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Blue Cross Medicare Advantage Plan Options

Senior Couple stretchingMany plan options available for Blue Cross Medicare Advantage

There is probably no insurer with greater name recognition than Blue Cross Blue Shield. Whether you live in California, Florida or parts in between, you may have been insured by Blue Cross Blue Shield at some point in your life.

Blue cross Medicare Advantage plans will be a mainstay for those on Medicare for some time to come. There are many Advantage plan options available and will vary depending on where you live. Blue Cross has the luxury of converting many of their employer group and under 65 individual insured members to one of their Medicare plans when those members age into Medicare. This is a benefit not available to companies like HealthSpring or WellCare who do not have tens of thousands of under 65 members to convert to Medicare Advantage.

Blue Cross offers Medicare beneficiaries; Advantage plans, Medigap and Part D drug coverage. Although Blue Cross Medigap plans offer beneficiaries standardized coverage, Blue Cross Medicare Advantage plans vary from State to State and often from County to County.

Types of Blue Cross Medicare Advantage plans available

The types of Medicare Advantage plans available where you live will vary and the names of the plans are not standardized. For example, in California the Blue Cross Medicare HMO is offered by Anthem and is called; Blue Cross Senior Secure. In Florida, plans are available from BlueCross BlueShield of Florida, and the Medicare HMO is aptly called BlueMedicare HMO. Plan benefits will also vary from plan to plan.

Blue Cross Medicare Advantage Plans in California include:

Blue Cross Senior Secure Plan 1 HMO, Freedom Blue Plan 1 Regional PPO, Freedom Blue Plus Regional PPO, Freedom Blue Classic Regional PPO, Smart Value Classic PFFS and Smart Value Plus PFFS.

Blue Cross Medicare Advantage Plans in Florida include:

BlueMedicare HMO, BlueMedicare PPO, BlueMedicare Regional PPO and Blue Medicare PFFS.

Medicare Advantage plans are available on an annual basis. There is no guarantee that plans will have the same benefits or premiums the following year. In fact, there is no guarantee that your plan will renew for the following year. Many carriers have announced that they would not renew or offer PFFS plans in the future.

Should you enroll in a Blue Cross Medicare Advantage plan?

As was mentioned earlier, Blue cross has the advantage of name recognition and a sense of loyalty from those that had employer group insurance through Blue Cross. This does not necessarily mean that you should enroll in a Blue Cross Advantage plan by default.

Plans vary from one service area to the next and can change on an annual basis. This is true of all Medicare Advantage plans. You should consider Blue Cross as one of your options when researching available plans. Blue Cross has some very attractive plan offerings, but they are not the only game in town.


65 comments

  1. Can you tell me information about the coverage gap for blue advantage special needs plan for 2011. Blue cross sent us a mailing , but is not clear.

  2. I tried signing up for a special members – only meeting on line. It proved unsuccessful. Could you tell me what I did wrong and how I can get signed up? JLR

  3. I’m sorry I can’t help. I’m not certain as to what you are referring to. If you are a BCBs member, contact your agent or try the customer service number on the back of your insurance card. I hope this gets you going in the right direction.

  4. Clora, Some plans offer additional coverage in the coverage gap or donut hole. Medicare Advantage plans are offered on a County by County basis and plans vary widely. As such, there are countless plan variations and I am not aware of all of them. If you were signed up by a local agent, I would start there. Another resource is your local Area Council on Aging or other community assistance organizations. The Council on Aging will help you work through and understand most all issues related to Medicare plans and Part D coverage.

  5. I was not happy with your enrollment for the advantage plans, I filled out the form and when you got to county it would not let me enter a county, but I called The # and a very nice lady had to summit my appl. Thank you !!

  6. Sudie, I glad you were able to get the help you needed. Sometimes websites have glitches. For the most part, enrollment online for a Medicare Advantage plan is fairly straight forward.

  7. I can not find a special needs progam for my daughter in Tuscaloosa , Al. Does not every county have to offer at least one?

  8. The County has no say in what plans are available. Insurance companies choose which Counties to offer plans and what type of plans will be offered. It seems that you have a very limited choice for Medicare Advantage plan for 2011 in Tuscaloosa Alabama. HealthyAdvantage Select HMO is the least expensive at $41/mo. Humana Choice is a regional PPO and has a monthly premium of $59. Your most expensive choice would be the Blue Advantage Complete PPO at a whooping $279/mo.!

