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Blue Cross Blue Shield Health Insurance (Complete Guide)

Blue Cross Blue Shield Health Insurance (Complete Guide) | Very Good Coverage

What is Blue Cross Blue Shield? And what type of health insurance and Medicare services do they offer to seniors?

Blue Cross Blue Shield initially started as two different players in the health sector. Both companies merged in the 1940s. Since then, they have provided top notch health service. With over a decade of experience BCBS is one of the most reputable health insurance providers in the US.

Blue Cross Blue Shield is one of Medicare approved health providers. They offer various services such as Original Medicare, Medicare Advantages, and Medigaps. We will cover all these and their numerous benefits.

This guide will provide you with all the necessary details you need to know about BCBS. Every information here was curated from reliable sources and experiences of BCBS members.

What are Blue Cross Blue Shield Health Insurance Services for Medicare?

All four of BCBS Medicare services are under the federal government health insurance plan.

Only seniors that are 65 years old or more or people less than 65 years old with disabilities will qualify for BCBS Medicare services.

  • The first 2 parts of the BCBS health insurance, Parts A and B covers the payment for various health care issues. They are also referred to as Original Medicare.
  • The third part, Part C, is an exclusive plan that also covers parts A and B. Another name for the Part C plan in Medicare Advantage.
  • Part D is the fourth and last plan that covers drug prescriptions. Although this plan is sometimes included with Medicare Advantage, it is also accessible on its own.
  • Another notable plan from BCBS is the Medicare supplemental insurance that covers all the payments the Original Medicare service does not cover.

Now, let us look at these plans in details:

Part A and B, Original Medicare

The government oversees Original Medicare and when you enrol, you get all the Parts A and Parts B benefits. However, Original Medicare does not involve drug prescription and some supplemental benefits such as vision, ear, and dental care.

Part A, Hospital Insurance

Part A Medicare deals with hospital insurance. It covers the costs in hospitals, nursing homes, and hospices care. Many patients are not required to pay for this at all.

Part B, Medical Insurance

Part B on the other hand deals with medical insurance. It covers the costs for health practitioners visits and any other thing that does not involve a stay over in a health center. An example of a cost that Part B will cater for is an influenza shot. The costs for Part B insurance are deducted from the patient’s social security.

Part C, Medical Advantage

Part C is also known as Medicare advantage. It combines both Part A and B, and sometimes even part D. The plans under Part C are accessible via private health insurance institutions. Some of the cost that they will cover include:

  • Constant Dental, ear, and vision checkup
  • Hearing and eyewear aids
  • Medical Assessments
  • Cost of treating chronic complications
  • Programs for overall wellness
  • Services to prevent health issues.

When you sign up for Part C (Medicare Advantage) you will automatically be eligible for every cost that Parts A and B (Original Medicare) covers. Signing up for Medicare advantage also means that a private health insurance company will be in charge of all Medicare benefits.

BCBS comes in here as your private insurer and they will obtain all your benefits via any of the Medicare advantage plans you choose.

It is also important to know that this policy is for only one senior. For seniors that want the same coverage as their spouse, separate policies are required.

Before you can become eligible for Medicare Advantage plan, you must satisfy all of these criteria:

  • Live in the USA: You must have lived in the area of service for the plan coverage, for a minimum of 6 months.
  • You must enroll in Part A and B plans.
  • You must keep paying for your Part B plan.

Part D, Drug Prescription Coverage

For people with the original Medicare plan, this part will help sort all the bills that pertain to drug prescription. Private health insurers like BCBS are also responsible for this plan. So it is important that you enroll to receive this coverage.

You can choose your Part D plan to standalone by adding it to the medical benefits. But this is only after you have chosen both the Medicare supplement and Original Medicare plans.

Another way you can get this Part D plan is to purchase via a Medicare Advantage plan from a hospital that offers this coverage.

Medigap or Medicare Supplement

Medigap, also referred to as Medicare supplements will cover the costs between your original Medicare and the accumulation of all medical services. Medigap will fill in for part or all of a Medicare deductible.

You will get renewable Medicare supplements at all times if you pay a premium. Your monthly premium can however be affected by some factors such as the place you live, your age and your gender.

But this will only happen within your Medigap open enrollment period. The Medigap open enrollment period is also known as enrollment timeline. It is important to know that when you are within the enrollment period, the premium will not be conditioned by your already existing health status.

