About Blue Cross Blue Shield
Blue Cross Blue Shield is one of America’s most recognized and well-earned brand names in terms of health insurance. Since its founding in 1929, Blue Cross Blue Shield has become one of the largest insurance companies in the United States.
Blue Cross Blue Shield (BCBS) is independently owned and operated locally in many markets throughout the United States and grouped into the Blue Cross Blue Shield Association.
BCBS provides health care coverage nationwide for 115 million people across all 50 states, Washington, D.C., and Puerto Rico. It has a health network of 1.7 million doctors and hospitals that contract with it, which is more than any other insurer.
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What’s New In BCBS Medicare Coverage for 2025?
With such a diverse range of policies and plans, BCBS Medicare options are always changing. Many plans are very location-specific, and you’ll need to learn about those available in your area and any updates to coverage, costs, and structure.
Across the board, some changes have occurred with Blue Cross Blue Shield Medicare, including:
- Medicare Advantage supplement plans will now send you a list, halfway through the year, about the coverage you have yet to use.
- Medicare Advantage plans now contain more resources for mental health support, including family and individual therapy services.
- Also, if you have Medicare Prescription D coverage, there’s now a $2000 out-of-pocket cap for most people and no donut hole. You’ll also be able to make monthly payments on costs if you like.
Medicare Coverage for You
There are several ways to obtain health coverage. If you qualify for Medicare, you may elect Original Medicare.
Medicare is a social insurance program available to Americans 65 or older and those with specific disabilities. Medicare provides hospital coverage, medical services such as doctor visits, and prescription medications. It also covers many of the costs associated with long-term care, such as nursing homestays. Medicare has two parts, Part A and Part B.
Medicare Part A
Medicare Part A, also known as hospital insurance, provides coverage for Medicare inpatient care, including care received during a stay at home. For most people, Medicare Part A enrollment is automatic. However, some scenarios require you to manually sign up for Medicare Part A during the Initial Enrollment Period (IEP), the seven-month period beginning three months before turning 65, including your 65th birthday month and ending three months later.
In general, services covered under Medicare Part A:
- Hospital care (inpatient)
- Limited home health services
- Care in a skilled nursing facility (SNF), provided that custodial care not be the only care required
- Hospice care
Medicare Part B
Medicare Part B, or medical insurance, covers medical services and supplies to diagnose or treat a health condition. This policy covers outpatient and preventative services such as hospital visits and disease screenings. Individuals who meet eligibility requirements for premium-free Medicare Part A coverage are automatically eligible for Part B coverage. Medicare Part A coverage is available for individuals over 65, people with disabilities, and those with end-stage renal disease.
Medicare.gov offers an online tool to help determine Medicare eligibility. However, those who do not qualify for Medicare Part A coverage may still be eligible for Part B if they meet one or more of the following criteria:
- 65 years of age or older
- Paid Medicare taxes for the past ten years
- Senior citizen and lawful permanent resident
- Currently, receive disability benefits
Medicare Part B covers medical services and supplies your physician requires to treat a policyholder’s health condition. The following are examples of costs covered by Medicare Part B:
- Visits to a healthcare facility
- Ambulance services
- Part-time or temporary home health care
- Rehabilitation services and physical therapy
- Flu and Hepatitis B shots
- Cardiovascular, cancer, and diabetes screenings
- Limited outpatient prescription drugs
- Durable medical equipment
- Clinical research
- Mental health services (inpatient, outpatient, and partial hospitalization)
- Second opinions before surgery
Blue Cross Medicare Plans
Among the many health insurance products offered by Blue Cross Blue Shield, the company provides Medicare Advantage Plans and Medicare Supplemental (Medigap) coverage options. Policies range widely based on location and age. Consider the following options. You can use these plans to meet more of your needs.
Blue Cross Blue Shield Medicare Advantage Plans
Medicare Advantage Plans take the place of Original Medicare. These plans are an all-in-one type of plan that often includes prescription medication coverage.
Medicare Advantage Plans from BCBS are extensive. The company offers options that are:
- HMOs
- PPOs
- Regional PPOs
- Private Fee-for-service plans
Availability differs from location. It’s very important to use the plan finder tools on the BCBS website to compare options in your area. However, some features of these plans include:
- Premiums: You continue to pay your Part B insurance premium. Some plans have separate monthly insurance premiums.
- Deductibles: Some plans have deductibles.
- Copays: You may have to pay a copay for some services, though this differs from one plan to the next.
