BayCarePlus Signature (HMO)
Complete Coverage with One Plan from One Company
BayCarePlus bundles medical, hospital and prescription drug coverage together into one convenient plan. With one insurance card and one number to call, we eliminate the hassle and cost of dealing with multiple insurance companies so you can focus on more important things.
Low Monthly Premium and NO Deductibles
With BayCarePlus, there are no additional premiums to pay. There are also no annoying deductibles to meet. Your coverage begins right away.
Coverage When Traveling
Whether you’re making a trip out of state or out of the country, BayCarePlus has you covered. If you ever get sick or injured when away from home, you can rest easy knowing you have emergency or urgent care coverage.
Financial Security
All of our plans include out-of-pocket protection that limits your annual health care costs and protects your savings in case of an emergency or unexpected illness. This important protection isn’t offered by traditional Medicare plans.
Money-Saving Extra Benefits
Every BayCarePlus plan comes with important extra benefits including preventive dental, vision and even free memberships to health clubs through the popular SilverSneakers® program for no additional premium.
New for 2021, BayCarePlus Signature (HMO) plan members will also receive massage therapy, accupuncture and post-hospitalization meal benefits as well as access to BayCareAnywhere®, offering 24/7 virtual doctor visits via video chat.
Great Doctors
The BayCarePlus provider network includes many of the area’s doctors and hospitals. These providers all share our commitment to delivering high-quality care and personal and attentive service. As a member of BayCarePlus, you’ll have access to the hospitals and doctors of BayCare, plus other hospitals and doctors throughout the Tampa Bay region. As a BayCarePlus member, you’ll choose a participating primary care physician to serve as your personal doctor. Your physician will work closely with you, help you manage your health and help coordinate your care with specialists and others.
Benefits at a Glance
The following tables highlight some of the many benefits available to you as a valued BayCarePlus member. For more details and a complete list of benefits, please review our downloadable Summary of Benefits or Evidence of Coverage below.
Hospital and Medical Coverage
Your BayCarePlus plan provides comprehensive medical and hospital coverage with no annual deductible and low copayments.
Hospital and Medical Coverage |
|
|---|---|
Monthly Premium |
$28 |
Part B Premium Reduction |
$0 |
Maximum Out-of-Pocket Limit |
$2,800 Per year |
Annual Deductible |
$0 |
Preventive Care/Screenings |
$0 Copay |
Primary Care Physician Visits |
$0 Copay |
Specialist Doctor Visits |
$10 Copay |
Urgent Care |
$30 Copay |
Emergency Care |
$120 Copay |
Lab Services |
$0 Copay |
Home Health Care |
100% Coverage |
Chiropractic Services |
$10 Copay |
Inpatient Hospital Care |
$150 Copay per day, per stay: Days 1-5 $0 Copay per day, per stay: Days 6 and beyond |
Outpatient Surgery at Hospital |
$95 Copay |
Outpatient Surgery at Ambulatory Surgery Center |
$50 Copay |
Part D Drug Coverage
This table shows the drug tiers associated with your plan, and the copayments or co-insurance that you will pay in each tier. A drug formulary provides a list of drugs that are covered by our plan.
Part D Drug Coverage |
|
|---|---|
Annual Deductible |
$0 |
Tier 1 – Preferred Generics |
$0 Copay |
Tier 2 – Generics |
$0 Copay |
Tier 3 – Preferred Brands |
$35 Copay |
Tier 4 – Non-Preferred Brands |
$85 Copay |
Tier 5 – Specialty Drugs |
33% Co-insurance |
Mail Order – 90 Day Supply |
$0 / $0 / $95 / $245 / no coverage |
Initial Coverage Limit |
$4,130 |
Extra Benefits
Your BayCarePlus plan offers many valuable extras not offered by Original Medicare or Medicare supplement plans – at no additional cost to you.
Extra Benefits |
|
|---|---|
Vision Care |
$0 Copay: routine eye exam $0 Copay: eyeglasses or contacts ($200 max benefit/calendar year) |
Preventive Dental Care |
$0 Copay |
Over-the-Counter (OTC) Items |
$100 Per quarter |
Hearing |
Up to two hearing aids every two calendar years (one per ear) $599 or $899 copay per hearing aid |
Transportation Assistance |
$0 Copay (24 one-way trips to approved locations per calendar year) |
Fitness Club Membership |
Included at no additional cost |
Travel Benefits |
Emergency or urgent care coverage if you are making a trip out of state or country |
Post-Hospitalization Meals |
56 Home-delivered, post-discharge meals per calendar year |
Therapeutic Massage
|
$20 Copay for up to 30 combined total visits between acupuncture and therapeutic massage, per calendar year |
Optional Supplemental Benefits
In addition to comprehensive coverage and money-saving extra benefits that come with a BayCarePlus (HMO) plan, we also offer optional supplemental benefits which give you an opportunity to enhance your benefits for a low additional monthly premium.
Optional Supplemental Benefits |
|
|---|---|
Comprehensive Dental Care |
New! Add comprehensive dental care for a low additional premium of only $14 per month!
Some limitations apply. See Evidence of Coverage for complete details. Services must be received from an Argus dental provider. |
