BlueMedicare Preferred (PFFS) 2025 Plan Details for Hot Spring County, Arkansas Residents
BlueMedicare Preferred (PFFS) 2025 Plan Details for Hot Spring County, Arkansas Residents
Choosing the right Medicare Advantage plan in Hot Spring County is crucial for your healthcare needs in 2025. With BlueMedicare Preferred (PFFS) as one of the options, you can compare it side-by-side with other available plans to find the best fit for you. Whether you prefer enrolling online or seeking advice from a licensed agent, we’ve made the process simple and straightforward.
According to CMS enrollment data (May, 2025), there are approximately 1,237 members enrolled in this plan, 14 in Hot Spring County.
BlueMedicare Preferred Overview
| Plan ID H4213-017-1 Overview | |
|---|---|
| Health Plan ID: | H4213-017-1 |
| Medicare Advantage Plan Type: | PFFS |
| Plan Year: | 2025 |
| Monthly Premium: | $38.00 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $7,500.00 (In-Network) |
| Part B Give Back: | $0.00/mo |
| Part D Drug Plan Benefit: | Basic, $490.00 deductible |
| Additional Benefits: | Dental, Hearing |
| Availability: | Hot Spring County, AR |
| Insured By: | Arkansas Blue Medicare |
Explore the Benefits of BlueMedicare Preferred
This MAPD Private Fee-for-Service (PFFS) plan offers both flexibility and full Medicare coverage — including hospital, medical, and prescription drug benefits. With a monthly premium of $38.00, it includes all the core features of Medicare Part A and Part B, plus drug coverage to support your ongoing prescription needs. The annual Part D deductible is $490.00. You can visit any Medicare-approved provider who accepts the plan’s payment terms — no referrals or network restrictions.
Officially designated as CMS plan H4213-017-1, BlueMedicare Preferred also includes a maximum out-of-pocket (MOOP) limit of $7,500.00 . Once you hit that limit, the plan pays 100% of your covered healthcare expenses for the rest of the year. It’s a great fit for people who want broad provider choice and confidence in what they’ll spend.
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Out-of-Pocket Expenses
BlueMedicare Preferred includes cost-sharing, which refers to the out-of-pocket expenses you'll incur when accessing approved healthcare services. The table below outlines the most common in-network out-of-pocket costs for plan H4213-017-1.
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | $20 Copay |
| Specialist: | $50 Copay |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | $110 Copay |
| Urgent care: | $45 Copay |
| Ground ambulance: | $325 Copay |
| Inpatient hospital care: | $390.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
| Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $203.00 per day for days 21 and beyond |
This section covers Medicare-approved foot care services, including exams and routine foot care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Foot Exams and Treatments (Medicare-covered): | $50 Copay |
| Routine Foot Care: | Not Covered |
Understand the coverage for Medicare-approved chiropractic services and routine chiropractic care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Medicare-covered chiropractic: | $15 Copay |
| Routine chiropractic: | Not Covered |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | $35 Copay |
| Outpatient group therapy: | $35 Copay |
| Inpatient psychiatric hospital care: | $390.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | $35 Copay |
| Occupational therapy: | $35 Copay |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | $0 Copay |
| Durable medical equipment: | 20% Coinsurance |
| Prosthetics: | 20% Coinsurance |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | $340 Copay |
| Lab services: | 20% Coinsurance |
| Outpatient x-rays: | 20% Coinsurance |
| Diagnostic tests and procedures: | 20% Coinsurance |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | 20% Coinsurance |
| Other Part B drugs (Medicare-covered): | 20% Coinsurance |
This section details the dental services covered under your plan including, Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
| Service | Member Cost (in-network) |
|---|---|
| Medicare Covered Preventive Dental | $50 Copay |
| Oral exam | $0 Copay |
| Dental x-rays | $0 Copay |
| Cleaning | $0 Copay |
| Periodontics | Not Covered |
| Endodontics | Not Covered |
| Restorative Services | Not Covered |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
| Service | Member Cost (in-network) |
|---|---|
| Fitting/evaluation | $0 Copay Limitations Apply |
| Hearing aids | Covered Limits may apply |
| Hearing exam | $0 Copay |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
| Service | Member Cost (in-network) |
|---|---|
| Medicare-covered eye exam (in-network) | $0 to $50 Copay |
| Routine eye exam (in-network) | Not Covered |
| Eyewear benefits | None |
Certain preventive services are covered 100% by BlueMedicare Preferred as a Part B benefit.
