All Blue Cross Medicare plans are not created equal – Medigap or Medicare Advantage?
Maybe you had Blue Cross Blue Shield health insurance through your employer or perhaps you had an individual Blue Cross health insurance policy. You’d like to stay with a familiar company but which is better for you; Blue Cross Medicare Advantage or a Blue Cross Medigap policy?
Or now that your circumstances have changed, maybe you should compare several companies just to keep Blue Cross Blue Shield honest.
It’s best to start with an understanding of the differences between a Medicare Advantage plan and a Medigap insurance policy. After you have done your research you can compare Blue Cross Blue Shield Medicare policies to other company’s plans. Our free 8 Part Video Mini-Course can help you sort things out.
Blue Cross Medicare Advantage plans
An Advantage plan is not a Medigap insurance policy. Many people refer to an Advantage plan as a Medicare supplement but only a Medigap policy is a supplement. A Medicare Advantage plan is another way to receive your Medicare benefits.
Advantage plans, also known as Medicare Part C, are available from private insurance companies that have been approved by and contracted with The Centers for Medicare and Medicaid Services (CMS) to administer your Medicare. The companies are paid a sum of money to provide your Medicare benefits. Plans must meet minimums set by CMS and often include additional benefits not included in original Medicare.
Some benefits of Advantage plans include:
- Lower premiums than Medigap policies.
- Set co-pays and coinsurance amounts.
- A maximum amount that you could be out-of-pocket annually.
- Part D drug coverage is often included.
- