Paul Sanchez
Blue Cross Blue Shield (BCBS) offers a range of Medicare coverage options, including Medicare Advantage (Part C) and Prescription Drug Coverage (Part D). Medicare is a federal health insurance program for individuals aged 65 and over, or for those under 65 with certain disabilities or medical conditions. BCBS has been providing members with reliable Medicare coverage for over 90 years, and most doctors trust BCBS for Medicare coverage. By entering your ZIP Code, you can explore the different Medicare coverage options available through BCBS to find the plan that best meets your unique health care needs.
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What You'll Learn
Medicare eligibility and enrolment
Medicare is a federal health insurance program for people aged 65 or older, or for people under 65 with certain disabilities or medical conditions, such as permanent kidney failure or End-Stage Renal Disease.
Eligibility
Medicare has different parts, known as Parts A, B, C, and D, which are designed to address different healthcare needs.
Most people get Part A for free, but some have to pay a premium. To be eligible for premium-free Part A, an individual must be entitled to receive Medicare based on their own earnings or those of a spouse, parent, or child. To receive premium-free Part A, the worker must have a specified number of quarters of coverage and file an application for Social Security or Railroad Retirement Board (RRB) benefits. The number of quarters of coverage required depends on whether the person is filing for Part A based on age, disability, or End-Stage Renal Disease (ESRD).
Individuals who are eligible for premium-free Part A are also eligible to enroll in Part B once they are entitled to Part A. Individuals who must pay a premium for Part A must meet additional requirements to enroll in Part B, including being a U.S. resident and citizen, or a lawfully admitted permanent resident who has been in the U.S. for at least 5 years.
Enrollment
Individuals already receiving Social Security or RRB benefits at least 4 months before being eligible for Medicare and residing in the United States are automatically enrolled in both premium-free Part A and Part B. People who are automatically enrolled can choose whether they want to keep or refuse Part B coverage. Individuals who are not receiving Social Security or RRB benefits are not automatically enrolled and must actively sign up for Medicare.
If you are already enrolled in Part A and want to enroll in Part B, you can sign up for Part B only. If you do not enroll in Part B when you are first eligible, you may have to pay a late enrollment penalty.
Other Insurance
If you have Medicare and other health insurance, such as from an employer group health plan, each type of coverage is called a "payer." The "primary payer" pays up to its limit, then sends the remaining balance to the "secondary payer." If the secondary payer doesn't cover the remaining balance, you may be responsible for the remaining costs.
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Medicare Advantage plans
Medicare is a federal health insurance program for people aged 65 or older, people under 65 who have certain disabilities, and people of any age who have kidney failure (End-Stage Renal Disease) or ALS (amyotrophic lateral sclerosis, also called Lou Gehrig's disease).
Medicare has four parts, referred to as Parts A, B, C, and D. Medicare Part A and Part B are also known as Original Medicare and are managed by the federal government. Part A covers inpatient hospital, skilled nursing facility, hospice, and home health care. Part B covers care received from doctors, preventive services, outpatient care, home health care, and durable medical equipment.
Medicare Advantage, also known as Part C, is an alternative to Original Medicare. It is offered by private health insurance companies approved to participate in the Medicare program. These plans can be HMOs, PPOs, Regional PPOs, or Private Fee-for-Service plans. Medicare Advantage plans provide all Part A and Part B services while including some additional services, such as wellness programs, hearing aids, and vision services.
If you decide to enroll in a Medicare Advantage plan, you must continue to pay your Part B insurance premium, and you may also have to pay a separate monthly premium for the plan. Some plans may also have deductibles and copayments for specific services, such as doctor office visits.
To find out more about Medicare Advantage plans and how they can meet your unique health care needs, you can explore the options provided by Blue Cross and Blue Shield (BCBS). BCBS has been providing members with reliable health coverage for over 90 years, which is why most doctors trust them for Medicare coverage. By entering your ZIP Code on their website, you can discover the Medicare coverage options available in your area.
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Medicare prescription drug coverage
Medicare is a federal health insurance program for people aged 65 or older, people under 65 with certain disabilities, and people of any age with kidney failure (End-Stage Renal Disease) or ALS (also known as Lou Gehrig's disease). Medicare has four parts: Part A, Part B, Part C, and Part D.
Part A and Part B are often referred to as Original Medicare and are managed by the federal government. Part A covers inpatient hospital, skilled nursing facility, hospice, and home health care. Part B covers care received from doctors, preventive services, outpatient care, home health care, and durable medical equipment. Most federal employees take Part A as soon as they can because it's typically free as long as you've paid enough in Medicare taxes, which usually means working for at least 10 years.
Part D of Medicare is the prescription drug plan. It is offered by a Medicare Advantage organization and/or Part D plan sponsor with a Medicare contract. Enrollment in Part D depends on the plan's contract renewal with Medicare.
