Alyssa Lane
Blue Cross and Blue Shield (BCBS) is a health insurance provider operating in several US states, including Texas and Illinois. In Illinois, the Centers for Medicare & Medicaid Services and the state of Illinois have contracted with Blue Cross and Blue Shield of Illinois to implement Medicaid across all counties. In Texas, Blue Cross and Blue Shield offer individual health plans, Medicare and Medicaid plans, and other health plan options. It is possible to be insured by both Blue Cross Blue Shield and Medicaid, and by law, the former will be primary and the latter secondary.
| Characteristics | Values |
|---|---|
| Can you be insured by both Blue Cross and Medicaid? | Yes, if you are enrolled in both. |
| What if you bought your BCBS plan from the state marketplace? | You need to cancel as soon as possible because you can't be eligible for both premium tax credits and Medicaid. |
| What if you're getting BCBS from an employer? | You can keep it, but it might not be worth the premium. |
| What if you're eligible for full Medicare? | There may not be a dual plan available for your zip code. |
| Blue Cross and Blue Shield of Illinois | The largest provider of health benefits in Illinois, serving more than 8.9 million members in all 102 counties across the state. |
| Blue Cross and Blue Shield of Texas | The largest provider of health benefits in Texas, serving more than 10.4 million members in all 254 counties across the state. |
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What You'll Learn
- Blue Cross and Blue Shield of Illinois offers two Medicaid plans
- Blue Cross and Blue Shield of Texas offers Medicare and Medicaid plans
- You can be enrolled in both Blue Cross Blue Shield and Medicaid
- If you receive premium tax credits, you cannot be eligible for Medicaid
- Blue Cross Blue Shield is the largest health benefits provider in Illinois
Blue Cross and Blue Shield of Illinois offers two Medicaid plans
Blue Cross and Blue Shield of Illinois (BCBSIL) offers two Medicaid plans: Blue Cross Community Health Plans and Blue Cross Community MMAI (Medicare-Medicaid Plan). These plans are the result of a contract between the Centers for Medicare & Medicaid Services, the state of Illinois, and BCBSIL, along with other Managed Care Organizations. The aim is to implement Medicaid across all counties in Illinois.
The Blue Cross Community Health Plans program was developed and administered by BCBSIL to provide integrated and quality managed care services to eligible members. This includes seniors, persons with disabilities, families, children (including those with special needs), and adults who qualify for the Illinois Department of Healthcare and Family Services Medical Program under the Affordable Care Act.
The Blue Cross Community MMAI (Medicare-Medicaid Plan) is a demonstration plan designed to serve individuals eligible for both Medicare and Medicaid. MMAI combines Medicare and Medicaid funding under a blended payment agreement to provide integrated, comprehensive care for dual-eligible enrollees.
To be eligible to participate in either of these plans, providers must be enrolled and credentialed through the Illinois Medicaid Program Advanced Cloud Technology system. BCBSIL also offers individual and family health insurance coverage, as well as other health plan options to meet diverse needs. If you no longer qualify for Medicaid, you may still be able to obtain an individual and family health plan with BCBSIL at little or no cost.
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Blue Cross and Blue Shield of Texas offers Medicare and Medicaid plans
Blue Cross Blue Shield (BCBS) is a health insurance provider operating across the United States. In Texas, the company offers a range of health insurance plans, including Medicare and Medicaid options.
BCBS of Texas provides Medicare Supplement Insurance plans, also known as Medigap policies, which help cover some of the costs that original Medicare plans (Parts A and B) do not. These include Part B coinsurance (generally 20% of Medicare-approved expenses) and the first three pints of blood each year. BCBS of Texas offers six different Medicare Supplement Insurance plans labelled A, F, G, N, K, and L. Plans F and G cover the Medicare Part A hospital deductible and co-payments, skilled nursing facility co-payments, and emergency care for foreign travel. Plan N is identical to Plan G, except for the addition of a $20 copay for office visits and a $50 copay for emergency room visits. Plans K and L are low-cost options that require the policyholder to pay a higher percentage of the costs in return for reduced premiums.
In addition to the standard plans, BCBS of Texas also offers Medicare-Select options for Plans F, G, K, L, and N. These plans offer the same benefits as the standard plans but at a lower cost, provided that the policyholder agrees to use a Medicare Select participating hospital for non-emergencies. With Medicare-Select plans, policyholders are still free to choose their own doctors and may use any hospital in the case of an emergency.
In the state of Illinois, BCBS has contracted with the Centers for Medicare & Medicaid Services and the state government to implement Medicaid across all counties. BCBSIL, the Illinois branch of BCBS, offers two plans: Blue Cross Community Health Plans and Blue Cross Community MMAI (Medicare-Medicaid Plan). BCBSIL's Illinois Medicaid networks include independently contracted physicians, hospitals, skilled nursing facilities, and other healthcare providers through which eligible members may obtain covered services.
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You can be enrolled in both Blue Cross Blue Shield and Medicaid
It is possible to be enrolled in both Blue Cross Blue Shield (BCBS) and Medicaid. In fact, you are required to use both if you are enrolled in both. By law, your BCBS will be primary and Medicaid will be secondary.
