Blue Cross Blue Shield Medicare
Interested in enrolling in a BCBS Medicare product? Call the number below to speak to a licensed Medicare agent.
1-888-327-3043TTY 711
Medicare.net is powered by Health Network Group, LLC, which is related to Health Compare Insurance Services, Inc., who is a licensed, authorized agent of: Anthem Blue Cross of California, Anthem Blue Cross of Colorado, Anthem Blue Cross of Connecticut, Anthem Blue Cross of Georgia, Anthem Blue Cross of Indiana, Anthem Blue Cross of Kentucky, Anthem Blue Cross of Maine, Anthem Blue Cross of Missouri, Anthem Blue Cross of New Hampshire, Anthem Blue Cross of Nevada, Anthem Blue Cross of New York, Anthem Blue Cross of Ohio, Anthem Blue Cross of Texas, Anthem Blue Cross of Virginia, Anthem Blue Cross of Wisconsin, Blue Cross Blue Shield of Illinois, Blue Cross Blue Shield of Montana, Blue Cross Blue Shield of New Mexico, Blue Cross Blue Shield of Oklahoma, Capital Blue Cross of Pennsylvania, Highmark of West Virginia, Premera in Washington, Premera in Alaska, and Vibra in Pennsylvania.
As with other large carriers, Medicare represents a crucial segment of Blue Cross Blue Shield’s policies. The insurer carries a variety of Medicare Advantage plans, which are private insurance policies that offer the same type of coverage as original Medicare (Parts A and B) along with Medicare Part D (prescription drug plans or PDP’s).
BlueCross BlueShield understands the importance of Medicare, and the company has gone to great lengths to ensure its continued success among beneficiaries. This is vital, as the United States Census predicts that between 2012 and 2050, the United states will experience considerable growth in its older population. By 2050, the population of people aged 65 and over is projected to be 83.7 million, almost double what it was in 2012. The population of people 80 and older is expected to triple by 2050 while the number of people living into their 90s and older is expected to quadruple. This has major implications on Medicare spending as people aged 80 and older account for the largest share of expenditures. Although people aged 80 and older account for just 24 percent of Medicare recipients, they account for 33 percent of the spending.
A recent report found that healthcare costs for couples in retirement are expected to be $260,000, a 6 percent increase over last year’s estimate of $245,000 and the highest since calculations began in 2002. To address these rising costs,Blue Cross Blue Shield announced the launch of a private health insurance exchange designed to assist Medicare-eligible retirees with the switch from group health benefits to individual Medicare Advantage coverage, including MA, Part D and Medigap plans.
If you have any questions at all, don't hesitate to call and speak with one of our healthcare professionals. Available 24/7 at 1-888-327-3043TTY 711
In 2016, the majority of the 57 million people enrolled in Medicare were covered by traditional Medicare, but 31 percent were enrolled in a Medicare Advantage plan. That number has more than tripled since 2004 with 17.6 million people enrolled, up from 5.3 million.
BCBS Medicare Plans
When selecting coverage, the Blue Cross Blue Shield website separates Medicare plans by individual states. That means that to enroll, you need to look for your state’s specific Blue Cross Blue Shield Medicare Advantage programs.Blue Cross Blue Shield has 36 individual and locally operated companies offer coverage in all 50 states; Washington, D.C.; and Puerto Rico. Generally, most states offer multiple MA plans depending on your medical needs and budget, although they may have different costs. As each state has its ownBlue Cross Blue Shield Medicare program, some have higher ratings than others. Rating criteria include factors such as prescription drug coverage, customer satisfaction, customer reviews, long-term care and a variety of options.
The insurer’s MA plans include both Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). You can also break them down into individual plans (the more common option), as well as those with or without prescription drug coverage.
In addition, plan options can be categorized by:
- Cost-Effectiveness
- Fundamentals
- Popularity
- Comprehensiveness
Among these plans’ benefits are:
- Inpatient services
- Outpatient services, including surgery
- Specialist services
- Emergency services
- Office visits
- Ambulance services
- Urgent care
- Preventive care
- Chiropractic care
- In-network vision services
- Lasik eye surgery
- Fitness membership
- Part D prescription drug coverage
- Durable medical equipment (DME) — meant for home use, long-lasting, medically prescribed and necessary
PPO
BCBS Medicare Plus Blue PPO Essential
With this PPO, you can visit in-network and out-of-network providers and facilities, and prescription drug coverage is included.
PPO
BCBS Medicare Plus Blue PPO Vitality
This plan’s copays are generally higher, except for office visits.
PPO
BCBS Medicare Plus Blue PPO Signature
Offering lower copays and cheaper prescription drug prices, this is the preferred BCBS plan. Additionally, copays, including those for office visits, are the same or lower than other plans.
PPO
BCBS Medicare Plus Blue PPO Assure
This PPO offers the lowest deductible and maximum out-of-pocket costs, as well as lower copays. However, the monthly premium is higher.
