BlueJourney HMO More Coverage and Value for Your Life Journey 2017 HMO is issued by Keystone Health Plan Central, a subsidiary of Capital BlueCross. Independent licensees of the BlueCross BlueShield Association.
For nearly 80 years, Capital BlueCross has provided coverage, security, and peace of mind to our friends and neighbors in Central Pennsylvania and the Lehigh Valley. Along the way, we ve become more than just an insurance company. We re a partner in health your partner in health, for your life journey. BlueJourney plans are for your journey. With a BlueJourney plan, formerly known as SeniorBlue, you ll get more of what you re looking for more protection, more benefits, more savings all from Capital BlueCross, the hometown company you know and trust. What is BlueJourney HMO? BlueJourney HMO is a Medicare-approved Medicare Advantage plan. Also known as Medicare Part C, Medicare Advantage plans like BlueJourney provide members with their Medicare Part A and Part B coverage plus extra benefits that Original Medicare does not provide. How do BlueJourney HMO plans work? Unlike Original Medicare, with a BlueJourney HMO plan, all of your medical and hospital coverage is included. Instead of relying on Medicare Parts A and B to cover hospital and medical expenses, they are conveniently covered by one simple, comprehensive plan. What advantages does BlueJourney provide? A BlueJourney HMO plan gives you the peace of mind, convenience, and value that comes from knowing that you re covered by one comprehensive plan. With a BlueJourney HMO plan, you ll get: Service from a êêêê rated plan Access to one of the largest networks of hospitals, doctors, and specialists No referrals needed for specialist visits No deductibles to satisfy before your medical benefits begin Primary care visits as low as $15 Specialist visits as low as $20 Silver&Fit fitness membership at no additional cost Rewards for taking small steps toward living healthy Silver&Fit is a program of ASH Fitness, Inc. On behalf of Capital BlueCross, ASH Fitness, Inc. assists in the administration of this fitness program. ASH Fitness, Inc. is an independent company.
Extra benefits to help you stay healthy Silver&Fit A FREE standard membership at a participating Silver&Fit fitness club or exercise center or The Silver&Fit Home Fitness Program that entitles you to receive up to two home fitness kits focusing on your choice of strength training, walking, yoga, Tai Chi, Pilates and more. Wellness Programs Educational materials and phone support are available for customers who have chronic conditions. Customers who have complex medical needs have the support of case managers who help coordinate care and resources. And discounts on nutrition plans, gym memberships, and fitness apparel are a click away. Nurse Line Nurse Line lets you pick up the phone, 24/7, and speak to a Registered Nurse or simply access recorded information on more than 1,100 health topics, including nutrition and fitness tips, medications, minor illnesses and injuries and more. Find network doctors and hospitals Enjoy the peace of mind knowing you are backed by the stability and security of one of the largest provider networks in our 21-county service area. Visit CapitalBlueMedicare.com to find doctors, hospitals, specialists, and Silver&Fit fitness centers. Beyond your access to network doctors and hospitals, you also have coverage for emergencies across the nation and around the world. Nurse Line is not intended to be a substitute for services or advice received from your health care providers who are the only ones that can diagnose or treat your individual medical conditions. Capital BlueCross and its affiliated companies believe this service to be useful for general information or support but do not assume any liability associated with its use.
Important enrollment information you need to know Who is eligible: There are three basic requirements to be eligible to enroll in a BlueJourney HMO plan: You must permanently reside in Adams, Berks, Centre, Columbia, Cumberland, Dauphin, Franklin, Fulton, Juniata, Lancaster, Lebanon, Lehigh, Mifflin, Montour, Northampton, Northumberland, Perry, Schuykill, Snyder, Union, or York County. You must be enrolled in Medicare Part B (Medical Insurance) and be entitled to Medicare Part A (Hospital Insurance). If you have Medicare Part B only, you must purchase Part A through Social Security. You must continue to pay your Part B premium. You must currently not have End-Stage Renal Disease (ESRD), which requires regular kidney dialysis. This does not apply if you are currently a non-medicare member of a plan offered by Capital BlueCross or its subsidiaries. How to enroll: Check the BlueJourney HMO Provider Directory to choose a participating Primary Care Physician. There are four ways to enroll: 1. Complete the enclosed enrollment form and mail in the included reply envelope. Send no money with your form. 2. Call a Sales Person toll-free at 1-888-233-7064 (TTY: 711) 8 a.m. to 8 p.m., Monday through Friday (with extended hours October 1, 2016 through February 14, 2017). 3. Enroll at CapitalBlueMedicare.com. 4. Visit a Capital Blue store. Find locations at CapitalBlueStore.com. You will receive a letter acknowledging receipt of your enrollment form. Upon acceptance, you will receive a separate mailing with your membership card, new member information, and first premium bill. Note: You may enroll in BlueJourney HMO only during certain times of the year. Please contact us for details.
