Skip to main content
  • Blue Cross Blue Shield of Massachusetts Logo Blue Cross Blue Shield of Massachusetts Logo
  • Menu
    • Medicare Options
    • Home
    • Find a Doctor
    • My Account
      • Pay My Bill with Direct-Pay
      • MyBlue
    • Shop Plans
      • 2023 Plans
        • 2023 Medicare Advantage Plans
          • Medicare PPO Blue SaverRx
          • Medicare PPO Blue ValueRx
          • Medicare PPO Blue PlusRx
          • Medicare HMO Blue SaverRx
          • Medicare HMO Blue ValueRx
          • Medicare HMO Blue FlexRx
          • Medicare HMO Blue PlusRx
        • 2023 Medicare Supplement Plans
          • Medex Core
          • Medex Sapphire
          • Medex Bronze
          • Medex Vision & Hearing
        • 2023 Prescription Drug Plans
        • 2023 Dental Plans
        • 2023 Group Plans
        • 2023 Travel Medical Insurance Plans
    • Learn More
      • Intro to Medicare
        • Introduction
        • Eligibility and Enrollment
        • Frequently Asked Questions
        • Your Coverage Choices
        • Original Medicare
        • Medicare Advantage
        • Prescription Drug Coverage
        • Plan that’s Right for you
        • Sign-Up for a Guide Book and Email
        • Medicare Basics Video Series
      • Are You Eligible For Medicare?
      • Are Your Drugs Covered?
      • Attend a Seminar
      • About Medicare
        • Health Plan Basics
        • Important Dates
      • Request a Call
    • Health & Wellness
      • Finding Care
        • 24-Hour Nurse Line
        • Care Management
        • ER Alternatives
        • Find a Doctor
        • Member Support & Assistance Program
          • In-home Care from Landmark Health
          • In-home Health Assessments with Signify Health®´
          • Personalized Support for Disease Management
          • Quality Optimizer
          • Additional Programs
        • Mental Health
        • Supporting Caregivers
      • Manage Your Health
        • Managing Diabetes
        • Preventive Care
        • Flu Prevention
        • Chronic Care
        • Fall Prevention
        • Urinary Incontinence
        • Meals and Nutrition
    • Member Resources
      • Plan Information
        • Plan Documents
        • Quality Assurance
        • National Coverage Determination
        • Ending Membership
      • Pharmacy Benefits
        • Drug Benefits
          • Home Delivery
          • Formulary Overview
          • Coverage Requirements
          • Formulary Changes
        • Medicare Advantage Pharmacy Network
        • Plan Drug Transition Policy
        • Medication Therapy Management
        • Prescription Drug Utilization Review
      • Learn to Live
      • Get More With MyBlue
      • Discounts & Programs
      • Payment Options
      • Fraud & Disaster
      • Appeals & Grievances
        • Medicare Advantage Part C Medical Care Plan Rights
        • Medicare Advantage Part D Prescription Drug Plan Rights
      • Medicare Advantage Billing Change Request
      • Medicare Advantage Designation of an Authorized Representative
      • Medex Member Designation of an Authorized Representative
      • Prior Prescription Drug Coverage
      • Contact Us
    • Other Sites
      • Blue Cross MA Home
      • MyBlue
      • Employer
      • Broker
      • Careers
      • About Us
      • Contact Support
  • {Mobile Break}
  • Medicare Options
  • Search
  • Get Care
    • Contact Us
    • Request a Call