Part D Prescription Drug Costs & Benefits
BlueMedicare Preferred offers a basic benefit Medicare Part D plan (PDP), meaning it meets the minimum coverage requirements set by the Centers for Medicare & Medicaid Services. In contrast, enhanced benefit plans provide additional coverage beyond the basics.
Part D Plan Premium
The Part D prescription drug plan premium is included in your overall Medicare Advantage plan cost. However, additional expenses or subsidies may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help. LIS, provided by Social Security, helps those with limited income and resources to lower or eliminate Part D costs. LIS benefits are not part of Medicare Advantage coverage.
| Basic Part D Premium: | $19.20 |
|---|---|
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $19.20 |
| Low-Income Premium Subsidy: | ${part_d_lips_amount} |
| Low-Income Premium Subsidy Paid by CMS: | $19.20 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program.
Prescription Drug Plan Deductible
This plan has a $490.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Arkansas Blue Medicare starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, BlueMedicare Preferred may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic* | $10.00 | $10.00 |
| Generic | $15.00 | $15.00 |
| Preferred Brand | 20.00% | 20.00% |
| Non-Preferred Drug | 32.00% | 32.00% |
| Specialty Tier | 27.00% | 27.00% |
| *Deductible does not apply. | ||
How CMS Star Ratings Guide Your Choice
Each year, the Centers for Medicare & Medicaid Services (CMS) evaluates health and drug plans using a comprehensive 5-star rating system. These ratings offer valuable insights into the quality of care, member satisfaction, and overall plan performance.
When selecting a Medicare Advantage plan, looking at the star ratings can help you gauge how well a plan might meet your healthcare needs, making it easier to choose a plan with confidence.
| CMS Measure | Star Rating |
|---|---|
| 2025 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 |
If you are new to Medicare or Medicare Advantage plans, the following information will help you understand the enrollment process and restrictions.
Am I Eligible for BlueMedicare Preferred ?
To enroll in BlueMedicare Preferred , you must meet the following criteria:
- Be eligible for Medicare Part A and Part B.
- Reside in the plan’s service area.
If you meet these requirements, you are eligible to enroll in BlueMedicare Preferred and benefit from its comprehensive coverage options.
Enrollment Periods for BlueMedicare Preferred
Understanding the right time to enroll in BlueMedicare Preferred is crucial. Here are the key enrollment periods:
- Initial Enrollment Period (IEP): Your first opportunity to enroll in Medicare starts three months before your 65th birthday and lasts until three months after your birthday month.
- Annual Enrollment Period (AEP): Occurring annually from October 15 to December 7, the AEP allows you to enroll in, switch, or drop a Medicare Advantage plan if you are currently enrolled in a Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31 each year, the MA OEP gives you the chance to switch Medicare Advantage plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Certain life changes, like moving or losing other coverage, may make you eligible for a SEP, allowing you to adjust your plan outside the usual periods.
Not sure when to enroll? Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711) to speak with a licensed insurance agent who can guide you through your options.
How to Sign Up for BlueMedicare Preferred
Joining BlueMedicare Preferred is straightforward. Here are the steps you can take:
- Online: Use our online enrollment partner's Secure Online Enrollment Form to sign up.
- By Phone: Reach out to HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711). A licensed insurance agent will help you with the enrollment process and answer any questions you might have.
- Through Medicare.gov: Enroll directly through the official Medicare website. Visit Medicare.gov, log in or create an account, and follow the steps to join BlueMedicare Preferred .
- Direct Enrollment: You can also choose to enroll directly with BlueMedicare Preferred . The contact information can be found below in the "Contact" section.
Make sure you enroll during the appropriate period to activate your coverage as soon as possible.
Contact 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 |
| New Member Part D Help: | (888)605-0322 |
| New Member Part D TTY Users: | 711 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, visit the Social Security Administration website. For more information about Medicare Advantage, visit medicare.gov.
- Arkansas Blue Medicare, http://www.arkansasbluecross.com/medicare, Last Accessed June 1, 2025
- Medicare.gov, "Compare types of Medicare Advantage Plans", Last Accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You", Last Accessed 25 May, 2025
- Medicare.gov, "Explore your Medicare coverage options", Last Accessed 25 May, 2025
- CMS.gov, Landscape Source Files, Last Accessed October 15, 2024
- CMS.gov, Medicare Part C & D Performance, Last Accessed October 15, 2024
- CMS.gov, Plan Benefits Package, Last Accessed October 15, 2024
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County, Last Accessed June 6, 2025
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