- Medicare Blue Plus - takomabibelot
United States citizens 65 years of age and older are eligible to receive Original Medicare (Parts A and B), which is administered by the federal government (through the Department of Health and Human Services' Centers for Medicare and Medicaid Services).
Those eligible for Original Medicare have the option of purchasing supplemental insurance coverage from a private insurance company (such as Humana, Aetna, and BCBS, three of the largest private providers in the United States.)
Blue Cross Blue Shield Medicare plans provide a broad range of Medicare Advantage, Medicare Part D, and supplemental policies. This article presents the spectrum of policies available.
(Note: BCBS offers Medicare through regional companies across the United States. The information in this article comes from BCBS in Florida, and offers representative plans.)
BCBS Medicare Blue – Medicare Advantage Plans
Medicare Advantage plans are essentially enhanced Original Medicare plans sold privately by insurance companies. Such plans provide coverage for Parts A and B as well as additional coverages, including prescription drugs, dental, hearing, vision, and other services.
BCBS offers three Blue Medicare Advantage plans, which are listed below from the most basic to the most advanced:
- Blue Medicare HMO – under this plan, beneficiaries are provided with a network of health care providers within which they must find care. There are no copayments for primary care physicians, and low copayments for specialists. Preventative care is free, and emergency coverage is available nationwide;
- Blue Medicare PPO – under this plan, beneficiaries have the freedom to either access the company's network of health care providers or go outside of the network (though going outside the network incurs greater costs.) There are low copayments for primary care physicians and specialists, and monthly premiums are both predictable and affordable. The plan includes generic drug coverage at little-to-no cost and provides emergency nationwide coverage;
- Blue Medicare PFFS – under this plan, beneficiaries have no network requirements, and can see any doctor they choose for the same price. While primary care physician copayments are modest, specialist copayments can be more expensive. Beneficiaries can receive coverage at any facility in the United States which accepts Medicare, and there are no deductible payments. Prescription drug coverage is included, as well as free wellness exams.
The premiums for each of the above plans will vary by state, and premiums increase as beneficiaries move from the more basic to the more advanced plans.
BCBS Medicare Blue – Medicare Part D Plans
Medicare Part D sold by private insurers adds additional prescription drug coverage to Original Medicare. Also known as Prescription Drug Plans (PDP), Blue Medicare Part D plans offer two basic levels of coverage, which are listed below from the most basic to most advanced:
- Blue Medicare Rx, Option 3 – while this option has a high deductible ($300 in Florida) on brand drugs, copayments for generic drugs are low.
- Blue Medicare RX, Option 1 – under this option, there is no deductible, and copayments are low. After a certain spending limit is reached, 100% of the costs are covered for brand and generic drugs.
While there is no obligation to purchase a Part D plan, some professionals advise beneficiaries to purchase and enroll in a Part D plan when they become Medicare-eligible in order to avoid possible late enrollment penalties down the road (and to protect against future drug coverage needs).
BCBS Medicare Blue – Medicare Supplemental Plans
Blue Cross Blue Shield provides a number of insurance supplemental plans which fill in coverage gaps left by Original Medicare. These plans, which generally provide advanced hospital coverage, vary by state.
For more information on supplemental plans, or any of the policies listed in this article, click on any Blue Medicare link at the top of this page, or visit the BCBC Florida coverage guide, from which the information for this article was gleaned.
David Harris-Gershon - David Harris-Gershon – a blogger for Tikkun magazine and a freelance writer on Israel, the Middle East and America’s role in ...