RX
Stand-alone BCBS Prescription Drug Plans
If you prefer an individual drug plan, then your options include:
- BlueRx Option I: This plan has a lower monthly payment than Option II with a deductible that must be met before benefits begin. This option only covers Medicare-approved prescription drugs.
- BlueRx Option II: This plan has no deductible, and benefits begin immediately, although monthly premiums are higher. In addition, BlueRx Option II features an expanded drug list that covers more brand-name drugs than Blue Rx Option I. Make sure the option you choose covers all the drugs you are currently taking.
Both BlueRx plans offer preferred cost-sharing benefits at a wide network of pharmacies. Cost-sharing provides you with lower copays if you use a participating pharmacy. You not only pay less for a 30-day supply of your medication, but you can also opt for a 90-day supply at just twice the copay, effectively getting a 30-day supply for free.
Blue Cross and Blue Shield (BCBS) is a worldwide insurance provider. More than 99 million Americans have a Blue Cross Blue Shield insurance policy. As a health insurance provider, the company’s history dates back to 1929. It was started as a health insurance provider for teachers under Blue Cross and a plan for employers of mining camps in the Pacific Northwest as Blue Shield. At the very beginning, employees paid monthly fees to groups of physicians for coverage. The companies eventually merged to become BCBS.
The company’s current headquarters are in Chicago, and have they have strong financial standing. BCBS supports their 100 million members with $320 million in revenue each year. There are actually 39 different insurance companies that comprise Blue Cross and Blue Shield, but coverage is available in all 50 states.
It can be confusing to find information about Medicare plans through Blue Cross and Blue Shield since you have to look up plans by state first. All BCBS Medicare plans are separated into different regions. There are many options for Medicare Advantage plans, whether you need individual or group plans, and if you want prescription drug coverage or not.
Additional Information Regarding BCBS / Anthem
Breaking Down the “Blues” of BCBS
Under the Blue Cross Blue Shield organizational system, the carrier is made up of 36 independent and locally-owned companies that serve one-third of the nation’s population, or over 106 million consumers. BCBS also includes the larger Blue Cross and Blue Shield Association (BCBSA), which owns and manages the companies and their many trademarks and licenses, nationally and internationally. The BCBSA is responsible for the carrier’s business and political matters as well. These companies are designed to function as nonprofit organizations, although some are publicly traded, leading to controversy both inside and outside the organization.
Among the Blues, the largest plan is publicly traded Anthem Inc., which offers coverage in 14 states:
- California
- Colorado
- Connecticut
- Georgia
- Indiana
- Kentucky
- Maine
- Missouri
- Nevada
- New Hampshire
- New York
- Ohio
- Virginia
- Wisconsin
In 20 of these states, Anthem has a Medicaid presence, but in 14 there is a separate BCBS plan. Other Blues serving multiple states include Health Care Service Corp., the nation’s largest nonprofit insurer; CareFirst; The Regence Group; and Highmark.
BCBS has direct access to 327,000 medical professionals and 2,000 medical facilities, ensuring a stable, high level of care as well as financial strength for enrollees. BCBS has made a commitment to value-based care, encouraging doctors and hospitals to improve patient health rather than using a traditional fee-for-service approach. In 2015, BCBS spent more than $146 billion providing incentives for better health outcomes while reducing costly duplication and waste.
Overview of BCBS Medicare
There are a few different Medicare Advantage and supplemental plans offered by BCBS. In some cases, these plans combine Medicare Part A and Part B with prescription drug coverage. This means that your hospital insurance, medical insurance, and prescription drugs can all be covered in one plan by using a Medicare Advantage plan through BCBS.
In addition to Medicare Advantage plans, you can also get Medicare supplemental policies, like Medigap and standalone prescription drug coverage, if you currently have original Medicare but want help for medication costs.
BCBS has a number of different Medicare plans that are broken down into four categories: cost-effective, fundamental, popular and comprehensive. These plans are typical HMO and PPO plans that provide Part A and Part B coverage along with some extras thrown in. To enroll in these plans, you will need to look for BCBS Medicare Advantage programs in your state as plans are only available to compare by area.
Getting Medicare with BCBS
Blue Cross and Blue Shield offers plan finders by state. Each state has its own BCBS Medicare site. For example, BCBSM.com is Blue Cross Blue Shield of Michigan. You can search for plans on these sites, though some are more convenient to use than others.
On these sites, you’ll typically find links to individual coverage or group coverage. Individual coverage is what you will most likely be looking for. However, if you are interested in Medicare group coverage through BCBS, here are some tips:
- Medicare Plus Blue Group PPO is a group plan for comprehensive health coverage
- It combines Part A (hospital) and Part B (medical) insurance
- Additional preventive services are included
- You can choose any doctor or hospital that accepts original Medicare
- It offers lower out-of-pocket costs
Most likely, you’ll sign up for individual coverage since group policies are typically reserved for employers. Exceptions would be if you have multiple individuals who want to join together with the group PPO plan, and you live in a state that supports it.
