PARTCRX

Plan Summary

Insurance Type
Medicare Advantage Plan (Part C w/ RX)
Insurance Provider
BlueCross BlueShield of Tennessee
CMS Rating
Plan Type
PPO
Annual Deductible
$0.00

What To Know About This Plan

  • This plan has health and drug coverage

Why We Like This Plan

  • has both Health and Drug Coverage
  • has no additional premium costs outside of your Medicare Part B premium
  • was the best selling plan in Bedford in 2014

All cost-sharing assumes in-network healthcare providers.

Plan Details

Costs and Other Important Information

Plan Year:
2016
Optional Supplemental Benefits?
Information Not Available
Choice of Doctors?
Information Not Available
Prescription Drugs Covered?
Information Not Available
Out-Of-Pocket Spending Limit
Information Not Available
Other Health Plan Deductibles?
Information Not Available
Health Plan Deductible
Information Not Available
Monthly Drug Plan Premium
Information Not Available
Monthly Health Plan Premium
Information Not Available

Cost Sharing Information

Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit

30 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$3 copay$3 copay$3 copay
Tier 2: Non-Preferred Generic$12 copay$12 copay$12 copay
Tier 3: Preferred Brand Name$45 copay$45 copay$45 copay
Tier 4: Non-Preferred Brand Name$90 copay$90 copay$90 copay
Tier 5: Specialty Tier33% coinsurance33% coinsurance33% coinsurance
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$7.5 copay$7.5 copay$7.5 copay
Tier 2: Non-Preferred Generic$30 copay$30 copay$30 copay
Tier 3: Preferred Brand Name$112.5 copay$112.5 copay$112.5 copay
Tier 4: Non-Preferred Brand Name$225 copay$225 copay$225 copay
Tier 5: Specialty Tier33% coinsurance33% coinsurance33% coinsurance

CMS Ratings

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Colorectal cancer screening
Annual flu vaccine
Improving or maintaining physical health
Improving or maintaining mental health
Monitoring physical ability
Adult BMI assessment

Managing Chronic Conditions

Special needs plan care management
Not Rated
Care for older adults – medication review
Not Rated
Care for older adults – functional status assessment
Not Rated
Care for older adults – Pain screening
Not Rated
Osteoporosis management in women who had a fracture
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Controlling blood pressure
Rheumatoid arthritis management
Reducing the risk of falling
Plan all-cause readmissions

Member Experience with Health Plan

Getting needed care
Getting appointments and care quickly
Customer service
Overall rating of health care quality
Overall rating of plan
Care Coordination

Member Complaints, and Changes in Health Plan's Performance

Complaints about the health plan
Members choosing to leave the health plan
Beneficiary access and performance problems
Health plan quality improvement

Health Plan Customer Service

Plan makes timely decision about appeals
Reviewing appeals decisions
Call center – foreign language interpreter and TTY/TDD availability - Medical

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - Drugs
Appeals auto-forward
Appeals upheld

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Members choosing to leave the drug plan
Beneficiary access and performance problems
Drug plan quality improvement

Member Experience with Drug Plan

Rating of drug plan
Getting needed prescription drugs

Drug Pricing and Patient Safety

MPF Price Accuracy
High risk medication
Part D medication adherence for diabetes
Part D medication adherence for hypertension
Part D medication adherence for cholesterol
Medication Therapy Management program completion rate

Physician Finder

Physicians that accept BlueAdvantage Garnet (PPO) for Tennessee

/
D'AMICO, STEPHEN
4200 MURFREESBORO PIKE
ANTIOCH, TN 37013
EWELL, MELANIE
660 BELL RD APT 312
ANTIOCH, TN 37013
GIBBS, TANYA
5519 DORY DR
ANTIOCH, TN 37013
YORK, JAMES
5801 CROSSINGS BLVD
ANTIOCH, TN 37013
VO, THAO
700 CANOE RIDGE PT
ANTIOCH, TN 37013
WILLIAMS, CHRISTINE
14838 OLD HICKORY BOULEVARD
ANTIOCH, TN 37013
DEPENNDABLE FOOTCARE, PC
3408 BRIDGETON COVE
ANTIOCH, TN 37013
TURNER, GRETCHEN
2510 MURFREESBORO PIKE
NASHVILLE, TN 37217
MCREDMOND, THERESA
909 MASSMAN DR
NASHVILLE, TN 37217
LAVIE, THOMAS
1921 RANSOM PL
NASHVILLE, TN 37217
ALLEN, ANNA
2510 MURFREESBORO ROAD
NASHVILLE, TN 37217
Details
STEPHEN D'AMICO, MD
Phone Number
(615) 771-9958
Office Locations
4200 MURFREESBORO PIKE
ANTIOCH, TN 37013
4200 MURFREESBORO PIKE ANTIOCH TN, 37013

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