- Coinsurance: Cost-sharing differs based on services and plans.
- Out-of-pocket expenses: You will have an annual limit on the amount of out-of-pocket expenses you have. That’s something that’s not available through Original Medicare.
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Blue Cross Blue Shield Medicare Supplement Plans
If you want to keep Original Medicare but want more help with out-of-pocket costs, consider supplemental plans, also known as Medigap. Like other services provided by BCBS, you have a lot of options to select from for Medigap coverage, but policies are based on location, age, and needs. You can explore the options in your area that are available through BCBS.
When you select Medigap coverage, you’ll be able to choose policies based on a plan type. For 2025, BCBS Medicare Medigap coverage options include all 10 of the available Medigap plans. However, pricing, availability, and offerings differ based on location and age.
Plan A
Plan A supplemental insurance is the most basic plan covering the most important gaps when using Medicare. These are the hospital coinsurance and hospital outpatient coinsurance. Your Plan A will pay for your daily hospital copays when you have any inpatient stays lasting longer than 60 days.
Additionally, Plan A will provide 365 days of healthcare coverage after your Medicare Part A hospital benefits have run out.
Blue Cross Blue Shield’s Part A insurance covers:
- 100% of the Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used
- 100% of the Part B coinsurance or copayment
- 100% of the cost of the first three pints of blood
- 100% of the Part A hospice care coinsurance or copayment
Plan F
Plan F is considered one of the more complete Medigap plans on the market, covering almost every gap found in Medicare Part A & Medicare Part B plans. With Plan F, your out-of-pocket expenses are covered for any hospital and outpatient medical services.
Plan F provides all the basic benefits of Plan C with these extra benefits:
- 100% of the Part B excess charge
Plan G
Plan G Medigap plan is the second most popular plan in the nation, covering the same items found in Plan F except for the Part B deductible.
Going to your first outpatient visit for any calendar year, you have to pay the Part B deductible, which is out of pocket. Then, your plan will work the same as a Plan F for the remainder of the year.
Plan K
Medicare Supplement Plan K is one of 10 different Medicare health insurance supplemental plans. Plan K supplemental insurance plan is a cost-sharing plan that will split the medical cost between the insurance company and the individual beneficiary. Although shared-cost plans provide fewer benefits, they cost less than the broader coverage plans.
Plan K has out-of-pocket limits; check with Member Services or the Medicare.gov customer service team to learn additional details.
Plan L
Medicare Supplement Plan L is a basic plan with some cost-sharing. For instance, you pay 25% of the costs for several benefits, such as your Medicare Part A deductible or Medicare copayments and coinsurance. Once you have met your out-of-pocket limit on this supplement insurance policy, then it will cover 100%. Plan L has an out-of-pocket limit of $3,110.
Plan N
Plan N, first offered in 2010, is one of the latest Medigap plans offered today. Plan N often has lower premiums than Plan G because you will have to pay for additional copays for some of your medical services. You must spend as much as $20 on copays for doctor visits and as much as $50 on emergency room visits. Any additional excess charges and your Part B deductible must be paid by you.
Plan N with Blue Cross Blue Shield Medicare Supplement insurance works well for many beneficiaries looking for lower premiums in exchange for the additional out-of-pocket expenses on the back end.
Choosing the Right Plan
Blue Cross Medicare is versatile and has many options. To choose from all of your Medicare coverage options, be sure to learn which types of policies are available in your area. Your local Blue Cross and Blue Shield Company can help you compare costs and coverage based on your doctors, hospitals, and specific health needs. With options like hearing and vision benefits and low-cost plans, you are sure to find the right coverage for your needs.
Benefits of Choosing Blue Cross Blue Shield Medicare Plans
Blue Cross Blue Shield is an exceptional company and one of the largest providers of Medicare Advantage Plans and Supplement plans in the US. They offer low- and no-deductible coverage options, competitive premiums, and robust policies to select from for most people across all 50 states.
Enrolling in Blue Cross Blue Shield & Open Enrollment Period
You can apply for a Medicare Supplement insurance policy if you are:
- A resident of a state where the policy is offered
- Enrolled in Medicare Parts A and B
- Age 65 or over or, in some states, under age 65 with a disability (plan offerings and eligibility vary by state)
In most cases, once you are enrolled in Medicare, you don’t have to re-enroll or renew your Medicare plan every year.
If you want to change your Medicare policy, you can do that during the annual Medicare open enrollment period. This gives you the chance to change your policy or choose a different coverage option that meets your needs.
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