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Fiorida, Blue � D <br />In the pursuit of health <br />BlueMedicare Group PPO out-of-pocket maximum includes all covered health services member <br />cost share rendered in/out of network on a calendar year basis. Supplemental services and Part <br />D costs are not applied to out-of-pocket maximum. <br />Medicare Part B - the premium provided under this plan excludes the Medicare Part B premium <br />payments. (Members must continue to pay the Medicare Part B premium unless paid by <br />Medicaid or another third party.) <br />Florida Blue is a PPO Plan with a Medicare contract. . <br />Y0011_31917 0913R2 EGWP C: 09/2013 5 <br />105 <br />