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.
With BayCarePlus Complete, there are no additional premiums to pay. There are also no annoying deductibles to meet. Your coverage begins right away.
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.
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.
The BayCarePlus Complete plan also includes preventive dental coverage, transportation to and from doctor appointments, hearing aid coverage and even coverage for over-the-counter health care expenses.
BayCarePlus Complete members will also receive acupuncture benefits, post-hospitalization meals and access to BayCareAnywhere® 24/7 virtual doctor visits via video chat at no additional cost.
Technology has changed the way we do everything, and that includes how we see doctors. If you’re too sick to leave the house or just want to practice social distancing, BayCarePlus covers telemedicine visits with your primary care doctor and specialists. You can also use the BayCareAnywhere mobile app to have an unscheduled video visit with a doctor for urgent care needs any time of day or night—even on holidays.
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.
Your BayCarePlus plan provides comprehensive medical and hospital coverage with no annual deductible and low copayments.
Hospital and Medical Coverage |
|
---|---|
Monthly Premium |
$0 |
Part B Premium Reduction |
$0 Per Month |
Maximum Out-of-Pocket Limit |
$3,500 Per Calendar Year |
Annual Deductible |
$0 |
Preventive Care/Screenings |
$0 Copay |
Primary Care Physician Visits |
$0 Copay |
Specialist Doctor Visits |
$15 Copay |
Urgent Care |
$35 Copay |
Emergency Care |
$90 Copay |
Lab Services |
$0 Copay |
Home Health Care |
100% Coverage |
Chiropractic Services |
$20 Copay |
Inpatient Hospital Care |
$175 Copay per day, per stay: Days 1-5 $0 Copay per day, per stay: Days 6 and beyond |
Outpatient Surgery at Hospital |
$125 Copay |
Outpatient Surgery at Ambulatory Surgery Center |
$75 Copay |
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 (30 day retail supply) | ||||||||||
Tier 2 – Generics |
$4 Copay (30 day retail supply) | ||||||||||
Tier 3 – Preferred Brands |
$35 Copay (30 day retail supply) | ||||||||||
Tier 4 – Non-Preferred Brands |
$85 Copay (30 day retail supply) | ||||||||||
Tier 5 – Specialty Drugs |
33% Co-insurance (30 day retail supply) | ||||||||||
Mail Order – 90 Day Supply |
Tier 1 – Preferred Generics:
Tier 2 – Generics:
Tier 3 – Preferred Brands:
Tier 4 – Non-Preferred Brands:
Tier 5 – Specialty Drugs:
|
||||||||||
Initial Coverage Limit |
$4,430 | ||||||||||
New for 2022! Special Supplemental Benefits for People with DiabetesAt BayCarePlus Medicare Advantage, we believe our members should be able to have affordable, easy access to benefits that’ll help them effectively manage their diabetes and avoid serious illness. Any BayCarePlus Complete or Premier plan member who’s been diagnosed with diabetes will receive these new benefits. This includes the Insulin Savings Program. Members will have a predictable, stable copay for Select Insulins during the Initial Coverage and Coverage Gap phases. You aren’t eligible for the Insulin Savings Program if you receive Extra Help from the government or are a member of the BayCarePlus Rewards plan. If you’re a member of the Rewards plan, insulins are covered at the regular tier cost-share. |
|||||||||||
Select Insulins |
$4-$35 Copay per month (remains through the coverage gap) (30-day supply) |
||||||||||
Diabetes Supplies | $0 Copay when using a network pharmacy or contracted durable medical equipment (DME) provider | ||||||||||
Additional Over-the-Counter (OTC) Dollars | +$25/Quarter | ||||||||||
Expanded Dental Benefit | Up to three routine cleanings and one deep cleaning every 12 months | ||||||||||
Enhanced Podiatry Benefit | $0 Copay for up to four routine visits/calendar year, which include nail trimmings | ||||||||||
Extra Nutrition Counseling | $0 Copay for four additional hours/calendar year | ||||||||||
Insulin Savings Program
As a member of the BayCarePlus Complete or Premier plan, you’ll have low, predictable copays on Select Insulins† through our Insulin Savings Program. Standard Retail Cost-Sharing
Mail-Order Pharmacy
†Select Insulins are those that are part of the Insulin Savings Program and therefore will incur low, consistent copays through the coverage gap. For information regarding which insulins are Select Insulins under the plan’s benefit, refer to the plan’s Prescription Drug Formulary. See the Evidence of Coverage for more information regarding Select Insulins, including full cost-sharing information. Plans may offer supplemental benefits in addition to Part C benefits and Part D 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 |
|
Preventive Dental Care |
$0 Copay Includes exams, horizontal bitewing x-rays & cleanings |
Comprehensive Dental Care
|
Some limitations apply. See Evidence of Coverage for complete details. Services must be received from an Argus dental provider. Learn more about our comprehensive dental benefits. |
Over-the-Counter (OTC) Items |
$65 Per Quarter |
Hearing |
Up to two hearing aids every two calendar years (one per ear), $699 or $999 copay per hearing aid |
Transportation Assistance |
$0 Copay for 16 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 |
Meals |
Up to 56 Home-delivered, post-discharge meals per calendar year |
Therapeutic Massage |
No Coverage |
Acupuncture |
$20 Copay for up to 20 visits |
Download your FREE Medicare Advantage Decision Guide or request a copy by mail.
Request Your Decision GuideLearn more about BayCarePlus plans at a FREE live seminar or webinar.
Sign Up for a SeminarGet your questions answered in a virtual or in-person appointment with a BayCarePlus advisor.
Schedule a ConsultationDiscuss your options with a licensed Medicare advisor.
Call (877) 549-1741 (TTY: 711)