Blue Shield Medicare Options

Blue Shield of California has long been a trusted provider of Medicare options for California seniors. The company offers Medicare Advantage Plans, Medicare supplement (Medigap) plans, and Medicare Plan D drug coverage plans, giving seniors a variety of Medicare options. Before we get into how these plans work, let’s briefly review the basic Medicare options for seniors.

  • Option 1: Original Medicare (Parts A & B) + Medigap Plan + Part D Drug Plan

  • Seniors have the option of enrolling in Original Medicare, which consists of Part A, hospital insurance, and Part B, medical insurance. Original Medicare does not cover everything and has out-of-pocket costs in the forms of copayments, coinsurances, and deductibles. Prescription drug coverage is also very limited under Original Medicare. To fill in the gaps of Original Medicare, many seniors choose a Medicare supplement (Medigap) plan. Many also elect to enroll a Medicare Part D prescription drug plan to ensure they have adequate drug coverage.
  • Option 2: Medicare Advantage (MA) Plan

Seniors can forego Original Medicare and instead choose a Medicare Advantage plan. Many seniors opt for this as they find that a Medicare Advantage plan better meets their needs. It’s important to note that you cannot enroll in a Medigap plan or a Part D drug plan when you’re enrolled in a Medicare Advantage plan. Medicare Advantage is meant to be a comprehensive alternative to Original Medicare. Those who opt for an MA plan need to make sure the plan meets their prescription drug needs and is generally affordable.

Now that we’ve covered some basics of Medicare, let’s take a look at the options Blue Shield of California offers.

Blue Shield of California Medicare Supplement Plans

Medicare Supplement plans help pay for costs not covered by Original Medicare, including copayments, coinsurance amounts, and deductibles. They can only be purchased with Original Medicare, and there are some restrictions on when you can enroll, so consult with an expert. The plans are numbered A through N, and each one offers a different set of benefits. Blue Shield of California offers the following plans:

  • Plan A
  • Plan C
  • Plan D
  • Plan F
  • High Deductible Plan F
  • Plan K
  • Plan N

All of the above plans include Medicare Part A and B copayments and coinsurance amounts, in addition to other benefits, which vary from plan to plan. Some plans cover skilled nursing facility care, some plans cover foreign travel emergencies, etc.

Plan F is the most comprehensive and thus the most popular plan, covering 100 percent of the Part B excess charges, in addition to other benefits. The High Deductible Plan F option has the same benefits of the standard plan F, but with a lower premium and a high calendar-year deductible of $2,180 (standard Plan F has no deductible).

Consult with the experts at CA Medicare to determine which plan will best meet your needs.

Blue Shield of California Medicare Advantage Plans

All Medicare Advantage plans are required to provide the same medical services as Original Medicare, and many plans offer additional coverage, such as vision and hearing benefits, and drug coverage. Blue Shield Medicare Advantage plans feature all of the following:

  • No monthly premium (beyond the Part B premium of $121.80 for most people—more on that below)
  • Zero or low copays for primary care physician office visit (depending on your region)
  • No copay for preferred generic drugs when you purchase them at certain retailers, including Costco and CVS
  • No copay for basic diagnostic tests, lab services, and basic X-rays.
  • Coverage through the Medicare Part D coverage gap (also called the “donut hole”)

The MA plans through Blue Shield of California are structured similarly to the HMO and PPO plans most of us are familiar with. Medicare Advantage plans become primary to Original Medicare, but you still must enroll in Medicare Parts A and B in order to get an MA plan, and you must pay the monthly premium for Part B, which is $104.90 for most people in 2015. Most people will pay no premium for Part A.

Be sure to enroll in Medicare Parts A and B when you first become eligible or during Medicare open enrollment, which takes place from October 15-December 7 every year.

It’s worth mentioning again how important it is to make sure the Medicare Advantage plan you choose fully meets your coverage needs. Use our Medicare Wizard to help you determine which Medicare option is best for you, or call us for help.

Blue Shield of California Medicare Part D Drug Plans

Medicare Part D prescription drug plans can be purchased with Original Medicare and help cover the cost of drugs. Blue Shield of California offers prescription Part D drug plans throughout California.

The basic plans through Blue Shield have a low monthly premium, a deductible of $360, and affordable copayment and coinsurance amounts. Their enhanced plans have a higher premium, but no deductible and a more robust formulary than the basic plan.

When Can I Enroll in a Drug Plan?

You can enroll in a prescription drug plan during the 7-month period that begins three months before your 65th birthday and ends three months after your 65th birthday. If you don’t join a drug plan when you first become eligible, you’ll have to wait until the next open enrollment, which happens between October 15 and December 7 each year. If you join during the three-month period before your 65th birthday, your coverage will become effective on your 65th birthday.

Consult with an Expert for Medicare Enrollment Help

Navigating the world of Medicare can feel overwhelming. There is a lot to know, and that’s why you need expert help and advice. The agents at CA Medicare have been helping seniors find affordable Medicare plans through trusted California health insurance companies like Blue Shield of California for more than 20 years. Call us today for more information and help with Medicare enrollment.

Call CA Medicare today at 1-800-356-3615 to get a free quote and one of our friendly licensed agents will help you explore your Blue Shield of California options today.