Our Verdict
Blue Cross Blue Shield’s Medicare Advantage plans provide Original Medicare benefits with other bundled options, such as wellness programs, dental coverage and vision services. Availability of specific plans varies based on location, but overall, Blue Cross Blue Shield’s offerings are workable solutions for those looking for comprehensive Medicare coverage.
Key Features
- Options for plans include regional PPO plans, private fee-for-service plans, preferred provider organization (PPO) plans, and health maintenance organization (HMO) plans.
- Medicare Part D, which covers prescription medicines, is a part of several programs.
- Restraints: Blue Cross Unlike original Medicare, Blue Shield retains a yearly cap on out-of-pocket costs.
Blue Cross One of the biggest health insurance firms in the country, Blue Shield is made up of 34 different local businesses. The company was founded in 1929 and has been offering health insurance ever since. Since the Medicare program was established in the 1960s, it has also provided Medicare coverage to its clients.
Blue Cross Blue Shield Medicare Advantage at a Glance
A range of plans is offered, including private fee-for-service, regional PPO, HMO, and PPO options.
Wide-ranging coverage: In almost all 50 states, affiliate providers supply Medicare Advantage coverage.
Blue Cross provides drug coverage. For prescription medication coverage, Blue Shield provides at least one Medicare Advantage plan option with Medicare Part D.
How It Works
Blue Cross The Medicare Advantage plans offered by Blue Shield differ in terms of the particular coverage options and monthly costs, but they all provide customers with additional coverage on top of Original Medicare benefits.
Medicare Parts A and B are covered by every Medicare Advantage plan offered by Blue Cross Blue Shield. Hospitalizations and the usage of additional services, such as home health care, hospice care, and certain nursing facilities, are covered under Part A. Part B covers doctor visits, additional outpatient care, medical supplies, and preventative services. Blue Cross Blue Shield Medicare Advantage plans also provide extra benefits like wellness initiatives, vision care, and coverage for hearing impairments. Certain plans also include gift card rewards, over-the-counter health product coverage, transportation services, and telehealth services. Part D coverage is also available for prescription medication, prescribed vaccinations, and/or shots under certain Medicare Advantage plans.
Blue Cross In 2023, 2,466 counties will have Medicare Advantage plans available through Blue Shield’s affiliates.
The Cost
Medicare Advantage plans usually include monthly premiums that are less expensive than Original Medicare; nevertheless, beneficiaries must still pay the normal Part B premium, which for 2023 will be $164.90 as set by the Centers for Medicare and Medicaid Services (CMS). Blue Cross The federal government mandates that Blue Shield’s plans cap out-of-pocket expenses, and those who have these plans typically have lower overall cost sharing—that is, Blue Cross Blue Shield shares cost-sharing responsibilities with the policyholder.
Certain Blue Cross Blue Shield plans may mandate coinsurance and copays. Customers should confirm that their selected healthcare providers are in network as there are defined geographic service area limitations in place. Selecting an out-of-network provider is usually more expensive.
The Fine Print
Blue Cross Blue Shield has contracts with over 1.7 million physicians and hospitals nationwide, making it part of a vast provider network. Customers with Medicare Advantage plans, however, might require recommendations in order to see a specialist. These commercial Blue Cross Blue Shield plans are subject to Medicare’s coverage guidelines and are governed by yearly contracts with the government. Notifying insured individuals of any modifications to their plans prior to the commencement of the following enrollment year is one of these regulations.
What Experts Say
Chief medical officer for insurance operations and strategic partnerships at Geisinger Health and member of the Forbes Health Advisory Board John Bulger, D.O., says, “The Medicare Advantage audience in particular benefits from high-value care and coverage that prioritize the overall well-being of the entire person.” “Plans that prioritize the member and provide this kind of experience are typically excellent choices for individuals [65 and older] and frequently originate from community-based, nonprofit payers.” These factors contribute to BCBS Medicare Advantage programs’ generally good beneficiary outcomes. CMS currently rates the plans offered by Blue Cross Blue Shield an overall 4.17 out of 5.
