Forever Blue Medicare Advantage Plan

This health insurance plan is available only to retirees & their eligible dependents (who are enrolled in Medicare Part A and Part B) having mandatory enrollment as negotiated. 

In addition to basic insurance coverage, the plan offers added value benefits such as:

• $500 annual dental allowance for each enrolled participant

• $400 annual vision allowance for each enrolled participant

• Annual physical – Zero co-pay

• Most immunizations– Zero co-pay (shingles shot only $7)

• Preventative care (such as mammograms and bone density tests) – Zero co-pay

• Zero co-pay for physician visits following hospitalization or admission to an outpatient hospital facility for follow-up

• Zero co-pay  for compression stockings

• Zero co-pay for diabetic supplies

• Tru Hearing benefit: Hearing aids at a cost of either $699 or $999 per device, based on the model selected by the member. 

Below you will find enrollment forms and a summary of the benefits for the two plans.

In-Area

Applicants whose address with Medicare is registered within one of the five counties of Western New York. 

Out-of-Area 

Applicants whose address with Medicare is registered outside of the five Western New York counties.

Email or call the Benefits Office: Benefits or 716-816-3754 to obtain an information packet and enrollment form.

• Forever Blue Enrollment Application

• Forever Blue Summary of Benefits (In Area)

• Forever Blue Summary of Benefits (Out of Area)

• Davis Vision Direct Reimbursement Claim Form

• Dental Reimbursement Form

• Acupuncture Massage Therapy Reimbursement Form

• Well360 Virtual Health

• FitOn Health Account (New in 2025)