Benefits

• Improvements:
  • All telemedicine visits will have a $0 cost share. All services rendered as telemedicine will have a $0 copay for Specialists, Outpatient Mental/BH, Outpatient Substance Abuse in accordance with our payment policy
  • High Tech Radiology Mammograms will have a $0 cost share.
• Reductions:
  • All BlueCHiP for Medicare plans will have a pharmacy deductible ranging from $350-$615. Most deductibles apply to Tiers 3-5.
  • Inpatient cost sharing will now be for days 1-6, up from 1-5.
  • Hearing aid cost share is higher by varying amounts across all plans.
  • Vision hardware allowances have been lowered by varying amounts across all plans.
• Eliminations:
  • Flex Card Dental & Hearing Allowance, Non-Medicare covered Acupuncture, Post Discharge Meals (Group Medicare excluded)
• Changes:
  • Preferred diabetic test strips and meters DME vendor is changing from One Touch to Abbott. All members will be given one 30-day transition fill in the first 90 days of the year before being required to transition to the new vendor. $0 copay for diabetic supplies will stay the same. You can begin to transition your patient to Abbott starting 10/1 for a smoother transition in 2026.
  • BlueCHiP for Medicare Access:
    • Grocery benefits offered will now require a member to have Low Income Subsidy (LIS), often referred to as Extra Help, and a qualifying chronic condition.
    • Cost share levels are now the same for all members and the High Value Provider designation has been removed in accordance with Centers for Medicare and Medicaid Intervention (CMMI) terminating the Value Based Insurance Design (VBID) demonstration on December 31, 2025. 

Plan Offerings 

• BlueCHiP for Medicare Enhanced, BlueCHiP for Medicare Extra, BlueCHiP for Medicare Core, and BlueCHiP for Medicare Access will continue to be offered with noted changes.
• New BlueCHiP for Medicare Essential plan
  • Includes a Part B deductible and basic supplementals
• BlueCHiP for Medicare Value members will be combined into the BlueCHiP for Medicare Enhanced plan
  • Referrals and authorizations will carry over
  • Member ID numbers will not change
• BlueCHiP for Medicare Plus will be combined into the BlueCHiP for Medicare Extra plan
  • Referrals and authorizations will carry over
  • Member ID numbers will not change
• BlueCHiP for Medicare Preferred will be terminated
  • All members will have to actively select a new plan, which can include Medigap/Medicare Supplement, standalone Prescription Drug Plan (PDP) or a new Medicare Advantage plan.

BlueRI for Duals (DSNP) Changes on or after 1/1/26:

• Reductions:
  • Vision hardware allowances have been lowered.
  • Grocery/OTC allowances have been lowered.
  • Dental annual maximum has been lowered.
  • Part B deductible now included.
• Eliminations:
  • Flex Card Dental & Hearing Allowance, Non-Medicare covered Acupuncture, Post Discharge Meals, Personal Emergency Response System.
• Changes:
  • Preferred diabetic test strips and meters DME vendor is changing from One Touch to Abbott. All members will be given one 30-day transition fill in the first 90 days of the year before being required to transition to the new vendor. $0 copay for diabetic supplies will stay the same. You can begin to transition your patient to Abbott starting 10/1 for a smoother transition in 2026.
  • Grocery benefits offered will now require a member to have a qualifying chronic condition.