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HMO and PPO Plan Options Available
With Medicare Advantage plans from Blue Cross and Blue Shield of Nebraska you'll have predictable, easy-to-budget costs for doctor office visits, prescription drugs and more. Each plan offers a different level of benefits and out-of-pocket cost, so you can choose the one that is best suited to your needs.
Hospital & Medical Benefits
Prescription Drug Benefits
Medicare Advantage Core HMO | Medicare Advantage Connect PPO | Medicare Advantage Access PPO | |||||||
Rx Deductible | Copayment/Coinsurance | Rx Deductible | Copayment/Coinsurance | Rx Deductible | Copayment/Coinsurance | ||||
30-day supply: In-network pharmacy | 90-day supply: Mail order | 30-day supply: In-network pharmacy | 90-day supply: Mail order | 30-day supply: In-network pharmacy | 90-day supply: Mail order | ||||
Tier 1 (Preferred Generic) | $0 | $4 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
Tier 2 (Generic) | $0 | $14 | $0 | $0 | $14 | $0 | $0 | $14 | $0 |
Tier 3 (Preferred Generic) | $250 | $47 | $141 | $175 | $47 | $141 | $100 | $47 | $141 |
Tier 4 (Non-preferred brand) | $100 | $300 | $100 | $300 | $100 | $300 | |||
Tier 5 (Specialty tier) | 28% | N/A | 30% | N/A | 31% | N/A |
Individual Plan Information
- 2023 Part B Drug Cost Addendum
- 2023 Medicare Advantage Plan Overview Access PPO and Connect PPO
- 2023 Medicare Advantage Plan Overview Core HMO
- 2023 Summary of Benefits Access PPO and Connect PPO
- 2023 Summary of Benefits Core HMO
- 2023 Evidence of Coverage Core HMO
- 2023 Evidence of Coverage Access PPO
- 2023 Evidence of Coverage Connect PPO
- 2023 PPO Star Rating
- 2023 HMO Star Rating
- 2023 ANOC Access PPO
- 2023 ANOC Core HMO Central
- 2023 ANOC Core HMO Metro
Group Plan Information
Have Questions?
Request your Medicare Options Guide
Understanding all the coverage options available may feel confusing. Download information from Blue Cross and Blue Shield of Nebraska about Medicare options, important dates to remember and more.