BlueMedicare Value (PFFS) Medicare Advantage Plan H4213-019 • 2027 • Conway County, AR
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $1,000
- Maximum Out-of-Pocket
- $7500.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Not Included
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Conway County, AR
- Local Enrollment
- 0 beneficiaries in Conway County
BlueMedicare Value (PFFS) Introduction
This Medicare Advantage PFFS plan, BlueMedicare Value, is offered by Arkansas Blue Medicare and uses a Medicare Private Fee-for-Service (PFFS) provider network. It comes without prescription drug coverage. For the 2027 plan year, the monthly premium is $0.00, the medical deductible is $1,000, and the in-network maximum out-of-pocket is $7500.00. The plan is identified by CMS Plan ID H4213-019.
Enrollment in this plan requires residence in Conway County, Arkansas. CMS enrollment data reports 0 plan members in Conway County. New members can call the plan directly at (888)605-0322 (TTY 711) for assistance.
Compare Similar Plans in Conway County
Compare this plan with the two most-enrolled PFFS plans available in Conway County, Arkansas. Enrollment is based on CMS local enrollment data.
| Plan Detail | BlueMedicare Value | BlueMedicare Preferred | Humana Gold Choice H8145-126 |
|---|---|---|---|
| CMS Plan ID | H4213-019-0 |
H4213-020-0 |
H8145-126-0 |
| Local Enrollment | 0 | 0 | 0 |
| Monthly Premium | $0.00 | $78.00 | $0.00 |
| Medical Deductible | $1,000 | $1,000 | $0.00 |
| Maximum Out-of-Pocket | $7,500.00 | $7,500.00 | $9,850.00 |
| Part B Giveback | Not offered | Not offered | Not offered |
| Primary Care | $10 copay | $10 copay | $0 copay |
| Specialist | $40 copay | $40 copay | $40 copay |
| Part D Deductible | Not Applicable | $700.00 | Not Applicable |
| CMS Star Rating | 3.0 | 3.0 | 4.0 |
| Dental | $0 copay | $0 copay | $0 copay |
| Vision | $0 copay | $0 copay | $0 copay |
| Hearing | $0 copay | $0 copay | $0 copay |
Want to explore more options? Browse all Medicare Advantage plans in Conway County, or compare Medicare Advantage plans across Arkansas, including premiums, out-of-pocket costs, CMS ratings, and enrollment.
Plan Benefits
Cost-sharing for BlueMedicare Value includes out-of-pocket expenses for covered healthcare services. The following tables provide a summary of typical in-network out-of-pocket costs for plan H4213-019.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H4213-019-0 Cost Compare.
Office Visits
- Primary care
- In-network: $10 copay
Out-of-network: $10 copay, 40% coinsurance - Specialist
- In-network: $40 copay
Out-of-network: $40 copay, 40% coinsurance
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
Out-of-network: $0 copay, 40% coinsurance - Telehealth benefit
- In-network: $0 copay
- Routine chiropractic
- Not covered
- Fitness benefits
- Coming soon
- Health education
- Not covered
- Counseling services
- Not covered
- Over-the-counter drug benefits
- In-network: $0 copay
Out-of-network: $0 copay - Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: $25-$340 copay
Out-of-network: $25-$340 copay, 40% coinsurance - Lab services
- In-network: 0%-20% coinsurance
Out-of-network: 0%-40% coinsurance - Outpatient x-rays
- In-network: 20% coinsurance
Out-of-network: 20%-40% coinsurance - Diagnostic tests and procedures
- In-network: 0%-20% coinsurance
Out-of-network: 0%-40% coinsurance
Emergency and Urgent Care Services
- Emergency room care
- $115 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $40 copay
- Inpatient hospital care
- In-network:
Tier 1
$390 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Out-of-network:
$390 per day for days 1-5
$0 per day for days 6-90
$0 and 40% per stay - Skilled Nursing Facility
- In-network:
Tier 1
$0 per day for days 1-20
$221 per day for days 21-100
Out-of-network:
$0 per day for days 1-20
$221 per day for days 21-100
$0 and 40% per stay - Ground ambulance
- In-network: $325 copay
Out-of-network: $325 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $35 copay
Out-of-network: $35 copay, 40% coinsurance - Outpatient group therapy
- In-network: $35 copay
Out-of-network: $35 copay, 40% coinsurance - Inpatient psychiatric hospital care
- In-network:
Tier 1
$390 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Out-of-network:
$390 per day for days 1-5
$0 per day for days 6-90
$0 and 40% per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $35 copay
Out-of-network: $35 copay, 40% coinsurance - Occupational therapy
- In-network: $35 copay
Out-of-network: $35 copay, 40% coinsurance
Medical Equipment and Supplies
- Diabetes supplies
- In-network: $0 copay
Out-of-network: 20% coinsurance - Durable medical equipment
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance - Prosthetics
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Medicare Part B Drugs
- Chemotherapy
- In-network: 0%-20% coinsurance
Out-of-network: 0%-40% coinsurance - Other Part B drugs (Medicare-covered)
- In-network: 0%-20% coinsurance
Out-of-network: 0%-40% coinsurance
Dental Services
- Oral exam
- In-network: $0 copay
Out-of-network: 50% coinsurance - Dental x-rays
- In-network: $0 copay
Out-of-network: 50% coinsurance - Cleaning
- In-network: $0 copay
Out-of-network: 50% coinsurance - Periodontics
- In-network: 20% coinsurance
Out-of-network: 50% coinsurance - Endodontics
- Not covered
- Restorative services
- In-network: 20% coinsurance
Out-of-network: 50% coinsurance - Implant services
- Not covered
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- In-network: 20% coinsurance
Out-of-network: 50% coinsurance
Vision Services
- Routine eye exam
- In-network: $0 copay
Out-of-network: 40% coinsurance - Contact lenses
- In-network: $0 copay
Out-of-network: $0 copay - Eyeglass frames only
- Not covered
- Eyeglass lenses only
- Not covered
- Eyeglasses (frames & lenses)
- In-network: $0 copay
Out-of-network: $0 copay - Upgrades
- In-network: $0 copay
Out-of-network: $0 copay
Hearing Services
- Hearing exam
- In-network: $0 copay
Out-of-network: $0 copay - Fitting/evaluation
- In-network: $0 copay
Out-of-network: $0 copay - Prescription hearing aids
- In-network: $699-$999 copay
Out-of-network: $699-$999 copay - OTC hearing aids
- Not covered
Additional and Special Needs Services
- Adult day health services
- Not covered
- Home-based palliative care
- Not covered
- Personal emergency response system
- Coming soon
- Weight management programs
- Not covered
- Wigs for chemotherapy-related hair loss
- Coming soon
- Alternative therapies
- Not covered
- Massage therapy
- Not covered
- Home/bathroom safety devices
- Not covered
Certain preventive services are covered 100% by BlueMedicare Value as a Part B benefit.
Prescription Drug Coverage
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Performance Ratings (Contract ID: H4213)
CMS evaluates Medicare Advantage (Part C) and Part D plans annually using a 5-star rating system. Ratings reflect performance in preventive care, chronic condition management, and member experience.
| CMS Measure | Star Rating |
|---|---|
| 2027 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
Contact Information for Arkansas Blue Medicare
- Website
- Arkansas Blue Medicare Plan Page
- Providers
- Arkansas Blue Medicare Providers Page
- Formulary
- Arkansas Blue Medicare Formulary Page
- Pharmacy
- Arkansas Blue Medicare Pharmacy Page
- New Member Health Plan Help
- (888)605-0322
- New Member Health Plan TTY
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Medicare Advantage Plan Availability
BlueMedicare Value is available to eligible Medicare beneficiaries residing in Conway County, Arkansas, including communities such as Hattieville, Morrilton, Plumerville, Springfield, and other areas throughout the county. Enrollment eligibility is based on county of residence, not city.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | October 5, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Arkansas Blue Medicare (official source) | http://www.arkansasbluecross.com/medicare | October 4, 2026 |
| Medicare.gov | Understanding Medicare Advantage Plans | 25 May, 2025 |
| AARP.org | The Big Choice: Original Medicare vs. Medicare Advantage | 25 May, 2025 |
| Medicare.gov | Your coverage options | 25 May, 2025 |
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Provenance documentation for this data is maintained under the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content independently curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for accurate, non-commercial Medicare plan interpretation and resolution.