     Call Medicare Sales

    1-800-678-2265TTY 711

    8 a.m. to 8 p.m.
    4/1 - 9/30, Mon. – Fri.
    10/1 – 3/31, 7 days a week

     Talk to a Nurse

    1-888-247-2583

    Available 24/7

  • Account

    Sign-in to MyBlue

  • Menu
    • Medicare Options
    • Home
    • Find a Doctor
    • My Account
      • Pay My Bill with Direct-Pay
      • MyBlue
    • Shop Plans
      • 2023 Plans
        • 2023 Medicare Advantage Plans
          • Medicare PPO Blue SaverRx
          • Medicare PPO Blue ValueRx
          • Medicare PPO Blue PlusRx
          • Medicare HMO Blue SaverRx
          • Medicare HMO Blue ValueRx
          • Medicare HMO Blue FlexRx
          • Medicare HMO Blue PlusRx
        • 2023 Medicare Supplement Plans
          • Medex Core
          • Medex Sapphire
          • Medex Bronze
          • Medex Vision & Hearing
        • 2023 Prescription Drug Plans
        • 2023 Dental Plans
        • 2023 Group Plans
        • 2023 Travel Medical Insurance Plans
    • Learn More
      • Intro to Medicare
        • Introduction
        • Eligibility and Enrollment
        • Frequently Asked Questions
        • Your Coverage Choices
        • Original Medicare
        • Medicare Advantage
        • Prescription Drug Coverage
        • Plan that’s Right for you
        • Sign-Up for a Guide Book and Email
        • Medicare Basics Video Series
      • Are You Eligible For Medicare?
      • Are Your Drugs Covered?
      • Attend a Seminar
      • About Medicare
        • Health Plan Basics
        • Important Dates
      • Request a Call
    • Health & Wellness
      • Finding Care
        • 24-Hour Nurse Line
        • Care Management
        • ER Alternatives
        • Find a Doctor
        • Member Support & Assistance Program
          • In-home Care from Landmark Health
          • In-home Health Assessments with Signify Health®´
          • Personalized Support for Disease Management
          • Quality Optimizer
          • Additional Programs
        • Mental Health
        • Supporting Caregivers
      • Manage Your Health
        • Managing Diabetes
        • Preventive Care
        • Flu Prevention
        • Chronic Care
        • Fall Prevention
        • Urinary Incontinence
        • Meals and Nutrition
    • Member Resources
      • Plan Information
        • Plan Documents
        • Quality Assurance
        • National Coverage Determination
        • Ending Membership
      • Pharmacy Benefits
        • Drug Benefits
          • Home Delivery
          • Formulary Overview
          • Coverage Requirements
          • Formulary Changes
        • Medicare Advantage Pharmacy Network
        • Plan Drug Transition Policy
        • Medication Therapy Management
        • Prescription Drug Utilization Review
      • Learn to Live
      • Get More With MyBlue
      • Discounts & Programs
      • Payment Options
      • Fraud & Disaster
      • Appeals & Grievances
        • Medicare Advantage Part C Medical Care Plan Rights
        • Medicare Advantage Part D Prescription Drug Plan Rights
      • Medicare Advantage Billing Change Request
      • Medicare Advantage Designation of an Authorized Representative
      • Medex Member Designation of an Authorized Representative
      • Prior Prescription Drug Coverage
      • Contact Us
    • Other Sites
      • Blue Cross MA Home
      • MyBlue
      • Employer
      • Broker
      • Careers
      • About Us
      • Contact Support

 1-800-678-2265      TTY: 711

8:00 a.m. to 8:00 p.m. ET, Seven Days a Week.

  • Shop Plans
    • 2023 Plans
      • 2023 Medicare Advantage Plans
        • Medicare PPO Blue SaverRx
        • Medicare PPO Blue ValueRx
        • Medicare PPO Blue PlusRx
        • Medicare HMO Blue SaverRx
        • Medicare HMO Blue ValueRx
        • Medicare HMO Blue FlexRx
        • Medicare HMO Blue PlusRx
      • 2023 Medicare Supplement Plans
        • Medex Core
        • Medex Sapphire
        • Medex Bronze
        • Medex Vision & Hearing
      • 2023 Prescription Drug Plans
      • 2023 Dental Plans
      • 2023 Group Plans
      • 2023 Travel Medical Insurance Plans
  • Learn More
    • Intro to Medicare
      • Introduction
      • Eligibility and Enrollment
      • Frequently Asked Questions
      • Your Coverage Choices
      • Original Medicare
      • Medicare Advantage
      • Prescription Drug Coverage
      • Plan that’s Right for you
      • Sign-Up for a Guide Book and Email
      • Medicare Basics Video Series
    • Are You Eligible For Medicare?
    • Are Your Drugs Covered?
    • Attend a Seminar
    • About Medicare
      • Health Plan Basics
      • Important Dates
    • Request a Call
  • Health & Wellness
    • Finding Care
      • 24-Hour Nurse Line
      • Care Management
      • ER Alternatives
      • Find a Doctor
      • Member Support & Assistance Program
        • In-home Care from Landmark Health
        • In-home Health Assessments with Signify Health®´
        • Personalized Support for Disease Management
        • Quality Optimizer
        • Additional Programs
      • Mental Health
      • Supporting Caregivers
    • Manage Your Health
      • Managing Diabetes
      • Preventive Care
      • Flu Prevention
      • Chronic Care
      • Fall Prevention
      • Urinary Incontinence
      • Meals and Nutrition
  • Member Resources
    • Plan Information
      • Plan Documents
      • Quality Assurance
      • National Coverage Determination
      • Ending Membership
    • Pharmacy Benefits
      • Drug Benefits
        • Home Delivery
        • Formulary Overview
        • Coverage Requirements
        • Formulary Changes
      • Medicare Advantage Pharmacy Network
      • Plan Drug Transition Policy
      • Medication Therapy Management
      • Prescription Drug Utilization Review
    • Learn to Live
    • Get More With MyBlue
    • Discounts & Programs
    • Payment Options
    • Fraud & Disaster
    • Appeals & Grievances
      • Medicare Advantage Part C Medical Care Plan Rights
      • Medicare Advantage Part D Prescription Drug Plan Rights
    • Medicare Advantage Billing Change Request
    • Medicare Advantage Designation of an Authorized Representative
    • Medex Member Designation of an Authorized Representative
    • Prior Prescription Drug Coverage
    • Contact Us
  • Other Sites
    • Blue Cross MA Home
    • MyBlue
    • Employer
    • Broker
    • Careers
    • About Us
    • Contact Support