  9. My parents ( now on their 90s) both wear dentures. Do they still have to pay for a dental plan with Bluemedicare PPO ADV?
    They are paying 26.05 for each one. They want to stop paying it.
    Thank you,

    Ivette

  10. Ivette, plans vary from State to State and you would want to determine if the dental coverage is an optional rider on their BlueMedicare PPO Advantage plan or whether it is included as a standard benefit. If it is included as a standard benefit, you may want to compare other 2011 Medicare Advantage plans to see if their is one available without a monthly premium.
    David

  11. i have the bcbs advantage special needs plan. i received a letter stating that my current plan will not be in effect after the end of this year (2010). i need to join a similar plan, as i am very satisfied with the one i have now. how do i compare plans? i can’t find a site that takes me there. thanks!

  12. Susan, Visit http://www.medicare.gov and select compare plans from the home page. You will need to enter your geographic information, as Medicare Advantage plans are offered County by County. Select the type of Special Needs plan that you qualify for and the site will filter plan results. If you live in a less populated area, don’t be surprised if you have very few or no 2011 Special Needs Advantage plans available. Also, you may want to consider a Medigap policy as an alternative if it is affordable. Since your Medicare Advantage plan is not renewing for 2011, you will have guaranteed issue rights for Medigap enrollment. Check out Medicare Supplement Plan N if this is a viable option for you.
    David

  13. in october i received a letter stating that my blue cross smart value was was being discontinued for 2011. then i reveived a packet for 2011 so i called blue cross and they told me to disregard the packet because the plan was being discontinued. after i enrolled in a different plan for 2011, i got a message on my answering stating the the smart value plan was not being discontinued and that we received the letter in error. i don’t know what to believe or what do.

  14. Steve, Medicare Advantage plans are offered on a County-by-County basis. It’s possible for the Blue Cross Blue Shield Smart Value Plan to be discontinued in one County and not another. Since I’m not sure where you live, I am unable to research this for you. But you can find out quickly by doing one of two things. You could call the number on the back of your 2010 Blue Cross Blue Shield Smart value card and ask. The other option, if you don’t want to call, would be to visit the Medicare website and search for plans by entering your zip code. All 2011 Medicare Advantage plans will be listed on the Medicare website.

    If you want to stay with the new plan in which you recently enrolled, do nothing and you will have a new medicare Advantage plan for 2011. If the Smart value plan is available, you will need to submit a new application with Blue Cross. The last application submitted prior to midnight December 31, will be the one that will be effective for 2011.
    David

  15. i’ve been twirling around the assorted innerwebs sites looking for medicare advantage plans with dental in warren county, new york. my head is spinning and i’ve not gotten anywhere. can you please point me to plans with dental inn my area? i currently have today’s option. they do not cover dental.
    thanks!

  16. Kathleen, Unfortunately finding real dental coverage in a Medicare Advantage plan is often not easy. Many 2011 Medicare Advantage plans will offer some preventative coverage and nothing more. A plan available in Warren County New York that will give you a dental option is, Secure Horizons MedicareComplete Choice (Regional PPO). The plan has a $0 monthly premium and an option to add a dental rider for $32.00 per month.

    The Secure Horizons rider is called “Dental Platinum” and affords you a benefit maximum of up to $1000 per year after a $100 deductible is met. Preventative services, like cleanings, x-rays and exams are provided at a $0 copay. $1000 is not a lot of money when it comes to some dental procedures, but given the Medicare Advantage landscape, it’s not too bad. When you factor in the premium and the deductible, you are spending $484 to get $1000 in benefits plus $0 copay for preventative. If you have some dental needs, you may consider this plan and if your needs are met, drop the rider next year. As you know, you can change from year to year. I hope this points you in the right direction.
    David

  17. This is my first year with Medicare and I am satisfied with the product I currently have. It is time to elect a plan, if I am satisfied do I need to sign any forms before Dec.31st?