In situations where you are still within the enrollment period, the premium can still be affected by your preexisting health situation.

The cost of Medicare supplements varies from one provider to another. So you must know the benefits and what you stand to gain from the plans on offer.

Since costs vary, it’s important to compare all BCBS Medicare supplement policies.

It is also important to understand that the benefits within the plans that are offered nationwide are standard, but premiums will vary by carrier. Most providers will only offer standard plans, but there are still those with premiums.

Blue Cross Blue Shield Medicare Enrollment Timeline

  • For BCBS, there are 3 various openings for your Medicare enrollment. They consist of the following:
  • The first enrollment period, also known as the initial enrollment period, is 7 months around when you will be 65 years old. This could either be:
  • Three months before or after the birthday month.
  • Two months before or after the birthday month.
  • One month before or after the birthday month.
  • On the birthday month.
  • The second enrollment period will allow you to join for the duration of the nation’s annual election. The time frame for this is the 15th of October to the 7th of December.
  • The last enrollment period will only allow you to sign up in specific situations defined by BCBS.

Medicare Advantages Plan with BlueCross

If you are a senior that is just getting to learn about Medicare Advantage plans, you might find out that the Original Medicare plan does not exactly cover all health benefits. This is why it is important to carefully learn what is on offer for you before enrolling for a Medicare Advantage Plan.

Some of the most popular Medical Advantages plans you will get with BlueCross include:

  • Preferred Proper Organization, also known as PPO
  • Health Maintenance Organization, also known as HMO
  • Health Maintenance Organization Point of Service, also known as HMO-POS.

Most BCBS Medicare advantage plans will cover drug prescriptions and other add-ons such as online attendance, over the counter allowance, and unrestricted fitness schedules.

Most of these plans will also cover benefits that have to do with hearing, dental, and vision care. All you have to do is make a careful comparison of the plans, and see the one that contains the benefits that will come in handy for you. This will help you save a lot of money.

BCBS knows that their Medicare Advantage plans will not perfectly fit every individual, so they have managed to adjust it in such a way that plans are available for the majority of people. BCBS has in mind those that want plans but do not need referrals and those in need of plans with very low premiums.

Some of their preventive health benefits you can look forward to includes the following:

  • Yearly health checkup
  • Fitness programs in collaboration with other reputable brands
  • Medicare program to prevent diabetes
  • Immunizations for hepatitis B, pneumonia, and flu
  • Assessment for cancer of the lungs
  • A program for the termination of the use of tobacco and smoking
  • Screening for circulatory system health issues
  • Counseling and prevention of the misuse of alcohol.

BCBS Medicare advantages plan contains a lot of interesting incentives that will not only keep you healthy but allow you to save money. Some of these benefits include the following:

Benefits of Part D Drug Prescription Coverage

Most of the Medical Advantage plans that BCBS has to cover drug prescription for most of the generic and popular drugs. BCBS also has various locations for pharmacies, making it extra convenient.

For this aspect, what they will offer you in detail include the following:

  • Pharmacy locations close to your home for a stress-free drug pickup.
  • Access to about 25,000 Pharmacies.
  • Popular pharmacies that are easily accessible and locatable while traveling.
  • Online tool to search pharmacies easily.

Some of the Medicare Advantage plans for dental and hearing benefits include the following:

  • Scheduled examination for dental and hearing and visions.
  • The benefit is included with many other plans, so they come at zero cost.

Silversneakers Fitness benefits

  • Blue Cross will give you access to some of the best tools online that will keep you fit even at home.
  • There is access to about 18,000 fitness locations in the country.
  • Sessions with health, fitness, and wellness experts to provide you with the necessary information to keep you in a great state.

Nurse Confidentiality

  • BCBS will grant you 24 hours’ access to a Nurse that prioritizes confidentiality.
  • The nurse is obliged to respond to any issue or question you have, regardless of if it is an emergency situation or not.

Over Counter Purchases

  • Every member that has a plan allowance with BCBS will be able to buy necessary items over the counter.
  • Some of the items that this plan covers include vitamin supplies, dental eye, and vision care items, pain suppressors, first aid materials, and fever suppressors.

