About Blue Cross Blue Shield
Blue Cross Blue Shield is one of America’s most recognized and well-earned brand names in health insurance.
BCBS is decentralized: It is a federation of 35 independent, locally operated companies (e.g., Anthem, Highmark, etc.) that operate under the national Blue Cross Blue Shield Association. This means plan offerings, pricing, and availability are specific to your local market.
BCBS provides health care coverage nationwide for 115 million people across all 50 states, Washington, D.C., and Puerto Rico, and maintains the largest health network in the country.
OR
Get Your FREE
Medicare Quote
Medicare Quote
What’s New In BCBS Medicare Coverage for 2026? (CRITICAL UPDATES)
Federally mandated changes driven by the Inflation Reduction Act (IRA) and CMS policies will affect all local BCBS companies and plans for 2026.
| Change | 2026 Amount/Details (Mandated by Federal Law) |
| Medicare Part D Out-of-Pocket Cap | Cap increases to $2,100 (from $2,000). You pay $0 above this limit. (source) |
| Part D Maximum Deductible | Maximum standard deductible increases to **$615** (from $590). (source) |
| Cap on Insulin Costs Remains | Out-of-pocket costs for a one-month supply of insulin are capped at $35. (source) |
| **$0 Cost for Adult Vaccines** | All ACIP-recommended adult vaccines remain $0 cost-sharing. (source) |
| First Negotiated Drug Prices | Negotiated prices for certain high-cost drugs take effect Jan. 1, 2026. |
| MA Maximum Out-of-Pocket (MOOP) | The maximum allowed in-network MOOP limit decreases slightly to $9,250 (from $9,350). (source) |
| Supplemental Benefits Guardrails | Plans (especially D-SNPs) must send an annual list of unused supplemental benefits. New federal rules restrict non-primarily health-related benefits (like some healthy food or utility cards) to those with verified chronic conditions. |
Medicare Coverage for You (Original Medicare Costs)
Medicare has two parts, Part A and Part B.
Medicare Part A (Hospital Insurance)
- Part A Deductible: The deductible (per benefit period) is projected to increase for 2026 to approximately $1,716 (from $1,676 in 2025).
- Hospital Coinsurance: Daily coinsurance amounts for days 61-90 and lifetime reserve days are also projected to increase.
Medicare Part B (Medical Insurance)
- Part B Standard Premium: The standard monthly premium is projected to increase for 2026 to approximately $206.50 (from $185.00 in 2025).
- Part B Deductible: The annual deductible is also projected to increase for 2026 to approximately $288 (from $257 in 2025).
Note: All Original Medicare costs for 2026 are projections based on the Medicare Trustees Report until officially announced by CMS in the fall of 2025. (Source for projections)
Blue Cross Medicare Plans
Among the many health insurance products offered by local Blue Cross Blue Shield companies, options include Medicare Advantage Plans, Prescription Drug Plans, and Medicare Supplemental (Medigap) coverage options.
Blue Cross Blue Shield Medicare Advantage Plans
Medicare Advantage Plans take the place of Original Medicare. They are an all-in-one plan that often includes Part D prescription medication coverage and extra benefits (dental, vision, etc.).
Due to financial pressures in the MA market for 2026, many local BCBS companies are eliminating certain plans or reducing benefits/allowances. Members must check their local plan’s Annual Notice of Change (ANOC) this fall.
Local BCBS companies offer these plan types:
- HMOs (Health Maintenance Organizations)
- PPOs (Preferred Provider Organizations)
- Regional PPOs
- Private Fee-for-service plans
Plan Features (May change locally for 2026):
- Premiums: You continue to pay your Part B premium. Some plans have a separate monthly plan premium.
- Out-of-pocket expenses: All MA plans have an annual medical limit on out-of-pocket costs.
OR
Get Your FREE
Medicare Quote
Medicare Quote
Blue Cross Blue Shield Medicare Supplement Plans
If you want to keep Original Medicare but need help covering out-of-pocket costs, Medigap policies are standardized across most states.
Note: The original list of 10 plans is misleading; Plans C and F are closed to new Medicare beneficiaries eligible on or after January 1, 2020. Most people choose among these three popular options:
- Plan A: The most basic plan, covering core benefits (Part A and B coinsurance, blood, hospice).
- Plan F: The most comprehensive plan, covering all Medicare gaps. Only available to those eligible for Medicare before 2020.
- Plan G: The broadest coverage available to new beneficiaries. Covers the same items as Plan F, except for the Medicare Part B deductible.
- Plan N: Has a lower premium in exchange for mandatory copays (up to $20 for office visits; up to $50 for ER visits) and responsibility for Part B excess charges (where applicable).
- Plan K & L: Cost-sharing plans where you pay a percentage of costs until you hit a maximum annual limit (which increases each year).
Choosing the Right Plan
Blue Cross Medicare is versatile, but the options are highly dependent on the policies of your local BCBS company. Use your local BCBS company’s website or contact an agent during the Annual Enrollment Period (AEP) to compare costs and coverage based on your specific doctors and medications.
Benefits of Choosing Blue Cross Blue Shield Medicare Plans
BCBS is one of the largest providers of Medicare Advantage Plans and Supplement plans in the US. They offer competitive options with the benefit of the largest health network in the country, often including extra benefits like the SilverSneakers fitness program.
Enrolling in Blue Cross Blue Shield & Open Enrollment Period
- Annual Enrollment Period (AEP): Runs from October 15 through December 7. This is your chance to make changes to your coverage for the upcoming 2026 year.
- Medicare Advantage Open Enrollment Period (MA OEP): Runs from January 1 through March 31 each year.
- Special Enrollment Periods (SEP): You may be eligible for an SEP if your current BCBS plan is being discontinued or if you have a qualifying life event.
OR
Get Your FREE
Medicare Quote
Medicare Quote