If you combine your Medicare Part A and Part B coverage with FEP (the Federal Employee Program), you don't need a supplemental Part D plan. According to OPM, the prescription drug coverage under FEP pays out the same or more than a Part D plan and is considered Creditable Coverage. If you don't take a Part D plan, you will still have prescription drug coverage, and you won't be penalized if you decide to take Part D later.
The FEP Medicare Prescription Drug Program (MPDP) is only available to residents of the United States or a US territory. If you have Medicare and other health insurance, each type of coverage is called a "payer." The "primary payer" pays up to the limits of its coverage and then sends the remaining balance to the "secondary payer." If the secondary payer doesn't cover the remaining balance, you may be responsible for the remaining costs.
Blue Cross Blue Shield offers Medicare Advantage and Prescription Drug Plans. You can explore their website to find Medicare coverage that fits your unique healthcare needs.
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Medicare costs
Medicare is a federal health insurance program for people aged 65 or older, people under 65 with certain disabilities, and people of any age with kidney failure or ALS. It is divided into four parts, A, B, C, and D, each designed to address different healthcare needs.
Medicare Part A and Part B are also known as Original Medicare. Part A is free for those who have paid enough Medicare taxes, which typically means having worked for at least 10 years. It covers inpatient hospital, skilled nursing facility, hospice, and home health care. Part B covers care received from doctors, preventive services, outpatient care, home health care, and durable medical equipment. You may pay a late enrollment penalty if you don't enroll in Part B when you're first eligible.
Medicare Advantage and Prescription Drug Plans are offered by a Medicare Advantage organization and/or Part D plan sponsor with a Medicare contract. Enrollment in these plans depends on the plan's contract renewal with Medicare. If you decide to combine your Part A and Part B coverage with FEP, you don't need a supplemental Part D plan as prescription drug coverage is included.
Even with coverage options, out-of-pocket costs may vary depending on policies for in-network versus out-of-network providers. There's no yearly limit on what you pay out-of-pocket unless you have supplemental coverage, like a Medicare Supplement Insurance (Medigap) policy, or join a Medicare Advantage Plan. If you have limited income and resources, you may be able to get help from your state to pay your premiums and other costs.
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Medicare coverage options
Medicare is a federal health insurance program for people aged 65 or older, people under 65 with certain disabilities, and people of any age with kidney failure (End-Stage Renal Disease) or ALS (also called Lou Gehrig's disease). Medicare has four parts: Part A, Part B, Part C, and Part D.
Part A and Part B are known as Original Medicare and are managed by the federal government. Part A covers inpatient hospital, skilled nursing facility, hospice, and home health care. Part B covers care received from doctors, preventive services, outpatient care, home health care, and durable medical equipment. Some individuals who receive Social Security benefits are automatically enrolled in Original Medicare, while others need to apply for it as they approach their 65th birthday.
If you choose Original Medicare and want to add drug coverage, you can join a separate Medicare drug plan (Part D). Medicare drug coverage is optional and available to everyone with Medicare. Most Medicare Advantage Plans (Part C) include Part D coverage, and in most cases, you can't join a separate drug plan with this option.
Medicare Advantage is another way to get your Part A and Part B benefits instead of Original Medicare. These plans are offered by Medicare-approved private companies and may include additional benefits. However, you may be restricted to using doctors who are in the plan's network.
Medicare Supplement Insurance (Medigap) is extra insurance you can buy from a private company to help pay your share of costs in Original Medicare. Some Medigap policies offer coverage when you travel outside the U.S., but they generally do not cover long-term care, vision, dental, hearing aids, private-duty nursing, or prescription drugs.
If you have Medicare and other health insurance, such as group health insurance, retiree coverage, or Medicaid, each type of coverage is called a "payer." The "primary payer" pays up to its limit, then sends the remaining balance to the "secondary payer." If there is still a balance remaining, you may be responsible for the costs.
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Frequently asked questions
Medicare is a federal health insurance program for people aged 65 or older, people under 65 with certain disabilities, and people of any age with kidney failure or ALS.
Blue Cross and Blue Shield (BCBS) is a private insurance company that has been providing Medicare coverage for over 90 years.
Medicare has four parts: Part A, Part B, Part C, and Part D. Part A and Part B are known as Original Medicare and are managed by the federal government. Part C is Medicare Advantage, which is an alternative to Original Medicare and offers additional benefits. Part D is prescription drug coverage.
Yes, you can have both Medicare and BCBS insurance. If you have multiple types of coverage, each type of coverage is called a "payer." The "primary payer" pays up to its limit, then sends the remaining balance to the "secondary payer."
When deciding between Medicare and BCBS insurance, it is important to consider your health needs, finances, and lifestyle. BCBS offers Medicare Advantage plans that provide additional benefits beyond Original Medicare, such as wellness programs, hearing aids, and eye exams. You can explore the different Medicare coverage options offered by BCBS and compare them to your needs.
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