Blue Cross Blue Shield Medicare Advantage Benefits Upgraded for 2021

Blue care has added more benefits for people with their Medicare advantage plans. They include the following:

Increased allowance for Over the Counter Purchases

  • BCBS has increased the allowance for their plans, with prices varying from $25 to $100 for each quarter of the year. However, the coverage for this benefit will depend on the plan enrolled for.
  • Medicare Advantages members with BCBS will be able to make use of online shopping, making purchases via a phone, mail, or physically. This upgrade comes with a better user interface and user experience for their online store options.
  • BCBS members are permitted to pay extra money if their over-the-counter purchase exceeds their allowance.

Support Services at Home

  • BCBS will provide assistance with home activities such as cooking, shopping, home education, home nursing, house chores, transportation, and many more.
  • Only senior members that live alone and require help with the aforementioned activities can qualify for these benefits.
  • It is important to know that this benefit is not for all Medicare Advantage plan

Support for Caregiver

  • BCBS will improve their caregivers’ abilities with training and extra coaching. This benefit is for caregivers attached to some of the high-risk BCBS members.
  • The benefit is not available for all plan holders. For a member to qualify, he or she must sign up for BCBS Coordinated Care. Such a member must also require home care, either from a family member or anybody that will undergo the training and extra coaching.
  • Only a care manager can refer a caregiver to this program.

Meal Benefits

  • Medicare Advantage plan members that require hospital stay will be entitled to BCBS meal benefit.
  • Only members that are under the BCBS Coordinated Care program will be able to benefit from this program.
  • The final requirement for meal benefits is a BCBS care manager approving the eligibility status of a member

Insulin Using HMO and HMO-POS

BCBS members that enroll for these Medicare Advantage plans will enjoy better cost prediction all year for the Part D plan. This is as a result of BCBS's partnership with Medicaid Services and the Center for Medicare. This benefit will allow the members to save more money with the Part D plan.

Transportation Benefit

Upon discharge from hospitals, members who live in certain regions will be eligible for free transportation services.

Grocery Items

Some Medicare Advantage members that have pre existing medical issues will be allowed to make use of over-the-counter allowances to purchase groceries and some other produce items at certain locations.

Programs for Care Management

BCBS with the help of some qualified medical practitioners will help members suffering from serious health complications. BCBS care managers will work with such members to choose the most suitable plan that will make them heal faster and better.

Concierge Services

BCBS will help you with services such as:

  • Keeping you in touch with your designated management team.
  • Organize meetings and appointments with you and health practitioners.
  • Set reminders for when you need to take certain tests, join a fitness program, or get vaccinated.

Blue Cross Blue Shield Access on the Go

  • Medicare Advantage members for HMO-POS and PPO plans will get a blue card. This will give them access to BCBS hospitals and health centers for Medicare services anywhere in the nation.
  • Emergency services of about $50,000 when members of travel, regardless of the plan they sign up for.
  • Transportation costs for all worldwide emergencies.

Snowbird Travel Care Program

If you are a member with a plan that covers travel costs, you are entitled to this limited offer for members traveling to a certain location for holidays.

The management team for this benefit will help you with the following:

  • Clear any concern you are having about the medication and treatment options available to you.
  • Help you with the management of medical items and supplies for diabetes.
  • Link you up with community services that will provide support.
  • Arrange the best health care with your providers.
  • Help you with care and support for serious health conditions.
  • Provide you therapy in case the need arises.

Latest Tech Access

BlueCross gives you access to some of the online services available for their latest Medicare advantages plan. You can make use of this anywhere in the USA from your smartphone or other browsing devices.

This tech will give you access to health practitioners that are trained and well vast in telemedicine, for non-emergency situations.

Blue Cross Blue Shield Medicare Advantage Plans in Detail

Medicare Plus Blue PPO

With this Medicare Advantage plan, you can make use of any hospital or healthcare provider in the USA, as long as they accept Medicare.

This plan will give you health coverage everywhere you go at a minimal cost. Also, you do not need a referral from anyone before visiting the hospital for services. The plan also includes every fitness program offered by SilverSneakers.

Other Aspects of this plan includes the following:

Medicare Plus Blue PPO Essential

BCBS offers the PPO plan at no cost for a lot of counties in Michigan. The plan does not require a referral, and it is perfect for people who need health providers beyond the BCBS-network. Some other incentives for this plan include benefits such as home services, limited meals, transport services, and purchase of grocery items.