  18. Shirley, If you are enrolled in a Medicare Advantage plan and are satisfied with the plan, in most cases there are no election forms to sign. Your plan will automatically renew for the following year and you should receive your membership card in the mail soon. The exception to this is if you were notified that your plan is not renewing for 2011. Some medicare Advantage plans, especially PFFS plans are not renewing for 2011 due to what is termed “service area reduction”, another way to say that your plan is not being renewed in your specific County.

    If your Medicare Advantage plan is not renewing for 2011 you will need to compare plans and elect a new one. If you are unsure about receiving any communications about your plan not renewing for 2011 or do not receive your 2011 insurance card soon, you should call your plan’s member services department to verify that your Advantage plan will be available.
    David

  19. Nancy M. Changelo

    I have been trying to find out if premiums are going to go up in 2011. Where can I find this information? Also, what is URI

  20. Nancy, I’m not sure where you are located or which plan you have, but you could call a local agent or visit http://www.Medicare.gov to get information on 2011 Blue Cross Blue Shield Medicare Advantage plan premiums. I’m not sure what you are asking in your second question, but if you are looking for a URL (website address) you will find that at the Medicare site. just click on the plan you are interested in and scroll down for a link to the plan’s website.
    David

  21. My son is attending college full time in Philaelphia. He is
    27 years old and cannot apply for student insurance. He is
    in good health. In this day and time he need health insurance and I am willing to help him pay for a policy.
    Can you direct us in the right direction in getting him a policy that include dental.

    Thsnks

  22. Shirley, I’m not familiar with all the options available in PA for under 65 health insurance. I would think you son needs to contact a health insurance broker that represents multiple carriers to compare plans. Blue Cross Blue Shield usually has some affordable premiums for you and health individuals.

  23. I am trying to help my grandmother. She lives in Marshall County Alabama, is 82 years old, lives in public housing, receives only $257 per month social security and this is her only income. I am sure she is food stamp eligible but she is too proud to apply. She has medicare and has had blue advantage since the info on it was mailed to her a few years ago telling her it was a free program. Last week she received a bill for January 2011 informing her that her premiums have gone from $0 per month to $90 per month.

    That is a lot of money for her! Is this the best plan available for her?

  24. Amanda, If your Grandmother lives in public housing she probably qualifies for your State’s Medicaid program. If she is enrolled in Medicaid she may not need a Medicare Advantage Plan. It’s possible that depending on Alabama’s level of assistance she is actually paying more for services through the Blue Advantage Complete PPO than she would with Medicare and Medicaid. If she has Medicaid she is considered to be dual-eligible. There are Special Needs Plans for people who are dual eligible, but Blue Advantage Complete PPO is not one of them and there are none available in Marshall County Alabama. Medicare Advantage plans are offered on a County-by-County basis and there are only two plans available in Marshall County. Other than the Blue Cross Blue Shield Medicare Advantage Plan, the only other plan available is Humana Choice Regional PPO. This plan has been flagged on the Medicare website as having received poor ratings for three years in a row. The Humana Choice Regional PPO monthly premium in Marshal County Alabama is $59.

    Get some help from the Local Area Council On Aging or some similar agency to get some objective advice. If she was my Grandmother I would check her status for Medicaid and consider enrolling her in a stand-alone Part D plan. Check out the Humana Walmart-Preferred RX Plan, it has a monthly premium of $14.80 per month. I hope you can get her some help.

  25. Thanks for the reply, David.

    Yes, she does have Medicaid and Medicare so I don’t think she needs anything else.

  26. Amanda, Just to clarify… make sure she has a 2011 Part D Plan in Place.

  27. I am help a friend who is currently enrolled in Blue Advantage, she was upset when she learned that her prem went from $41 to $279 because she lives in Tuscaloosa Co.
    Why is there such a difference prems by the Co., she goes to the Dr in Jefferson Co.–this seems like discrimination.
    She has had the Blue Advantage for several yrs & now has to change because she cannot afford $279 month!

    Can you explain the different in prem for Co’s??? Maybe I help explain this to her.

    Thanks

  28. I am also wondering about the increase from $41 to $181 in Etowah Co. for Blue Advantage. My husband’s parents are retired and my father-in-law suffers from Alzheimer’s. It is hard for them to make the co-payment for all of his doctor’s visits and medications. Now my mother-in-law is shocked to hear about the large increase in the premium per month.
    Thanks!

