Blue Cross Blue Shield Medicare Health Plans - Black Enterprise
Black Enterprise magazine Fall 2019 issue

What is the Right Blue Cross Blue Shield Medicare Plan for You?

Knowing which health insurance plan will work best for you isn’t always easy. So, let’s take a closer look at some Blue Cross Blue Shield Medicare coverage plans and how they can help you get the health care you need.

What is Medicare?

Medicare is a federal health insurance program. Medicare health plans offered are for:

  • U.S. citizens age 65 and over, or
  • Citizens under 65 with certain disabilities or medical conditions

Medicare has different parts: A, B, C, D. Each part is designed to help cover different health care costs. While Medicare Part A and Part B (Original Medicare) provide coverage for many health care costs, there are limitations and out-of-pocket expenses. Because of these limitations and out-of-pocket expenses, many individuals choose to enroll in a Medicare Part C (Medicare Advantage) plan or a Medicare Supplement (Medigap) plan. 

Part A Part B Part C                  (Medicare Advantage)       Part D Medicare Supplement (Medigap)
Coverage Offers inpatient care and home health care services Offers doctor services, outpatient care, and medical supplies Coverage may include wellness programs, hearing aids, and vision services Offers        prescription drug coverage Helps with out-of-pocket costs (such as deductibles, copays and coinsurance) not covered by Part A and Part B

Original Medicare Plans

Medicare Part A and Part B are also known as Original Medicare.

Part A covers (with certain limitations):

  • Inpatient care offered in hospitals or skilled nursing facilities
  • Inpatient mental health care
  • Hospice care for the terminally ill

Part B covers (with certain limitations):

  • Doctor services
  • Outpatient care
  • Medical supplies
  • Durable medical equipment
  • Preventive services

Now, let’s take a deeper look at Blue Cross and Blue Shield Medicare’s Advantage and Supplement plans.

Blue Cross Blue Shield Medicare Advantage (Medicare Part C) Plans

Medicare Part C plans, also known as Medicare Advantage plans, cover everything included in Part A and Part B and also provide additional benefits. Medicare Advantage plans are offered through private health insurance companies, like Blue Cross Blue Shield who contract with the government and are approved by the Centers for Medicare & Medicaid Services (CMS)

Medicare Advantage plans include health maintenance organizations (HMOs), preferred provider organizations (PPOs), regional PPOs, and private fee-for-service plans. 

In addition to the coverage found in Original Medicare, Medicare Advantage plans offer additional benefits and coverage, such as:

  • Wellness programs
  • Hearing aids
  • Vision services

Most Medicare Advantage plans also provide prescription drug coverage.

How Can I Enroll in a Blue Cross Blue Shield Medicare Advantage Plan?

You must first enroll in Medicare Parts A and B before signing up for a Medicare Advantage plan. 

You have the option to enroll in a Medicare Advantage plan or change Medicare Advantage plans during the the Annual Election Period (AEP) which occurs each year from October 15 – December 7. During AEP you can:

  • Join a Medicare Advantage plan
  • Leave your Medicare Advantage plan and return to Original Medicare (Part A and Part B)
  • Switch from one Medicare Advantage plan to another
  • Add or change your prescription drug coverage (Part D) plan if you are in Original Medicare

If you are already enrolled in a Medicare Advantage Plan, you are also able to change your plan during the Medicare Advantage Open Enrollment Period (MA OEP) which occurs annually from January 1 – March 31. MA OEP is a new enrollment period which began in 2019. During MA OEP you can:

  • Leave your Medicare Advantage plan and return to Original Medicare (Part A and Part B)
  • Switch from one Medicare Advantage plan to another

Blue Cross Blue Shield Medicare Supplement (Medigap) Plans

If you have Medicare Part A and Part B coverage, Medicare Supplement (also called Medigap) plans can help you pay for out-of-pocket costs, such as coinsurance, copayments, and deductibles.

Like Medicare Advantage plans, Medigap plans are offered through private insurance companies. 

How Can I Enroll in a Blue Cross Blue Shield Medicare Supplement Plan?

You must first enroll in Medicare Part A and Part B before joining a Medigap plan. 

The Open Enrollment Period for Medigap is the six-month period that starts the first day of the month you turn 65 or older and are enrolled in Original Medicare. Your ability to opt into a specific Medigap plans depends on which state you live in.

Once you’re enrolled in a Medigap plan, it renews annually as long as you pay your premium and the plan is available.

Medicare Prescription Drug Coverage (Medicare Part D)

Medicare Part D, also known as the Medicare prescription drug plan, is offered by private health insurance companies and covers your prescription drug costs for covered medications. 

You can select a Medicare prescription drug plan (PDP) in addition to:

  • Original Medicare (Part A and Part B)
  • Original Medicare (Part A and Part B) with a Medigap Plan

Medicare Part D coverage is included in most Medicare Advantage (Part C) plans.

Blue Cross Blue Shield Medicare Coverage – Frequently Asked Questions (FAQs)

Q: Can I have the Blue Cross Blue Shield Medicare Advantage plan and a Medicare Supplement plan at the same time?

A: No. You must pick between the Medicare Advantage plan (Part C) or a Blue Cross Blue Shield Medicare Supplement plan. It is against federal law for someone to be enrolled in both plans at the same time.

Q: How is Medicare different from Medicaid?

A: Medicaid is a state-based health insurance program that helps low-income individuals and families, people with disabilities and older individuals.

Medicare is a federal health insurance program designed primarily for people 65 and older as well as for people under age 65 who have disabilities and/or certain medical conditions.

Medicaid eligibility differs from Medicare eligibility. Certain rules apply for individuals eligible for both Medicare and Medicaid.

The Bottom Line

Getting Original Medicare is a good start for basic health care coverage. But you also have additional options with Blue Cross Blue Shield Medicare to help cover more of your health care needs.

Medicare Advantage plans focus on providing additional health care services, including prescription drug coverage. Medicare Supplement or Medigap plans focus on helping to keep your out-of-pocket costs for health care affordable.

To learn more about Medicare Advantage, Medicare Supplement, and prescription drug plans, you can obtain a free, personalized quote.