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Blue Cross Medicare Advantage Value (HMO) H9706-005-0 Plan Details
Blue Cross Medicare Advantage Value (HMO) H9706-005-0 Plan Details
When selecting a Medicare Advantage plan for 2025, it's important to compare all your options. Blue Cross Medicare Advantage Value (HMO) is among the plans you can review side-by-side with others, ensuring you find the coverage that suits your needs. You can easily enroll online or reach out to a licensed agent for personalized guidance.
- Doctor Visits
- Foot Care
- Chiropractic
- Urgent & Emergency
- Mental Health
- Rehab Services
- Equipment & Supplies
- Diag, Lab, Imaging
- Part B Drugs
- Dental
- Hearing Aids
- Vision
- Prescriptions
Blue Cross Medicare Advantage Value Overview
Plan ID H9706-005-0 Overview | |
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Health Plan ID: | H9706-005-0 |
Medicare Advantage Plan Type: | HMO |
Plan Year: | 2025 |
Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
Health Plan Deductible: | $0.00 |
Annual Out-of-Pocket Maximum: | $4,100.00 (In-Network) |
Part B Give Back: | $0.00/mo |
Part D Drug Plan Benefit: | Enhanced, $0.00 deductible |
Additional Benefits: | Dental, Vision, Hearing |
Availability: | See List |
Insured By: | Blue Cross and Blue Shield of Texas |
We're Here to Help You Enroll |
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Out-of-Pocket Costs
Blue Cross Medicare Advantage Value includes cost-sharing, which refers to the out-of-pocket expenses you'll incur when accessing approved healthcare services. The table below outlines the most common in-network out-of-pocket costs for plan H9706-005-0.
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
Service | Enrollee Cost (in-network) |
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Primary: | $0 Copay |
Specialist: | $15 Copay Prior Authorization Required, Referral Required |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
Service | Enrollee Cost |
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Emergency room care: | $135 Copay |
Urgent care: | $40 Copay |
Ground ambulance: | $295 Copay |
Inpatient hospital care: | $295.00 per day for days 1 through 8 $0.00 per day for days 9 and beyond |
Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $214.00 per day for days 21 through 39 $0.00 per day for days 40 and beyond |
This section covers Medicare-approved foot care services, including exams and routine foot care.
Service | Enrollee Cost (in-network) |
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Foot Exams and Treatments (Medicare-covered): | $35 Copay Prior Authorization Required, Referral Required |
Routine Foot Care: | Not Covered |
Understand the coverage for Medicare-approved chiropractic services and routine chiropractic care.
Service | Enrollee Cost (in-network) |
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Medicare-covered chiropractic: | $20 Copay Prior Authorization Required, Referral Required |
Routine chiropractic: | Not Covered |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
Service | Enrollee Cost (in-network) |
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Outpatient individual therapy: | $35 Copay |
Outpatient group therapy: | $35 Copay |
Inpatient psychiatric hospital care: | $295.00 per day for days 1 through 6 $0.00 per day for days 7 and beyond |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
Service | Enrollee Cost (in-network) |
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Physical therapy and speech and language therapy: | $35 Copay Prior Authorization Required, Referral Required |
Occupational therapy: | $35 Copay Prior Authorization Required, Referral Required |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
Service | Enrollee Cost (in-network) |
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Diabetes supplies: | 35% Coinsurance Prior Authorization Required |
Durable medical equipment: | 20% Coinsurance Prior Authorization Required |
Prosthetics: | 20% Coinsurance |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
Service | Enrollee Cost (in-network) |
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Diagnostic radiology services: | $300 Copay Prior Authorization Required, Referral Required |
Lab services: | $50 Copay Prior Authorization Required, Referral Required |
Outpatient x-rays: | $100 Copay Prior Authorization Required, Referral Required |
Diagnostic tests and procedures: | $100 Copay Prior Authorization Required, Referral Required |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
Service | Enrollee Cost (in-network) |
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Chemotherapy: | 20% Coinsurance |
Other Part B drugs (Medicare-covered): | 20% Coinsurance |
This section details the dental services covered under your plan including, Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
Service | Member Cost (in-network) |
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Medicare Covered Preventive Dental | $35 Copay |
Oral exam | |
Dental x-rays | |
Cleaning | |
Periodontics | |
Endodontics | |
Restorative Services |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
Service | Member Cost (in-network) |
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Fitting/evaluation | $0 Copay Limitations Apply |
Hearing aids | Covered Limits may apply |
Hearing exam | $0 Copay |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
Service | Member Cost (in-network) |
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Medicare-covered eye exam (in-network) | $0 Copay |
Routine eye exam (in-network) | $0 Copay 1 Every year |
Eyewear benefits | Eyeglasses: No Contact Lenses: Yes Eyeglass Lenses: Yes Eyeglass Frames: Yes Eyewear Upgrades: Yes |
Maximum eyewear benefit: | $150.00 Every year |
Certain preventive services are covered 100% by Blue Cross Medicare Advantage Value as a Part B benefit.