  29. Kari, Wow! Sounds like you need to help your husband’s parents shop for a new plan. They have until December 31 to submit an application with another plan. Of the seven 2011 Medicare Advantage plans available in Etowah County Alabama Blue Advantage Complete (PPO) has the highest monthly premium. If you check out Medicare’s rating for these plans, the Blue Advantage doesn’t even have the highest ratings to match their highest price.

    Plans in Etowah County that have a $0 monthly premium include; HealthSpring Healthy Advantage Plus (HMO) and VIVA Plus Medicare RX (HMO). The VIVA plan is given a higher star rating by Medicare than the Blue Advantage Complete. Visit http://www.medicare.gov and choose Health and Drug Plans, then choose Compare Drug and Health Plans, enter the zip code and follow the on screen prompts to see all plans available in your area. Good luck!

  30. Debbie, Insurance companies that offer Medicare Advantage Plans enter into an annual contract with CMS to offer plans on a Count-by-County basis. Variances in premium could be related to cost of care in a specific County, negotiated rates for service, operating costs, etc. The good news is that your friend has some other options for 2011 Medicare Advantage plans in Tuskaloosa County Alabama. She may even want to consider a Medigap policy. Medicare Supplement Plan N is a good alternative should she decide to consider a plan with less volatility.

  31. My 79 year old mother lives in Jackson County, Alabama and is on medicare, not medicaid. She received notice that her premium was increasing to $99 with bcbs blue advantage complete. It was $41.00 last year with her only having to pay $23.30, because she receives the extra help. She has already been approved for the extra help this time also but she is only getting about $9.00 help, saying her monthly premium is $90.60. Would she not be better off to go back to original medicare only and find a drug plan? Do you know what is available and affordable in Jackson County, Al?

  32. Rita, There are only two 2011 Medicare Advantage Plans available in Jackson County Alabama, Blue Advantage Complete (PPO) at $99 per month and HumanaChoice (Regional PPO) at $59 per month. The Humana Medicare Plan has been flagged by Medicare as having been given low ratings for the past three years. There are 29 stand-alone Part D Plans with the Humana Walmart-Preferred RX Plan having the lowest premium at $14.80 per month.

    The monthly premium is not the most important factor in choosing a 2011 Part D Plan. What makes the biggest difference in which plan to choose is the Plan’s formulary (drug list). After all, if your mother’s drugs are not covered, the price doesn’t matter. Another popular Part D Plan is AARP Medicare RX Preferred (PDP) at $39.80 per month. The Humana Plan required a $310 annual deductible the AARP Plan doers not require a deductible. With 29 part D plans available in Jackson County, you should be able to find something that will work.

  33. I am currently insured with BCBS of Florida under a conversion plan from the State of Florida. I am on medicare and a friend of mine has a BCBS of Fla. Advantage Regional PPO. She pays a lot less than I do and has better coverage. My plan pays for prescriptions. I would like to know if this same plan would be available for me.

  34. Penny, In order to enroll in a Medicare Advantage Plan you must be eligible or enrolled in Medicare and live within the Plan’s service area. Advantage plans are offered on a County-by-County basis, so the particular plan may or may not be available if you live in a different County. You also must enroll during the Annual Enrollment Period or have a Special Enrollment Period available.

    Check the Medicare And You Handbook published by Medicare or speak with an agent about your set of circumstances to determine if you have a Special Enrollment Period. If not, the next Annual Enrollment Period will begin October 15 and end December 7 2011 and will allow you to enroll in a plan with an effective date of January 1, 2012.

  35. I need a supplment with dental. Is there a fairly cheap on eout ther, I need my teeth pullled and some dentures. I have medicare

  36. Diane, There are two types of Medicare plans available; Medicare supplements and Medicare Advantage Plans. Medicare supplements do not include routine dental. Supplements fill the gaps of Medicares unpaid charges. Dental with original Medicare is very limited.

    You may find a Medicare Advantage Plan in your area that includes some dental but given what you require, you will still have a large amount out-of-pocket and dentures are normally not covered in these types of plans. Visit http://www.medicare.gov and search for plans in your area. You may need to purchase a stand-alone dental policy to even get close to the level of coverage that you require. Expect to pay a hefty monthly premium and have a waiting period before work can be performed.

