BlueMedicare Value (PFFS) Medicare Advantage Plan H4213-019 • 2026 • Newton County, AR

BlueMedicare Value Overview

Plan Details for BlueMedicare Value

This Medicare Advantage Private Fee-for-Service (PFFS) plan allows access to Medicare-approved providers who accept the plan’s terms. Referrals are not required, and provider participation is determined at the time services are received. The monthly premium is $0.00, and the plan includes Medicare Part A and Part B benefits.

Primary care visits have a $10 copay | Out-of-network: $10 copay, 40% coinsurance, specialist visits come with a $40 copay | Out-of-network: $40 copay, 40% coinsurance, urgent care services carry a $40 copay, and ambulance transportation is $325 copay | Out-of-network: $325 copay. These costs apply toward the annual maximum out-of-pocket (MOOP) limit of $7500.00. Once this limit is reached, covered services are fully paid for the remainder of the year.

This plan is listed by CMS under Plan ID H4213-019. Cost-sharing details are provided below.

Cost-Sharing Overview

BlueMedicare Value has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The table below details the most common in-network out-of-pocket expenses for plan H4213-019.

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 Ratings

The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage (Part C) and Part D prescription drug plans each year using a 5-star system. These ratings measure plan performance in areas such as preventive care, management of chronic conditions, and member experience.