Part D Prescription Drug Costs & Benefits
Part D Plan Premium
While the prescription drug plan (Part D) premium is included in the overall plan cost, some plans may have additional costs or provide assistance through the Low-Income Subsidy (LIS) program. Also known as Extra Help, LIS is a Social Security program that assists individuals with limited income and resources in reducing or eliminating Part D expenses. It is not part of a Medicare Advantage plan.
The following table outlines the prescription drug plan premium details of this plan.
Basic Part D Premium: | $(0.70) |
Supplemental Part D Premium: | $0.70 |
Total Part D Premium: | $0.00 |
Low Income Premium Subsidy: | $18.30 |
Low Income Premium Subsidy CMS Pays: | $0.00 |
Low Income Subsidy Premium: | $0.00 |
For more information about the Low Income Subsidy, refer to the Social Security Extra Help page.
Prescription Drug Plan Deductible
This plan's Part D deductible is $0.00 per year. You'll pay this amount at the pharmacy before Blue Cross and Blue Shield of Texas begins paying its share.
Prescription Drug Plan Out-of-Pocket Costs
In addition to the monthly premium and deductible, Blue Cross Medicare Advantage Value may have costs when you pick up your prescriptions. The following table describes pharmacy out-of-pocket costs by drug tier.
Drug Tier | Retail | Mail Order | |
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Preferred Generic | $0.00 | $18.00 | |
Generic | $10.00 | $20.00 | |
Preferred Brand | $47.00 | $47.00 | |
Non-Preferred Drug | 30.00% | 30.00% | |
Specialty Tier | 33.00% | 33.00% | |
*Deductible does not apply. |
CMS 5-Star Rating Overview
Each year, the Centers for Medicare & Medicaid Services (CMS) evaluates health and drug plans using a comprehensive 5-star rating system. These ratings offer valuable insights into the quality of care, member satisfaction, and overall plan performance.
When selecting a Medicare Advantage plan, looking at the star ratings can help you gauge how well a plan might meet your healthcare needs, making it easier to choose a plan with confidence.
CMS Measure | Star Rating |
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2025 Overall Rating | |
Staying Healthy: Screenings, Tests, Vaccines | |
Managing Chronic (Long Term) Conditions | |
Member Experience with Health Plan | |
Complaints and Changes in Plans Performance | |
Health Plan Customer Service | |
Drug Plan Customer Service | |
Complaints and Changes in the Drug Plan | |
Member Experience with the Drug Plan | |
Drug Safety and Accuracy of Drug Pricing |
Plan Availability
Blue Cross Medicare Advantage Value (H9706-005-0) is available in the following locations (click to open):
Who Can Enroll in Blue Cross Medicare Advantage Value ?
To qualify for enrollment in Blue Cross Medicare Advantage Value , you must:
- Be entitled to Medicare Part A and enrolled in Medicare Part B.
- Live within the plan’s designated service area.
If you fulfill these criteria, you can enroll in Blue Cross Medicare Advantage Value and enjoy the extensive healthcare benefits it offers.
When Can I Enroll in Blue Cross Medicare Advantage Value ?
Understanding the right time to enroll in Blue Cross Medicare Advantage Value is crucial. Here are the key enrollment periods:
- Initial Enrollment Period (IEP): Your first opportunity to enroll in Medicare starts three months before your 65th birthday and lasts until three months after your birthday month.
- Annual Enrollment Period (AEP): Occurring annually from October 15 to December 7, the AEP allows you to enroll in, switch, or drop a Medicare Advantage plan if you are currently enrolled in a Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31 each year, the MA OEP gives you the chance to switch Medicare Advantage plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Certain life changes, like moving or losing other coverage, may make you eligible for a SEP, allowing you to adjust your plan outside the usual periods.
Not sure when to enroll? Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711) to speak with a licensed insurance agent who can guide you through your options.
Steps to Enroll in Blue Cross Medicare Advantage Value
Enrolling in Blue Cross Medicare Advantage Value is easy. Choose the option that works best for you:
- Online through MedicareEnrollment.com: Visit the enrollment page and complete your enrollment through their Secure Online Enrollment Form.
- By Phone: Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711). A licensed insurance agent can assist you with the enrollment process and provide answers to any questions.
- Through Medicare.gov: Go to Medicare.gov, log in or create an account, and follow the instructions to join Blue Cross Medicare Advantage Value through the official Medicare website.
- Directly with Blue Cross Medicare Advantage Value : You can also enroll directly with the plan. The necessary contact details are provided below in the "Contact" section.
Remember to enroll during the correct enrollment period to ensure your coverage starts on time.
Contact Blue Cross and Blue Shield of Texas
Website: | Blue Cross and Blue Shield of Texas Plan Page |
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Providers: | Blue Cross and Blue Shield of Texas Providers Page |
Formulary: | Blue Cross and Blue Shield of Texas Formulary Page |
Pharmacy: | Blue Cross and Blue Shield of Texas Pharmacy Page |
New Member Health Plan Help: | (877)583-8129 |
New Member Health Plan TTY: | 711 |
New Member Part D Help: | (877)213-1817 |
New Member Part D TTY Users: | 711 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, you can do so on the Social Security Administration website. For more information about the Medicare Part C program, visit the official Medicare website or call 1-800-MEDICARE.
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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