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Florida Blue | AEP Keeps Getting Better! Let’s Explore the Power of the PPO

October 23, 2023

Hold on to your seats, Florida Blue Medicare’s PPO plan offering, the fastest-growing in the state over the past 2 years has gotten even more incredible! Buckle up, as we dive into the many plan highlights and benefits to share with our future Florida Blue Medicare members. Check out this great coverage!

Additional Information

We’ve got some exceptional benefits that our members sure adore, including a $0 premium LPPO, known as Value PPO, and our newly expanded MA Only Patriot PPO.

Value PPO & MA Only Patriot PPO Highlights

  • National Coverage extending to 48 states (excluding Wyoming and Alaska), Puerto Rico, and Hawaii.
  • Members can now reside outside of Florida for up to 12 months, doubling the normal Medicare rule of 6 months (maintaining official Florida residency with Social Security).
  • No prior authorization or referral needed to see a PCP or Specialist outside of Florida – just call 1(800) 810-BLUE or go to BCBS.com (in-state providers, visit floridablue.com).
  • MA Only Patriot PPO expansion into 24 new counties, in addition to our existing 17 counties.
    • Monthly Part B giveback increased from $50 to a whopping $75 per month (totaling $900 per year).
    • Veterans now have the flexibility to participate in a private network for local providers while still using their VA benefits for prescription drugs.

Dental Improvement Across all PPO Plan Offerings

  • Introducing a brand-new schedule of services with a jaw-dropping $0 Co-Pay.
  • Say goodbye to annual limits within the schedule of services, ensuring you get the care you need.
  • Enjoy an unbelievable 66% discount for additional services, giving you more bang for your buck compared to the average market rate.

Dental Plans

Plan 10

Plan 68

Product

Patriot PPO

Select PPO

Value PPO

Member Cost

$0

$0

PREVENTIVE

Exam

2 per calendar year

2 per calendar year

Cleaning

2 per calendar year

2 per calendar year

X-Ray

1 set per calendar year

1 set per calendar year

COMPREHENSIVE

Fluoride Treatment

2 per calendar year

Extraction

2 per calendar year

4 per calendar year
(simple and surgical)

Crown

1 per calendar year
(only in conjunction with a covered root canal procedure)

Filling

2 per calendar year

Root Canal

1 per calendar year

Denture

1 set per 60 months

Denture Adjustment

2 per calendar year

1 per calendar year

Denture Repair

2 per calendar year

Deep Cleaning / Root Planing

1 per quadrant per 24-month period

Full Mouth Debridement

1 per 36-month period

All preventive and comprehensive services are covered up to an annual allowance except:

  • Implants
  • Cosmetic dentistry (including orthodontia (braces and Invisalign)
  • Veneers
  • Teeth whitening

PPO National BlueCard Map

For your convenience, access our PPO National BlueCard Map to explore the extensive network.

Extra Resources

Need easy access to benefits on the go? Scan the QR Code and enter the login credentials below to gain access to our 2024 First Look Benefits. You can find each Broker Manager’s email and direct cell phone number. Click on any county in the map to see all the plans available within that area.

Helpful Phone Numbers and Links

Below is a list of helpful links and phone numbers for our Florida Blue value added benefit vendors.

Service

Vendor

Phone Number

At Home Care

Papa

888-941-393

Blue Rewards

Florida Blue

833-509-1546

Caregiver Support

Carallel

855-955-3010

Dental

Florida Blue

888-223-4892

Drug Lookup

Prime

877-794-3574

Drug Lookup (FHCP)

FHCP

386-676-7110

DSNP Eligibility

Florida Blue

866-780-4240

Fitness

Silver Sneakers

888-423-4632

Fitness (FHCP)

Preferred Fitness

386-676-7110

Food Card

Nations

833-509-1546

Hearing Aids

Nations

866-311-3617

Meals

ILS Meals

888-941-3933

Members Services

Florida Blue

800-926-6565

Nutrition

Florida Blue

800-955-5692

OTC

Nations

877-270-4569

Transportation

Modivcare

855-875-5194

Vision

Premier

866-434-0015

Need Help?

Reach out to your Broker Manager today.

For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

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