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Blue Cross Medicare Advantage Protect (PPO)

Health Insurance Company: Blue Cross and Blue Shield of Texas

Medicare Advantage Plan Details

Blue Cross and Blue Shield of Texas
$0 /mo
monthly premium
Blue Cross Medicare Advantage Protect (PPO)
Additional Coverage
Overall Star Rating (2025)
  • Dental
  • Vision
  • Hearing
3
out of 5 stars

General Plan Details

Medical Deductible
$750
Out-of-Pocket Maximum
$6950
Rx Drug Coverage
No
Rx Deductible
$0
Primary Doctor Office Visit
$0 copay
Specialist Office Visit
$55 copay per visit

Additional Benefits

Dental Coverage
Yes
Vision Coverage
Yes
Mental Health Coverage
Yes
Transportation for non-emergency
No
Fitness Benefits
Yes
Worldwide emergency
Yes
Telehealth
Yes
Part B Give Back
Yes

Doctor & Hospital Coverage

Primary Doctor Office Visit
In-network: $0 copay
Out-of-network: $30 copay per visit
Specialist Office Visit
In-network: $55 copay per visit
Out-of-network: $75 copay per visit
Periodic Exam Coverage
In-network: $0 copay
Out-of-network: $0 copay

Emergency Room

$110 copay per visit (always covered)

Ambulance Coverage

In-network: $275 copay
Out-of-network: $275 copay

Lab, X-Ray, Radiology Coverage

Outpatient diag procs/tests/lab services:
Medicare-covered diagnostic procedures/tests: In-network: $0-100 copay
Out-of-network: $0-200 copay
Medicare-covered lab services: In-network: $0-55 copay
Out-of-network: $30-200 copay
Outpatient diag/therapeutic rad services:
Medicare-covered diagnostic radiological services (e.g., CT, MRI, etc): In-network: $0-300 copay
Out-of-network: $0-400 copay
Medicare-covered x-ray services: In-network: $0-100 copay
Out-of-network: $30-200 copay

Outpatient Surgery Coverage

Outpatient hospital:
Medicare-covered outpatient hospital services: In-network: $375 copay per visit
Out-of-network: $400 copay per visit

Hospitalization Coverage

Inpatient hospital-acute:
In-network: $370 per day for days 1 through 6
$0 per day for days 7 through 90
Out-of-network: $500 per day for days 1 and beyond
Inpatient hospital psychiatric:
In-network: $290 per day for days 1 through 6
$0 per day for days 7 through 90
Out-of-network: $500 per day for days 1 and beyond

Rehabilitation Coverage

Occupational therapy services:
In-network: $35 copay
Out-of-network: $75 copay
Physical therapy and speech and language therapy services:
In-network: $40 copay
Out-of-network: $75 copay

Urgent Care Coverage

$40 copay per visit (always covered)

Skilled Nursing Facility (SNF)

In-network: $0 per day for days 1 through 20
$214 per day for days 21 through 49
$0 per day for days 50 through 100
Out-of-network: $250 per day for days 1 and beyond

Mental Health Coverage

Medicare-covered individual sessions: In-network: $40 copay
Out-of-network: $50 copay
Medicare-covered group sessions: In-network: $40 copay
Out-of-network: $50 copay

Dental, Vision, Hearing Benefits

Dental Services

Oral exams:
In-network: $0 copay
Out-of-network: $0 copay
Prophylaxis (cleaning):
In-network: $0 copay
Out-of-network: $0 copay
Dental x-rays:
In-network: $0 copay
Out-of-network: $0 copay

Vision Benefits

Eye exams:
Routine eye exams: In-network: $0 copay
Out-of-network: $0 copay
Eyewear:
Contact Lenses: In-network: $0 copay
Out-of-network: $0 copay
Eyeglasses: Not covered

Hearing Benefits

Hearing exams:
Routine hearing exams: In-network: $40 copay
Out-of-network: $75 copay
Hearing aids:
Hearing aids (all types): In-network: $699-999 copay
Out-of-network: $699-999 copay

