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BayCarePlus Rewards (HMO)

BayCarePlus Complete Coverage

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.

BayCarePlus Low Premium

$0 Monthly Premium and NO Deductibles

Our BayCarePlus Rewards (HMO) plan offers you comprehensive coverage for a $0 monthly premium. Plus, we will give you back $113 every month on your Part B premium. That’s a savings of up to $1,356 a year. And, there’s no annoying deductibles to meet. Your coverage begins right away.

How can we offer $0 premiums? Find out.

BayCarePlus Coverage when Traveling

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.

BayCarePlus Financial Protection

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.

Are you protected? Find out.

BayCarePlus Money Saving Benefits

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 Silver&Fit® program for no additional premium.

BayCarePlus Rewards (HMO) plan members will also receive acupuncture benefits as well as access to BayCareAnywhere®, offering 24/7 virtual doctor visits via video chat.

Learn more about all the extra benefits.

BayCarePlus High Quality Providers

Telehealth: Video Doctor Visits

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.

 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. With the BayCarePlus Rewards plan, you receive $113 per month to subsidize the cost of your Part B premium. This is just another way we help you lower your out-of-pocket costs.

Hospital and Medical Coverage

Monthly Premium


Part B Premium Reduction

$113 Per month

Maximum Out-of-Pocket Limit

$4,500 Per year

Annual Deductible


Preventive Care/Screenings

$0 Copay

Primary Care Physician Visits

$0 Copay

Specialist Doctor Visits

$35 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

$250 Per day for days 1-6
$0 Per day for day 7 and beyond

Outpatient Surgery at Hospital

$195 Copay

Outpatient Surgery at Ambulatory Surgery Center

$125 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


Tier 1 – Preferred Generics

$0 Copay (30 day retail supply)

Tier 2 – Generics

$10 Copay (30 day retail supply)

Tier 3 – Preferred Brands

$47 Copay (30 day retail supply)

Tier 4 – Non-Preferred Brands

$100 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:

  • $0 Copay

Tier 2 – Generics:

  • $10 Copay

Tier 3 – Preferred Brands:

  • $47 Copay

Tier 4 – Non-Preferred Brands:

  • $100 Copay

Tier 5 – Specialty Drugs:

  • 33% Co-insurance

Initial Coverage Limit


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
($100 max benefit/calendar year)

Preventive Dental Care

$0 Copay

Includes exams, horizontal bitewing x-rays & cleanings

Comprehensive Dental Care
(Optional Supplemental Benefit only)

  • Additional Monthly Premium $25
  • $0 copays
  • No annual deductible
  • No maximum benefit amount per year
  • Crowns
  • Root canals
  • Complete or partial dentures with unlimited extractions

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

Not Offered


Routine hearing exam: $30 Copay (one per calendar year)

Transportation Assistance

No Coverage

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


No Coverage

Therapuetic Massage

No Coverage


$20 Copay for up to 20 visits

Important Plan Documents

Download: Summary of Benefits (Updated 09/30/2021)
Download: Resumen de Beneficios (Updated 09/29/2021)
Download: Provider Directory (Updated 04/06/2022)
Download: Directorio de Proveedores (Updated 04/06/2022)
Download: Drug Formulary Updated (03/22/2022)
Download: Formulario de Medicamentos Recetados (Updated 03/22/2022)
Download: Evidence of Coverage (Updated 09/28/2021)
Download: Evidencia de Cobertura (Updated 10/14/2021)
Download: Star Ratings (Updated 10/27/2021)
Download: Calificaciones por Estrellas (Updated 10/25/2021)
Download: Annual Notice of Change (Updated 09/22/2021)
Download: Aviso Anual de Cambio (Updated 10/06/2021)
Download: Low Income Subsidy Information (Updated: 09/30/2021)
Download: Información sobre Subsidios por Bajos Ingresos (Updated: 09/30/2021)

Ready to learn more about a BayCarePlus (HMO) plan?

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