Medicare Plus Blue PPO Vitality

This PPO plan is ideal for you if you would love to not see a provider physically from time to time. It requires just a minimal cost and you will have access to providers in and beyond the BCBS network. You do not need a referral.

Medicare Plus Blue PPO Signature

If you do not want to pay a lot of money for visits to health providers and drug prescriptions. This PPO plan is ideal for you. It will give you access to doctors in and beyond the BCBS network, and you do not require a referral.

Medicare Plus Blue PPO Assure

This is BCBS’s most inclusive Medicare advantage plan for PPO. It has the least payment for medical visits and there are no referrals for you to see doctors.

Medicare HMO-POS

This plan for BCBS will give you access to health coverage even beyond the area this service is intended for. Members of this plan are required to pay for out-of-state services when obtaining their blue card.

HMO-POS covers a wide range of health provider network services and all of them will enjoy fitness programs scheduled by SilverSneakers.

Other categories of this plan include the following:

HMO-POS Prime Value

If you would like to avoid making monthly premium payments, this is the ideal HMO-POS plan for you. You will still get the basic supplemental benefits such as hearing, dental and vision cost coverage. It is also possible for some members to be eligible for further benefits such as grocery purchases, food services, home services, and transportation.

HMO-POS Element

For seniors that do not necessarily need a drug prescription plan but regardless want comprehensive medical coverage at a decent and affordable price, this is the ideal plan. The plan will still include hearing, dental and vision cost coverage.

HMO-POS Community Value

This BCBS plan is community-based, and it is for people that require only local health providers for their needs. The plan will cover the basic dental, vision, and hearing coverage, and there will be no payment for an additional plan.

Another benefit of this plan is $100 to purchase items over the counter, and this is paid quarterly. Depending on their health condition, some members may also get benefits such as home supports and grocery purchases.

HMO-POS Classic

If you do not want to pay a lot of money for doctor's visits and drug prescription, this plan is right for you. Like most BCBS plans, it will include the basic hearing, vision, and dental benefits.

HMO-POS Prestige

This is the opposite of the classic plan as doctor’s visits and prescription drugs cost you extra fees. You, however, have the option to see doctors both within and outside your network.

HMO Connected Care Plan

This is one of BCBS's most accepted Medicare Advantage plans. It is approved by a lot of producers and about 100 hospitals in the US. It also includes fitness program benefits from Silverstreak.

Blue Cross Blue Shield Medicare Supplemental Plan

Medicare supplemental plan is a scheme that works hand in hand with Original Medicare. The main purpose of this plan is to cover up costs that Original Medicare does not offer.

With BCBS, a Medicare supplement plan is perfect for the original Medicare coverage. Based on your plan, it might even help settle all co-insurances and deductibles.

Some of the benefits of BCBS Medicare supplement plan includes the following:

  • It acts as a supplement for original Medicare and helps reduce costs to a reasonable amount.
  • BCBS offers a discount of 5% for members of the BCBS medical supplement from the same family.
  • BCBS will allow you to make use of your doctor or health provider so far they accept Medicare.
  • There is no form of network restrictions.
  • You have an unlimited list of specialists to use, with no referrals needed, as long as they accept Medicare.
  • BCBS Medicare supplement has nationwide coverage and is ideal for people who are always on the road.
  • BCBS Medicare supplement plan can settle all or various parts of your original Medicare deductibles.
  • It helps you meet the budget you already plan for healthcare

You can choose any of the following Medicare supplement plans from BCBS.

Plan A

This is BCBS's most subsidized Medicare Supplement plan. The plan has coverage for all basic benefits, however, you will have to pay for the deductible fees in Medicare part A and B, as well as the additional charges that Part B contains.

Plan G

BCBS Plan G is the most common of its Medicare supplement. You will benefit from extensive coverage with this plan, and you will not have to make payments that Original Medicare covers. The only deductible you will settle is $198 from Medicare Part B.

Plan Highly Deductible G

This plan is just like Plan G in terms of benefits, however, you will be required to pay less monthly premiums. This will accumulate to a deductible of $2,340 annually. This is the most ideal plan for seniors that are quite healthy and want a lower Medicare Supplement cost.

