Need help? Call the Medicare Sales team at 1-800-505-2583 (TTY:711).
Come back at the start of the Annual Enrollment Period (October 15) to select and enroll in a plan.
2025
BlueRI for Duals
(HMO D-SNP)

Monthly premium

$0.00
Apply now

Do you qualify for Medicare + Medicaid? If so, this plan will give you the most $0 benefits that we offer. You'll also get your very own Health Navigator to answer your questions, help with paperwork and appointments, and much more.

Questions? Call us at (401) 459-5477 or 1-855-430-9293 (TTY: 711).

Not sure what plan you need? Use the plan recommendation tool.

Medical

  • $0 monthly premium
  • $0 copay for primary care visits
  • $0 specialist visits
  • $0 labs/X-rays
  • $0 inpatient hospital stay
  • $0 outpatient surgery copay
  • $0 skilled nursing facility
  • $0 physical/speech/occupational therapy

Prescription Drugs

  • $0 prescription drugs**

Dental/Hearing/Vision

  • $0 hearing aids
  • $0 preventive and comprehensive dental
  • $0 for routine hearing and vision screenings
  • Get $300/year for eyewear
  • Get $1,500/year for dental and hearing (Flexible Benefit Card)

Extras

  • $0 fitness benefit
  • Get $165/month for groceries and over-the-counter (OTC) everyday health items (Flexible Benefit Card)**
  • 72 one-way rides/year
Qualify for Low-Income Subsidy (Extra Help) but not Medicaid?

Coverage
Copays & Details
Outpatient Care and Services1,2

Note: Plan does NOT have out-of-network coverage

Ambulance

$0

Dental Services

Medicare-covered: $0
Preventive: $0
Comprehensive: $0

$3,000 limit on all covered dental services for preventive and comprehensive dental services. All preventive and comprehensive services must be provided by an in-network plan-contracted dentist.

Diabetes Supplies and Services

In-network: $0

You must use OneTouch plan-designated monitors and test strips.

Diagnostic Tests, Lab and Radiology Services, and X-Rays

$0 for lab services
$0 for diagnostic tests and X-rays
$0 for high-tech radiology services (for example, MRIs)

Emergency Care

$0

Outpatient Hospital/Surgery

$0

Hearing Services

Routine hearing
$0

Non-routine hearing
$0 copay

Hearing aids
$0 per hearing aid (2 aids every year)

Primary Care Physician Visit

$0

Specialist Visit

$0

Vision Visit

Routine vision
$0 

Non-routine vision
$0 

Vision hardware
Our plan offers a $300/year allowance for vision hardware.

Preventive Care

$0

Inpatient Care1,2

Inpatient Hospital Care

$0 Days 1 and beyond

Skilled Nursing Facility

$0 per day for days 1-100

Our plan covers up to 100 days in a skilled nursing facility.

 
Standard
Prescription Deductible

No deductible

Initial Coverage (up to 30-day supply)**3

Tier 1 (Preferred Generic)

$0 copay

Tier 2 (Non-preferred Generic)

$0 copay

Tier 3 (Preferred Brand)

$0 copay

Tier 4 (Non-Preferred Drug)

$0 copay

Tier 5 (Specialty Tier)

$0 copay

Insulins (30-day supply)

$0 copay

Mail Order (100-day Supply)

$0 copay for Tiers 1 and 2

Hours: Monday through Friday, 8:00 a.m. to 8:00 p.m. (Open seven days a week, 8:00 a.m. to 8:00 p.m., October 1 – March 31.)You can use our automated answering system outside of these hours.

*Your premium may be higher than this amount depending on your Low Income Subsidy Program (LIS) level. If you are eligible for Medicare cost-sharing assistance under Medicaid, you pay $0 for your deductible, doctor office visits, and inpatient hospital stays. If you lose your Medicaid, you will be responsible to pay copays.  

**You must receive LIS or "Extra Help" to receive  the Over-the-Counter (OTC) + Grocery Food Card as well as $0 Part D drug copays

1 The out-of-pocket maximum includes only Medicare-covered services. This is the most a member would pay for these services during a calendar year. You must receive all routine care from plan providers unless you select the BlueCHiP for Medicare Value (HMO-POS), BlueCHiP for Medicare Enhanced (HMO-POS), BlueCHiP for Medicare Extra (HMO-POS), BlueCHiP for Medicare Preferred (HMO-POS), or the BlueCHiP for Medicare Access (HMO-POS) plan. If you select the BlueCHiP for Medicare Value, BlueCHiP for Medicare Enhanced (HMO-POS), BlueCHiP for Medicare Extra, BlueCHiP for Medicare Preferred, or the BlueCHiP for Medicare Access (HMO-POS) plan, with the exception of emergency or urgent care, ambulance, or dialysis services, it may cost more to get care from out-of-network providers.

2 A preauthorization may be required. Review may include but is not limited to pre-authorization and/or continued treatment by the plan and/or plan designee. Contact Plan for details.

3 You must use network pharmacies to access your prescription drug benefit, except under non-routine circumstances, quantity limitations and restrictions may apply. Please refer to the Summary of Benefits or the Evidence of Coverage for prescription drug cost share information in a long-term care setting, mail order and extended day retail supplies as well as detailed benefit information concerning the Initial Coverage stage, and the Catastrophic level stage.