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 |
Crown |
— |
1 per calendar year |
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.
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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