More Additional Benefits

Annual physical exams
Yes
Chiropractic Coverage
No
Acupuncture
No
Massage Therapy
No
Health Education
No
Counseling Services
No
Support for Caregivers of Enrollees
No
Personal Emergency Response System (PERS)
No
In-home support services
No
Home and bathroom safety devices
No
Meals for short duration
No

Plan Links

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Where This Plan is Available

State:
Counties:
Anderson, Andrews, Aransas, Archer, Armstrong, Austin, Bailey, Baylor, Bee, Bell, Bexar, Blanco, Borden, Bosque, Bowie, Brazoria, Brazos, Brewster, Briscoe, Brooks, Burleson, Calhoun, Cameron, Camp, Carson, Cass, Castro, Cherokee, Childress, Clay, Cochran, Coke, Coleman, Collin, Concho, Coryell, Crane, Crosby, Culberson, Dallam, Dallas, Dawson, Deaf Smith, Delta, Denton, De Witt, Dickens, Dimmit, Donley, Duval, Ector, Edwards, Ellis, El Paso, Erath, Falls, Fisher, Floyd, Foard, Fort Bend, Franklin, Freestone, Frio, Gaines, Galveston, Garza, Gillespie, Glasscock, Goliad, Grayson, Gregg, Grimes, Hale, Hall, Hamilton, Hansford, Hardeman, Harris, Harrison, Hartley, Haskell, Henderson, Hidalgo, Hockley, Hopkins, Houston, Howard, Hudspeth, Hunt, Hutchinson, Irion, Jack, Jackson, Jeff Davis, Jefferson, Jim Hogg, Jim Wells, Karnes, Kaufman, Kenedy, Kent, Kimble, King, Kinney, Kleberg, Knox, Lamar, Lamb, La Salle, Lavaca, Leon, Liberty, Limestone, Live Oak, Loving, Lubbock, Lynn, Madison, Marion, Martin, Mason, Maverick, Mcculloch, Mclennan, Menard, Midland, Mills, Mitchell, Montague, Montgomery, Moore, Morris, Motley, Nacogdoches, Nueces, Oldham, Orange, Palo Pinto, Panola, Parker, Pecos, Polk, Potter, Presidio, Rains, Randall, Reagan, Red River, Reeves, Refugio, Roberts, Robertson, Runnels, Rusk, San Augustine, San Jacinto, San Patricio, San Saba, Schleicher, Shackelford, Shelby, Sherman, Smith, Somervell, Starr, Stephens, Sterling, Stonewall, Sutton, Swisher, Tarrant, Terry, Throckmorton, Titus, Tom Green, Travis, Trinity, Tyler, Upshur, Upton, Uvalde, Van Zandt, Victoria, Walker, Waller, Washington, Webb, Wheeler, Willacy, Williamson, Winkler, Wise, Wood, Yoakum, Young, Zapata, Zavala
View all plans in your Texas County

Additional Plan Info

Plan Year:
2025
Insurance Company Website:
Blue Cross and Blue Shield of Texas

Health Insurance Companies Offering Plans

Medicare Advantage and Part D plans and benefits offered by the following insurance companies:

  • Aetna Medicare
  • Anthem Blue Cross Blue Shield
  • Anthem Blue Cross
  • Anthem Blue Cross and Blue Shield
  • Aspire Health Plan
  • Baylor Scott & White Health Plan
  • Capital Blue Cross
  • Cigna Healthcare
  • Dean Health Plan
  • Devoted Health
  • Florida Blue Medicare
  • Freedom Health
  • GlobalHealth
  • Health Care Service Corporation
  • Healthy Blue
  • HealthSun
  • Humana
  • Molina Healthcare
  • Mutual of Omaha
  • Medica Central Health Plan
  • Optimum HealthCare
  • Premera Blue Cross
  • SCAN Health Plan
  • Simply
  • UnitedHealthcareⓇ
  • Wellcare
  • WellPoint