BlueJourney HMO plan option for 2017 2017 Medical Services Options (January 1, 2017 through December 31, 2017) Doctor and hospital choice Maximum out-of-pocket limit Inpatient hospital care Inpatient mental health care Medical Services BlueJourney HMO Member Responsibility Cost Share Network providers $2,500 (excludes Part D drugs) Skilled nursing facility $0 days 1 100 Home health care Hospice Office visits primary care Office visits specialists Chiropractic services Podiatry services Outpatient mental health care Outpatient substance abuse care Outpatient services/surgery Partial hospitalization Ambulance services Emergency care (worldwide) Urgently needed care Outpatient rehabilitation services (including comprehensive outpatient rehabilitation facility) Cardiac rehabilitation services (Medicare-covered services) Pulmonary rehabilitation services Durable medical equipment Prosthetic services Diabetes self-monitoring, training and supplies Diagnostic tests, X-rays Laboratory services Renal dialysis Medicare Part B drugs Covered by Medicare $20 copayment $20 copayment (individual); (group) (individual); (group) per trip $50 copayment (waived if admitted) $50 copayment high tech imaging $0 therapeutic radiology continued
Preventive Services Annual wellness exams Bone mass measurement Colorectal screening exams Medicare-covered immunizations Mammograms (annual screening) Pap smears and pelvic exams Prostate cancer screening exams Dental, Hearing, and Vision Dental (Medicare-covered services) Hearing Services (Medicare-covered services) Vision (Medicare-covered services) Network Fitness Membership BlueJourney HMO Network
See What s in Store When you combine the strength and Power of Blue, great things happen. Like our Capital Blue health and wellness stores, where you can get in-person service to help answer your health plan questions and so much more! Fitness classes for all ages Wellness workshops, health fairs, and art receptions Senior social events with crafts, bingo, and other fun activities Healthy food and beverages at the in-store café A fun Kids Zone great for the grandkids that encourages healthy habits Locations Hampden Marketplace 4500 Marketplace Way Enola, PA Monday through Friday 8 a.m. 8 p.m. Saturday 8 a.m. 5 p.m. The Promenade Shops at Saucon Valley 2845 Center Valley Parkway Center Valley, PA Monday through Friday 9 a.m. 7 p.m. Saturday 9 a.m. 5 p.m. /capbluecross @capbluestore For more information, visit CapitalBlueStore.com or call (855) 505-2583 Capital Blue is brought to you by Capital BlueCross.
capbluecross.com capitalbluestore.com BlueJourney HMO is offered by Keystone Health Plan Central, a Medicare Advantage organization with a Medicare contract. Enrollment in BlueJourney PPO and BlueJourney HMO depends on contract renewal. Dental and vision benefits are issued by Capital Advantage Assurance Company, a subsidiary of Capital BlueCross. Capital BlueCross and its subsidiaries Capital Advantage Assurance Company and Keystone Health Plan Central are independent licensees of the BlueCross BlueShield Association. Communications issued by Capital BlueCross in its capacity as administrator of programs and provider relations for all companies. This information is not a complete description of benefits. Contact the plan for more information. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year. The formulary, pharmacy and/or provider network may change at any time. You will receive notice when applicable. For additional information, contact a Sales Person at 1-888-233-7064 (TTY: 711), 8 a.m. to 8 p.m., Monday through Friday (with extended hours October 1, 2016 through February 14, 2017). For Customer Service, please call toll-free 1-855-699-2464 (TTY: 711), Monday through Friday, 8 a.m. to 8 p.m. (with extended hours October 1, 2016 through February 14, 2017). Capital BlueCross and its family of companies comply with applicable federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex. If you, or someone you re helping, has questions about your health plan, you have the right to get help and information in your language at no cost. To talk to an interpreter, call 1-855-699-2464 (TTY: 711). Spanish Si usted, o alguien a quien usted está ayudando, tiene preguntas acerca de su plan de salud, tiene derecho a obtener ayuda e información en su idioma sin costo alguno. Para hablar con un intérprete, llame al 1-855-699-2464 (TTY: 711). Chinese 如果您, 或是您正在協助的對象, 有關於您的健康计划方面的問題, 您有權利免費以您的母語得到幫助和訊息 洽詢一位翻譯員, 請撥電話 [ 在此插入數字 1-855-699-2464 (TTY: 711) MED-40 (09/19/16)