True Blue Rx Option I (HMO)

Medicare Advantage Plan for Idaho

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PARTCRX

Plan Summary

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderBlue Cross of Idaho
Plan IDH1350-15-1
CMS Rating1
Plan TypeHMO
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 a copay of $0 for Tier 1 preferred generic drugs (30 day supply, preferred retail pharmacies)
  • was the 4th best selling plan in Ada in 2018

Plan Details

Costs and Other Important Information

Plan Year:
2018
Optional Supplemental Benefits
Yes
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
$6,700 In-network
Other health plan deductibles?
No
Health Plan Deductible
$0
Monthly Drug Plan Premium
$76.10
Monthly Health Plan Premium
$62.90

Benefits

Service
Cost
Inpatient hospital coverage
$175 for days 1 through 5
$0 for days 6 through 90
Outpatient hospital coverage
$125-175 per visit
Doctor visits
Primary:$5 per visit
Specialist:$25 per visit
Preventive care
$0 copay
Emergency care/Urgent care
Emergency:$80 per visit (always covered)
Urgent care:$25 per visit (always covered)
Diagnostic procedures/lab services/imaging
Diagnostic tests and procedures:10%
Lab services:10%
Diagnostic radiology services (e.g., MRI):10%
Outpatient x-rays:10%
Mental health services
$175 for days 1 through 5
$0 for days 6 through 90
Outpatient group therapy visit with a psychiatrist:$25
Outpatient individual therapy visit with a psychiatrist:$25
Outpatient group therapy visit:$25
Outpatient individual therapy visit:$25
Skilled Nursing Facility
$0 for days 1 through 20
$125 for days 21 through 75
$0 for days 76 through 100
Rehabilitation services
Occupational therapy visit:$25
Physical therapy and speech and language therapy visit:$25
Ambulance
$200
Transportation
Not covered
Foot care (podiatry services)
Foot exams and treatment:$25
Routine foot care:Not covered
Medical equipment/supplies
Durable medical equipment (e.g., wheelchairs, oxygen):20% per item
Prosthetics (e.g., braces, artificial limbs):20% per item
Diabetes supplies:$0 copay
Wellness programs (e.g., fitness, nursing hotline)
Covered
Medicare Part B drugs
Chemotherapy:20%
Other Part B drugs:20%

Coverage Area for True Blue Rx Option I (HMO)

StateIdaho
CountyAda

Cost Sharing Information

All cost-sharing assumes in-network healthcare providers.

Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit

30 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$0 copay$5 copayNot offered
Tier 2: Non-Preferred Generic$6 copay$12 copayNot offered
Tier 3: Preferred Brand Name$35 copay$45 copayNot offered
Tier 4: Non-Preferred Brand Name$85 copay$95 copayNot offered
Tier 5: Specialty Tier33% coinsurance33% coinsurance33% coinsurance
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$0 copay$15 copay$0 copay
Tier 2: Non-Preferred Generic$18 copay$36 copay$18 copay
Tier 3: Preferred Brand Name$105 copay$135 copay$105 copay
Tier 4: Non-Preferred Brand Name$255 copay$285 copay$255 copay
Tier 5: Specialty Tier33% coinsurance33% coinsuranceNot offered

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
Care for older adults – medication review
Care for older adults – functional status assessment
Care for older adults – Pain screening
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 True Blue Rx Option I (HMO) for Idaho

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BARTLETT, CHRISTY
10790 W OVERLAND RD
BOISE, ID 83709
HECKEL, MARY
448 S MAPLE GROVE ROAD
BOISE, ID 83709
STRICKLAND, TOSHA
10112 W OVERLAND RD
BOISE, ID 83709
GAMES, JENNIFER
6003 OVERLAND RD
BOISE, ID 83709
TREASURE VALLEY SPEECH AND LANGUAGE, LLC
1203 S FIVE MILE RD
BOISE, ID 83709
SAWYER, BRIAN
9211 W OVERLAND RD
BOISE, ID 83709
BAKER, CARMEN
1556 S TIMESQUARE LN
BOISE, ID 83709
MABBUTT, DEBRA
6000 WEST OVERLAND ROAD
BOISE, ID 83709
STERLING, HUGH
6000 W OVERLAND RD
BOISE, ID 83709
RYAN, MICHAEL
232 S WHISPERWOOD WAY
BOISE, ID 83709
MOHR, JOHN
3301 TERRA DR
BOISE, ID 83709
CHAPMAN, MELISSA
29377 RANCHO CALIFORNIA RD
TEMECULA, CA 92591
MAUK, KALYN
2366 N RAYMOND ST
BOISE, ID 83704
MILLER, JORDAN
777 N RAYMOND ST
BOISE, ID 83704
HARM, HEIDE
6855 W FAIRVIEW AVE
BOISE, ID 83704
MILLER, MELVIN
1084 N COLE RD
BOISE, ID 83704
BROWN, LAWRENCE
6533 W EMERALD ST
BOISE, ID 83704
KREUSEL, DANA
7550 W EMERALD ST STE 101
BOISE, ID 83704
KENNETH M LITTLE
6140 W CURTISIAN AVE
BOISE, ID 83704
MANNING NEUROSURGERY, PLLC
6140 W CURTISIAN AVE
BOISE, ID 83704
LENZI, KENDRA
6855 W FAIRVIEW AVE
BOISE, ID 83704
PENNY, TANYA
7272 W POTOMAC DR
BOISE, ID 83704
Details
CHRISTY BARTLETT, SLP
Phone Number
(208) 322-8709
Office Locations
10790 W OVERLAND RD
BOISE, ID 83709
10790 W OVERLAND RD BOISE ID, 83709

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