If you try to find and compare plans on BCBS.com, you won’t be able to find a lot of information as with Humana or AETNA. The plans are buried in the “Medicare Options” button, under “Shop for Health Insurance.” This button redirects you to AskBlueMedicare.com/bcbsa. A video will load and turn into a slideshow, where you can enter your ZIP code to get started. From here, you’ll have to fill out a questionnaire to see available options for Medicare Advantage with BCBS.
The questionnaire is fairly simple and takes you through preliminary questions to see what you’re looking for. You can also choose to have a copy of available plans emailed to you once you’re finished. Of course, this requires that you enter your email address.
It seems as if the questionnaire is unnecessary since the site directs you to the state Medicare Advantage site. It would be more efficient if BCBS simply asked for your ZIP code to load the plans for your state without the questionnaire.
Most states have a few different BCBS Medicare Advantage plans, including:
- Medicare Plus Blue PPO
- Medicare Plus Blue PPO Essential
- Medicare Plus Blue PPO Vitality
- Medicare Plus Blue PPO Signature
- Medicare Plus Blue PPO Assure
- Medicare Plus Blue Group PPO
- Prescription Blue PDP
These plans have different values depending on your medical needs and budget. You may be happier with group PPO coverage while others won’t mind paying higher co-pays for extras and lower annual deductibles. With its variety of different plans, BCBS makes it easier to get the right coverage for a price that works in your budget.
Benefits and Costs of BCBS Medicare
You can find all of the plans listed in a BCBS Medicare chart, but it doesn’t have any links. This chart is most suitable for seeing at a glance the possible available options in your region. To get coverage, you’ll need to find your state’s Blue Cross and Blue Shield Medicare site.
Most regions will have a number of plans, but in order to see these plans, you’ll need to fill out some information for yourself. This is cumbersome and doesn’t really play nice for those who want to compare plans privately. As always, we can help you navigate this process from start to finish.
Each plan includes the following benefits, but keep in mind that copays and costs are different depending on the plan that you pick:
- Inpatient services
- Outpatient services
- Office visits
- Specialist services
- Outpatient surgery
- Ambulance services
- Urgent care
- Emergency services
- Durable medical equipment
- Preventive care
- Chiropractic care
- Preventive care for dental
- In-network vision services
- Lasik eye surgery
- Fitness membership
- Part D prescription drug coverage
The costs of each BCBS Medicare plan break down as follows, but remember, these are average costs. For specific plans and pricing, you would have to look up BCBS Medicare plans by your state.
BCBS Medicare Plus Blue PPO Essential
Copays are generally lower for this plan. With this plan, prescription drug coverage is included as well.
BCBS Medicare Plus Blue PPO Vitality
Copays are generally higher with this plan. However, this plan has a lower copay for office visits.
BCBS Medicare Plus Blue PPO Signature
Most customers recommend the Signature Medicare Advantage Plan from BCBS. It has lower copays and cheaper prices for prescription drugs. The copays on this plan are the same or lower than other plays. The copay on office visits is lower as well. This plan is better for individuals who want to spread out their costs over time and want lower costs on medications.
BCBS Medicare Plus Blue PPO Assure
Out of all BCBS plans, the Medicare Plus Blue PPO Assure has the lowest deductible and maximum out-of-pocket costs, but the monthly premium is higher. This plan has lower copays as well.
Standalone BCBS Prescription Drug Plans
Blue Cross and Blue Shield also has standalone prescription drug plans. These include Prescription Blue PDP Option I and Option II.
Blue Cross and Blue Shield tries to cover all bases with its coverage. However, the system is a bit difficult to navigate if you are trying to look up coverage for someone else. For instance, you won’t be able to get any plan information in some states without offering specific details about the person’s age and health condition.
BCBS Medicare Rating
Quality ratings from the Medicare program for Blue Cross and Blue Shield will depend on each state. In some states, star ratings are higher. For example, Michigan received 4-star ratings, but in other areas, like Florida, plans only received 3 stars. These quality scores are based on several factors, including customer satisfaction, customer reviews, long-term care, variety of options and prescription drug coverage.
In general, Blue Cross and Blue Shield has a variety of different plans with different price points, broken down by features and benefits. The costs are a little bit higher, but these plans also have more flexibility. PPO plans allow you to see in-network and out-of-network doctors; this makes it easier to find a doctor or hospital that will accept your insurance.
However, to offer more quality customer service and assist customers in finding the right plan, BCBS needs a streamlined approach to its Medicare Advantage plan comparison. It’s difficult to compare the prices, even when you go to a state’s website. That’s because the costs vary so greatly and some of the plan names are different.
The extra dental, vision and wellness programs are great perks for these plans. The free fitness membership could also help you to stay fit as you age. For these extra services, you do pay a higher copay and deductible.
If you’re interested in purchasing a Medicare Advantage, Part D or a Supplement plan, we invite you to shop with us, at HealthNetwork.com/Medicare