2023 Medicare HMO Blue FlexRx

Costs & Benefits

Shop all plans available to you

Part A Eligible:
Coverage Year:
Zip Code:
Change Information

Your Information

What’s Part A?
part-a-date

Understand Plan Features

 Doctors Network  Prescriptions Eligibility  Discount & Programs

Plan Information

Medical

In-Network

Out-of-Network

Doctor Visits

$10 copay per office or telehealth visit

$65 copay per visit

Specialist Visits

$35 copay per office or telehealth visit

$65 copay per visit

Medicare Preventive Services

$0 copay per visit

$65 copay or 20% of the cost per visit depending on the service

Annual Medical Out-of-Pocket Maximum

$3,900 for Medicare-covered services

$9,900 for Medicare-covered services

Inpatient Care

Days 1-5: $245 copay per day

20% of the cost

Outpatient Surgery

$210 copay per visit

20% of the cost

Diagnostic Procedures, Tests, and Lab Services

$10 copay per day for lab, X-rays, and other diagnostic tests; $200 copay per day per category of test for certain high-tech imaging; $0 copay for therapeutic radiology

20% of the cost for lab, X-rays, and other diagnostic tests; 40% of the cost for high-tech imaging; 20% of the cost for therapeutic radiology

Emergency Care

$90 copay per visit

$90 copay per visit

 - - 

Enroll Online

See all Enrollment Options

We could not find Medicare Advantage Plans available in your area or Please enter a valid zip code.

However, you can choose a Medicare Supplement and Prescription Drug plan.

Other Preventive Services

In-Network

Out-of-Network

Preventive Dental

(maximum of two visits each calendar year)

$0 copay per visit, twice each calendar year

$45 copay per visit, twice each calendar year.

(Visit total is combined between in and out-of-network)

Annual Routine Vision Exam

$0 copay for one routine exam per 12 months with an EyeMed Provider

No Coverage

Eyeglasses Benefit

$200 limit for routine eyewear every 24 months with an EyeMed provider

No Coverage

Annual Physical Exam

$0 copay

$65 copay

Annual Routine Hearing Exam

$0 copay for one routine exam every 12 months with a TruHearing provider

No Coverage

Hearing Aid Benefit

$699 copay or $999 copay per hearing aid (one per ear per year) from a TruHearing provider

No Coverage

Annual Fitness Benefit

$150 toward fitness club membership, exercise class fees, online class fees, fitness equipment, and pool-only facilities

 

Weight Loss Benefit

Up to $150 toward fees paid for qualified weight loss programs per year

 

To confirm your eligibility and schedule a routine vision or hearing appointment please contact:

EyeMed: 1-866-490-7291 (TTY: 711)

October 1 through March 31: 8:00 a.m. - 11:00 p.m. ET., 7 days a week
April 1 through September 30: 8:00 a.m. - 11:00 p.m. ET., Monday through Saturday; 11:00 a.m. - 8:00 p.m, Sunday.