Blue Cross Blue Shield Medicare Supplement Well Being Program

BCBS's wellbeing program was created to work with you to improve your health, wellbeing and living as much as possible. Even as you get older and retire, you can still live and enjoy a very healthy lifestyle. Members of this plan will have access to BCBS adventures. All you have to do is pick from any of the supplement plans available, and BCBS will give you all support aimed at meeting the personal health standards that you set for yourself.

This wellbeing Medicare supplement will let you organize that holiday trip and party, having it at the back of your mind that BCBS has you covered throughout your life journey.

Some of the other benefits from this Medicare supplement include the following:

Surgery Support Program

BCBS has an online surgery program with the main purpose of helping you prepare prior to the surgery and recover fully after the surgery.

BCBS will also communicate to your doctor about the best options and treatment for you after surgery. For seniors and people that are in need of surgery, this program will help them know how they can avoid the common issues that happen post-surgery.

24 Hours Nurse Access

You are going to get unlimited access to a qualified nurse in case you have to deal with sickness or wounds. The nurse will help you plan how to get home treatments easily.

Online Wellbeing Access

The Medicare Supplement Wellbeing program will also give you access to support and guidance on your way to attaining personal healthiness. This will include virtual access to important webinars so that you can watch online from your phone or browsing device.

The webinars will focus fully on various aspects of well-being such as mental health, emotional health, physical health, financial security, preventive health measures, and a lot more.

These programs will also come with important materials and infographics that you can download and give to your health provider, family members, and caregiver on how to help manage your wellbeing.

Household Discount on Blue Cross Blue Shield Medicare Supplement Plans

BCBS offers discounts to members of a household that enroll for a particular plan. This will allow you to save about 5% on the monthly premium payment.

Blue Cross Blue Shield Drug Prescription Plan

You can add a BCBS drug prescription plan to your Original Medicare, the Medicare supplement plan will grant you full coverage.

BCBS offers two various options for your drug prescription. Both options are standalone plans and will cover the costs of branded and generic medications.

What Blue Cross Blue Shield Drug Offer

What you have on offer with BCBS drug prescription plans is a mail-in order and 3 months’ drug prescription and supply regardless of where you are in the USA.

Some of the benefits from the plan include the following;

  • An option to choose from a preferred pharmacy store with a network of branches all around the USA.
  • Reduced payments on branded and generic drugs that the plan already covers for.
  • Ideal for you on the go since it covers a wide range of pharmaceutical networks accessible anywhere in the country.
  • Safeguards against the side effects of some of the most dangerous drugs.

Some of the Most FAQ about Blue Cross Blue Shield Medicare

What time can I sign up for the Blue Cross Blue Shield Medicare Advantage Plan?

If you are a senior that is eligible for Medicare or someone, 65 years old or less with health complications, you can sign up for BCBS Medicare advantage plan. The enrollment window includes the following:

  • The first enrollment period, also known as the initial enrollment period, is 7 months around when you will be 65 years old. This could either be:
  • Three months before or after the birthday month.
  • Two months before or after the birthday month.
  • One month before or after the birthday month.
  • On your birthday month.
  • The second enrollment period will allow you to join for the duration of the nation’s annual election. The time frame for this is the 15th of October to the 7th of December.
  • The last enrollment period will only allow you to sign up in specific situations defined by BCBS.

When Can I Enroll for the Blue Cross Blue Shield Medicare Supplement Plans?

Enrollment for BCBS Medicare supplement can take place at any time in the year. But there are some periods and situations where insurance companies will not be able to use Medical underwriting to accept the application.

For BCBS, one of such periods is if you apply when it is the Medigap open enrollment period. This period is defined as 6 months starting from the first month you signed up for your Part B Medicare if you are at least 65 years old or more.

A situation that can lead to rejection for medical supplement coverage is when BCBS cannot determine if it can make use of your medical underwriting to accept enrollment.

What do I Need to Buy Blue Cross Blue Shield Medicare Supplement Policy?

To purchase BCBS Medicare supplement policy, you must have the following:

  • Part A Medicare, also known as hospital insurance
  • Part B Medicare, also known as medical insurance
  • Pay BCBS for the Medicare supplement policy and the Part B premium that you remunerate to Medicare.
  • If you have any health complications, your supplement policy will be renewable, as long as you cover the premium payment.

 

 

About THE AUTHOR

Greg McKnight

Read more about Greg McKnight

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