  37. I am currently living in Greene County, in New York State. I am covered under Senior Blue, for $40. per month. I am planning a move to Florida permanently and would like to find out about a supplement to Medicare, comparable to what I am paying now. Also, I have help with prescriptions through EPIC in NY. Is there anything like that in Florida. I will be in Brevard County. Thank you for any help.

  38. Joan, Welcome to Florida! The easiest way to assess your options for a Florida Medicare Plan is to visit http://www.medicare.org and choose Health and Drug Plans on the home page. Next, click Compare Drug and Health Plans and enter your new zip code. Follow the on screen prompts to eventually see all Medicare Advantage and Part D Plans available in Brevard County Florida. From there you you click on the plan with the option of visiting the plan’s website to get more detail.

  39. darla chenault

    Also does BLUE CROSS BLUE SHIELD ADV have any dental coverage?

  40. Darla, There are several Blue Cross Blue Shield Medicare Advantage Plans and they can have different coverage from County to County. In some cases you may have dental or an upgrade to add dental.

  41. I am eligible to sign up for Medicare now. I am still employed whith good health insurance and will not reach full retiremant age for another year. So I am really confused, I do not want to end up paying a penality for not signing up now yet I do not want to be paying for double insurance. To add to the confusion I am having joint surgery next month so if I sign up for Medicare now it becomes my primary with abig deductable plus the deductable from my work insurance which looks like it will be more out of pocket with both Medicare and my work insurance trying to pay out the least.

    Then there is the confusion over supplemental vs advantage. I think where I live ( rural Maryland ) we can’t get Advantage. or only one plan (Aetna) but then I read that one is discontinued due to non complience.
    The more I read the more confused I get.

  42. My mom will be 65 in oct. and i am trying to figure out which is best medicare only or medicare advantage? I am so confused on this…any help would be great…

  43. Cheryl, Determining which is best for your mom requires that you first have a clear understanding of your options and then taking her budget and health into consideration. She has 4 basic choices:
    1. Original Medicare and a stand-alone Part D Plan.
    2. Original Medicare, stand-alone Part D and a Medigap policy.
    3. A Medicare Advantage Plan that include Part D.
    4. A Private Fee-For Service Advantage Plan and a separate Part D.
    If you have not already filled in the web form on this website, take a minute to request the free mini-course to learn more. Another option is to meet with a knowledgeable insurance agent to help sort out your options.

  44. Cindy, I would meet with a local insurance broker and let them see your current plan information. In many cases enrolling in Medicare and purchasing a Medigap policy and Part D can be less expense both in premium and out of pocket costs than enrolling in Medicare and keeping your employer group coverage. An honest local broker should be able to help you sort out the situation

  45. I have cobra and am turning 65 in september. The Regional BCbs advantage plan has all my doctors but the hospital network is very limited. How much extra do you pay if you go out of network. Will there be new plans offored before September?

  46. Patricia, Medicare Advantage plans can have different benefits and cost sharing amounts County by County. Visit your State specific Blue Cross Blue Shield website and enter your zip code to see available plans. Once you find the plan you are interested in locate the summary of benefits document. This will answer all your questions related to both in and out of network cost sharing amounts.

    Medicare Advantage plans are annual plans for the calendar year. Marketing of plans for 2012 will begin October 1 but you will not be able to submit an application until October 15. The Annual Enrollment Period ends December 7. Plans will be effective January 1. So the plan you enroll in now, with an effective date of September 1, will only give you coverage until December 31.

    You may want to compare several Medicare Advantage plans both now and during the Annual Enrollment Period to find what’s best for you. Visit the Medicare website to search for all available plans. Good luck!

  47. David, I’m currently enrolled in AARP (United Health Plan ) Supplemental to my Medicare. I’m not pleased with the plan as takes several tries to get a doctor’s bill paid. I have very little medical problems, mainly the annual checkup. The doc said that Blue Cross was alot easier to work with. I would like to compare prices on the supplemental. Also my wife is turning 65 this Nov. and will go on same plan. I have been paying her insurance thru a former employer but will terminate at her 65 birthday. Do you have any suggestions? Thanks, Jerry Hope

  48. Jerry, First you should evaluate the plan’s benefits in relationship to your needs. Whether or not your provider is happy with them should not be your primary reason to switch. If your provider is unhappy they can choose not to accept the plan. Do you have a Medicare supplement or a Medicare Advantage plan? If you want to shop for another supplement that is easy enough and if you qualify medically you can switch anytime. If you have an Advantage plan you will need to wait until October 1 when the 2012 plans are publicized to compare. If your wife would like an Advantage plan she will have a 2011 plan with a November 1 effective date but will need to renew if the plan is still available or compare that plan with others for 2012 (always a good idea).