The Centers for Medicare & Medicaid Services and the state of Illinois have contracted with Blue Cross and Blue Shield of Illinois (BCBSIL) to implement Medicaid across all counties in Illinois. BCBSIL offers two plans: Blue Cross Community Health Plans and Blue Cross Community MMAI (Medicare-Medicaid Plan). The latter is a demonstration plan developed to better serve individuals eligible for both Medicare and Medicaid. MMAI combines Medicare and Medicaid funding under a blended payment agreement to provide integrated, comprehensive care to benefit dual-eligible enrollees.
BCBSIL has also developed the BCCHP program to support the delivery of integrated and quality managed care services to enrollees, such as seniors, persons with disabilities, families and children (including special needs children), and adults qualifying for the Illinois Department of Healthcare and Family Services Medical Program under the Affordable Care Act.
It is important to note that if you are getting premium tax credits for your BCBS plan from the state marketplace, you cannot be eligible for Medicaid at the same time. Therefore, you need to cancel your BCBS plan as soon as possible.
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If you receive premium tax credits, you cannot be eligible for Medicaid
In the United States, Blue Cross and Blue Shield (BCBS) is a federation of 36 separate health insurance organisations that provide health insurance across the country. One of these organisations is Blue Cross and Blue Shield of Illinois (BCBSIL), which has contracted with the Centers for Medicare & Medicaid Services and the state of Illinois to implement Medicaid across all counties in Illinois. BCBSIL offers two plans: Blue Cross Community Health Plans and Blue Cross Community MMAI (Medicare-Medicaid Plan).
Medicaid is a health insurance programme that is jointly funded by the state and federal governments and helps cover the medical costs for individuals and families with low incomes and limited resources. On the other hand, premium tax credits (PTC) are refundable tax credits that help eligible individuals and families cover the premiums for their health insurance purchased through the Health Insurance Marketplace.
To be eligible for PTC, your household income must be at least 100% and, for years other than 2021 and 2022, no more than 400% of the federal poverty line for your family size. However, for tax years 2021 and 2022, the American Rescue Plan Act of 2021 (ARPA) temporarily removed the 400% threshold, allowing taxpayers with a household income above 400% of the federal poverty line to still qualify for PTC.
If you are eligible for PTC, you cannot be eligible for Medicaid. This is because PTC is only available to those who have purchased health insurance through the Health Insurance Marketplace, and to be eligible for PTC, you must not be eligible for coverage through a government program like Medicaid. Therefore, if you are enrolled in a qualified health plan for which advance credit payments were made for one or more months of the year, and a Marketplace makes a determination that you are ineligible for Medicaid but eligible for advance payments of the PTC, you are treated as not eligible for Medicaid for the duration of the period of coverage under the qualified health plan.
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Blue Cross Blue Shield is the largest health benefits provider in Illinois
The Blue Cross and Blue Shield of Illinois Help Center provides members with the information they need to understand their benefits and get answers to their questions. The website also offers a mobile app that allows members to access their benefits and plan information on the go. This makes it convenient for members to stay connected to their health insurance and make informed decisions about their healthcare.
In addition to its standard health insurance plans, Blue Cross Blue Shield of Illinois also offers Medicaid plans. The Centers for Medicare & Medicaid Services and the state of Illinois have contracted with Blue Cross and Blue Shield of Illinois to implement Medicaid across all counties in the state. This ensures that eligible individuals have access to the healthcare services they need, regardless of their financial situation.
The Blue Cross Community Health Plans and Blue Cross Community MMAI plans are designed to provide comprehensive coverage for eligible members. These plans include a network of independently contracted providers, such as physicians, hospitals, skilled nursing facilities, and ancillary providers, who work together to deliver integrated and quality managed care services. This program is especially beneficial for seniors, persons with disabilities, families, and children, ensuring that they have access to the necessary healthcare services.
Overall, Blue Cross Blue Shield's presence as the largest health benefits provider in Illinois offers stability and reliability to its members. With a wide range of plan options, a dedicated help center, and access to a large network of healthcare providers, members can feel confident in their choice of insurance provider. The company's commitment to making healthcare insurance easy, affordable, and attainable aligns with the needs of individuals and families seeking comprehensive health coverage.
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Frequently asked questions
Yes, you can be insured by both. If you are enrolled in both, you are required to use both. By law, Blue Cross will be primary and Medicaid will be secondary.
If you bought your Blue Cross plan from www.healthcare.gov or your state marketplace and are getting premium tax credits, you need to cancel as soon as possible, as you cannot be eligible for both premium tax credits and Medicaid. If you got your Blue Cross plan from an employer, you can keep it, but it may not be worth the premium.
Blue Cross and Blue Shield of Texas offers Medicare and Medicaid plans for those who qualify. Blue Cross and Blue Shield of Illinois also offers a Medicare-Medicaid Plan (MMAI).
It is unclear whether this is possible. One source indicates that there are no Dual plans for their zip code.
