FYI: If you’re new to the world of Medicare Advantage, check out our comprehensive guide to Medicare Part C.
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September 25, 2023
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One of the most trusted names in health insurance, Blue Cross Blue Shield offers Medicare Advantage plans throughout the United States. They also have some robust plan extras on their Medicare Advantage options, such as free fitness memberships and dental coverage, making them one of our top Medicare Advantage providers.
FYI: If you’re new to the world of Medicare Advantage, check out our comprehensive guide to Medicare Part C.
Pro Tip: If you’re looking for a Medicare Advantage plan with no monthly premiums, check out our rundown of free Medicare Advantage plans.
Many factors determine your monthly costs, including your location, age, and gender. Below, we’ve compiled estimates from several states.
| Location | Monthly Premium | Deductible | Maximum Annual Out of Pocket |
|---|---|---|---|
| California | $0.00 | $0.00 | $4,200 |
| Florida | $0.00 | $50.00 | $6,700 |
| New York | $0.00 | $290.00 | $7,550 |
| Texas | $0.00 | $0.00 | $3,400 |
| Plan | Monthly Premium | Deductible | Maximum Annual Out of Pocket |
|---|---|---|---|
| California | $99.00 | $400.00 | $6,700 |
| Florida | $0.00 | $150 | $4,500 |
| New York | $26.00 | $350.00 | $7,550 |
| Texas | $0.00 | $480.00 | $7,550 |
HMO plans only allow in-network coverage. Except for in an emergency, you must use in-network doctors and facilities. You will have a primary care doctor that you choose who manages your healthcare.
These managed care plans are designed to focus on wellness and to help maintain your health. This allows your healthcare provider to catch and treat potential health concerns. This allows them to be treated and potentially avoided.
PPO plans to allow you to receive services for your health care from both in and out-of-network providers. You typically don’t need referrals.
You can expect to pay more for services provided out of network. Sometimes, you may be required to pay the total amount upfront and get a reimbursement from the plan.
PFFS comes with or without prescription drug coverage. With a PFFS, you can see any doctor nationwide participating with Medicare. The healthcare provider must agree to take the plan before each visit.
You may add a standalone Part D plan if you have a PFFS without drug coverage. This is the only MAPD that allows the addition of a Part D Prescription Drug Plan.
SNPs are designed for Medicare beneficiaries with specific situations such as certain health conditions, Medicaid, or living in an institutionalized setting.
These plans have benefits that cater to the beneficiaries in this situation. These plans are typically set up as HMO plans and will all include drug coverage.
All Medicare Advantage plans are contracted based on the calendar year, and unless you make a change in a valid enrollment period, the contract renewal will occur automatically.
Plan extras can vary depending on where you live and which plan you enroll with. These are some of the benefits that could be included in your Medicare Advantage plan through BCBS.
The over-the-counter allowance gives you an allotment to spend on items you can buy without a prescription. You can buy a variety of items. Some products you can purchase with this allowance include toothpaste, knee braces, bandages, and aspirin. You’ll receive a catalog in the mail and an order form to place your order.
SilverSneakers is included with Medicare insurance policies offered by Blue Cross Blue Shield Association members. Medicare beneficiaries can take advantage of the SilverSneakers fitness program to keep their health in check. These gym memberships are included at no cost and have various classes catering to Medicare beneficiaries who want a healthy lifestyle.
It's not just about preventing cavities; routine dental care can also be very important. Unfortunately, Original Medicare does not cover routine dental care. With preventative benefits such as cleanings and x-rays, Medicare Advantage plans through BCBS provide coverage that goes beyond just routine. These benefits can range from preventative benefits such as cleanings and x-rays to comprehensive services that can sometimes include dentures.
Original Medicare does not cover routine vision care. Thankfully, vision coverage is included in most Blue Cross Blue Shield Medicare Advantage plans. In addition to routine services such as eye exams, your plan will include an allowance for eyeglasses so you can get the perfect pair without paying a lot out-of pocket.
Since Medicare doesn’t consider hearing coverage medically necessary, many beneficiaries look for another way to receive these benefits. BCBS Part C plans can include the following benefits:
If you’re looking for a specific benefit, review the evidence of the coverage document that’s included in the plan information.
Since each company is an independent Blue Cross and Blue Shield Association licensee, your customer service numbers may depend on which company you’re enrolled with. Your plan's customer service phone number and contact information will be listed on the back of your Medicare Advantage ID card.
You can contact customer service via phone, email, online through your client portal, or the phone app for your insurance carrier.
BCBS Medicare Advantage plans are available nationwide. However, the name of the BCBS affiliate may differ depending on where you live.
Currently, Blue Cross Blue Shield services the following areas:
The financial strength ratings for Blue Cross Blue Shield can vary depending on which member of the Blue Cross and Blue Shield Association you are comparing. Most BCBS subsidiaries have an A or better rating from AMBest. The National Committee for Quality Assurance rates most Blue Cross plan affiliates with a 3.5-star rating or better.
To learn more about our favorite Medicare providers, check out our other guides:
BCBS offers each type of Medicare Advantage plan available. The plan types include:
Blue Cross Blue Shield offers plans throughout the United States. Their plan offerings will vary depending on where you live and the Blue Cross and Blue Shield Association company you enroll with.
Medicare Advantage plans cover your Medicare Part A inpatient Hospital and Medicare Part B outpatient medical services. Many plans also include Medicare Part D prescription drug coverage. These plans services will also include:
There is no way to say one is better than the other. These coverages work differently, and your situation will determine which is better. Medicare Supplements work as gap coverage to help cover your out-of-pocket costs associated with Original Medicare. Medicare Advantage plans take over your benefits from Original Medicare. These health plans have a Medicare contract with the federal government to administer your Medicare benefits. Your carrier pays your healthcare costs instead of Medicare.