TruHearing: 1-844-811-3762 (TTY: 711)

8:00 a.m. - 9:00 p.m. ET, Monday through Friday.

Prescription Drug Coverage

Prescription Drug Annual Deductible 

Cost
Tiers 1 and 2 $0
Tiers 3, 4, and 5

$260

Initial Coverage

Preferred Cost-Sharing Pharmacies
Amount for 30-day supply

Standard Cost-Sharing Pharmacies
Amount for 60-day supply

CVS Caremark Mail Service
Amount for 90-day supply

Tier 1: Preferred Generic

$0 copay

$6 copay

$0 copay

Tier 2: Generic

$5 copay

$10 copay

$10 copay

Tier 3: Preferred Brand

$42 copay

$47 copay

$84 copay

Tier 4: Non-Preferred Drug

$95 copay

$100 copay

$190 copay

Tier 5: Specialty Drugs

28% of the cost

28% of the cost

Not available at 90-day supply

Coverage Gap 

After your total yearly drug costs reach $4,660, you receive limited coverage by the plan on certain drugs. For covered generics, you pay 25% of the plan's costs. For covered brand drugs, you pay no more than 25% of the plan's costs (excluding dispensing fees).

Catastrophic Coverage 

After your yearly out-of-pocket drug costs reach $7,400 you pay the greater of:

  • $4.15 copay for generics or drugs treated like generic drugs and a $10.35 copay for all other drugs; or
  • 5% of the cost

CVS Caremark, an independent company that administers your pharmacy benefits on behalf of Blue Cross Blue Shield of Massachusetts.

Additional Benefits

As a Medicare HMO Blue FlexRx plan member, you get additional benefits beyond Original Medicare, such as:

  • Coverage for routine hearing exams and vision care
  • Allowances toward eyewear
  • Routine preventive dental care
  • Prevention and wellness programs
  • New for 2023 - Learn to Live Online Cognitive Behavioral Therapy
  • Worldwide coverage for emergency care

Prescription Drug Coverage

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.

Summary of Benefits and Evidence of Coverage

  • 2023 Medicare HMO Blue FlexRx (HMO-POS) Summary of Benefits (Updated 10/01/2022)
  • 2023 Medicare HMO Blue FlexRx (HMO-POS) Evidence of Coverage (Updated 10/01/2022)

Compare 2023 Medicare Plans

 Medicare Advantage

 Medicare Supplement

 Prescriptions

 Dental

 

No Plans Found

We could not find Medicare plans available in your area. Please make sure the Massachusetts ZIP code you entered is correct.


Other Medicare Plans

 Medicare Supplement

 Prescription Drug Plan

 Dental

  • Your monthly premium will be different if you qualify for Extra Help from Medicare.
  • This information is not a complete description of benefits. Call 1-800-200-4255 (TTY: 711) for more information.
  • Every year, Medicare evaluates plans based on a 5-star rating system.

Blue Cross Blue Shield of Massachusetts is an HMO and PPO Plan with a Medicare contract. Enrollment in Blue Cross Blue Shield of Massachusetts depends on contract renewal. Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont are the legal entities that have contracted as a joint enterprise with the Centers for Medicare & Medicaid Services (CMS) and are the risk-bearing entities for Blue MedicareRx (PDP) plans. The joint enterprise is a Medicare-approved Part D Sponsor. Enrollment in Blue MedicareRx (PDP) depends on contract renewal.

You can file a complaint if you feel that you received inaccurate, misleading or inappropriate information. Please call Member Service at 1-800-200-4255 (TTY users call: 711). If your complaint involves a broker or agent, be sure to include the name of the broker/agent when filing your complaint.

Y0014_22146
S2893_2244
Last Updated: 01/01/2023

Social Media Links

  • Facebook
  • Twitter
  • Linkedin
  • Youtube
  • itunes app
  • google play app

Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. ®, ℠ Registered and Service Marks of the Blue Cross and Blue Shield Association. ®' Registered Marks of Blue Cross Blue Shield of Massachusetts. ®’’, ℠´, ™ Registered Service and Trade Marks are property of their respective owners. ©   Blue Cross and Blue Shield of Massachusetts, Inc., and Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc.

Footer Menu

  • About Us
  • Terms of Use, Privacy & Security
  • Accessibility
  • Sitemap
  • Nondiscrimination and Translations Resources