ΙR�Jy�`���"J If you are no longer a current member of BlueAdvantage Administrators of Arkansas, the benefit summary is a summary of your benefits on the last day covered. /Widths 845 0 R 0 507 507 0 0 0 0 0 0 0 endobj 456 456 456 456 456 456 228 0 0 0 This is a summary of drug and health services covered under Blue Medicare HMO Plans . /ItalicAngle 0 833 610 666 666 666 666 666 666 1000 722 Summary of Benefits for Anthem MediBlue Dual Advantage (HMO SNP) Available in: Select Counties* in Ohio *See Page 2 for a list of counties. Benefits this is a summary of what we cover or list every limitation or exclusion Advantage from HMO,... 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