About Blue Cross Blue Shield
Blue Cross Blue Shield has been one of America’s most recognized and well-earned brand names regarding health insurance. Since its founding in the 1930s, 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.
Blue Cross serves over 107 million members across the country, including Washington, DC, and Puerto Rico and in total, insures about 1 in 3 Americans.
When it comes to Medicare plans, approximately 15% of all enrollees choose a Blue Cross Blue Shield Medicare Advantage plan.
Blue Cross Blue Shield Medicare Plans Available
Blue Cross Blue Shield and its subsidiaries sell Medicare Advantage plans in 41 states and Medicare Supplement plans in all 50 states. While they offer a wide variety of plans, their availability varies by region and state.
Blue Cross Blue Shield sells seven different Medicare Supplement plans:
- Plan A
- Plan F*
- High-deductible Plan F*
- Plan G
- Plan K
- Plan L
- Plan N
*Note that Plan F and high-deductible Plan F are only available to those who first became eligible for Medicare before January 1st, 2020.
Currently, Blue Cross Blue Shield does not sell Medicare Advantage plans in the following states:
- North Dakota
- South Dakota
- Washington, DC
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 Blue Shield Medicare Advantage (Part C)
Blue Cross Blue Shield offers Medicare Advantage Plans to consider for those having trouble finding affordable Medigap plans in the state they live in.
Medicare Advantage plans are a good choice for seniors with multiple chronic conditions and healthcare needs. These private insurance companies provide all Part A and B services and other benefits such as wellness programs or hearing aids.
Blue Cross Blue Shield Medicare Part D – Drug Plans
Over one million Americans are registered in BCBS Medicare Part D Rx drug plans. Part D plans are included in many Advantage plans that Blue Cross Blue Shield offers.
The lowest premiums can be found in the BCBS HMO plans, which require you to use a primary care physician who will provide referrals if you need to see a specialist and be treated within the network unless it’s an emergency. If you want Part D, you must be entitled to Part A or enrolled in Part B, and you must live in the designated geography of the plan you wish to register.
Blue Cross Blue Shield Medicare Supplement Plans
If you are enrolled in Medicare Part A and B through BCBS, you might consider securing a Medigap plan to fill coverage gaps; you must be enrolled in Medicare Part A and Part B before qualifying for a Medigap plan.
Medigap plans automatically renew each year.
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 co-payment
- 100% of the cost of the first three pints of blood
- 100% of the Part A hospice care coinsurance or co-payment
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 on Plan C with these extra benefits:
- 100% of the Part B excess charge
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.
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.
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, 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. Spending as much as $20 copays for doctor visits and as high as $50 for 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.
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, though, 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.