    Getting back to the doctor. Having an issue with an insurance company paying a claim if you have a supplement (an Advantage plan is not a supplement) is very rare. They are standardized plans and things are fairly simple. These plans are regulated by Medicare and though I’m sure there are differences in dealing with each company, if the claim is valid your doctor should and will get paid. Kind of unprofessional to even mention his business relationship with a company especially if it means your are switching plans based on his needs.

  49. Dave, I will be retiring in a few months. I’m split between BCBS of Florida supplemental plan and BCBS advantage plan. If I go with the advantage plan and am not happy with it will I be able to switch to the supplemental plan? Thanks, Steve

  50. Steve, Unless you have a Special Enrollment Period during the course of the year you will generally not be able to switch unless you act fast. There is a dis-enrollment period that begins January 1st and ends February 14th. You can dis-enroll and return to original Medicare during this time frame. At that point you could purchase a Medicare Supplement and stand-alone Part D plan.

  51. I am currently enrolled in AARP Medicare Complete Choice Plan 2, (Regional PPO). If you have competing plan please forward information so AARP policy can be compared with your plan, item by item, for year 2012.

  52. Donald, visit http://www.medicare.gov and click on, Compare Drug and Health Plans. Follow the on screen prompts to see all plans in your area.

  53. I presently have a Secure Horizons advantage plan that offers a “passport” feature that temporarily allows full coverage in Wisconsin when I spend the summer months there and time during the Christmas holidays. I am a Florida resident.
    Does Blue Cross offer a similiar plan?

  54. William, Blue Cross plans can include varying benefits depending on your service area. You would be best to visit the Blue Cross of Florida website to find available plans in your area. Once you locate plans, search for the plan’s Summary of Benefits which will detail how out of State services are covered.

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  56. Does BC/BS automatically end coverage when policyholders reach age 65? If that’s the case, how do you keep a stay-at-home/non employed spouse (who’s five years younger) covered after the husband reaches 65? Thanks in advance.

  57. R.E, I’m guessing by your the question that this coverage is through your employer or former employer? Depending on your State laws, you may have to buy a individual policy for her or she may have a COBRA option because she is losing coverage through no fault of her own. If it’s an individual policy for the two of you outside of your employment, she should be able to stay on as the primary insured. To be certain speak with an experienced insurance agent or if you have to contact your State’s Department of Insurance.

  58. Barbara Saulsbury

    I would like to know if you have a dental supplement insurance plan to go with my bcbs advantage insurance?

  59. Barbara, There are many different Blue Cross organizations across the United States. Advantage plans will vary greatly. Although many Blue Cross Advantage plans will include some type of dental coverage, many will not. Call the member services number on your insurance card and make your inquiry. They will know exactly what’s available. If you find that a credible plans is not an option, check with a Blue Cross agent. You may be able to buy a stand-alone dental plan.

  60. Your Silver & Fit program is a joke. I called and obtained the numbers of two facilities near me. The first facility said they had no personnel on site and would simply give me a key to access their fitness equipment. The second facility said they didn’t know if they had such a program and would call me back. They never did.

  61. John, This website is not affiliated with Blue Cross. see our About Page. Honestly, it sounds as the some of the problem lies with the facility and their employees lack of knowledge.

  62. I am from MI and have had MI BCBS which I now use in GA. When I sign up for BCBS advantage, do I sign up for MI or GA?

  63. Carol, If you are going to enroll in a Medicare Advantage Plan you should do so in the State where you have your permanent residence.

  64. I have a Florida blue medicare advantage HMO and i am traveling for couple months to Colombia. Can i use it there in Colombia in Emergency cases?

  65. Gilberto, You should consult your Summary of Benefits. Travel outside the US is normally not covered by an HMO. You may want to look into getting some medical travel insurance.

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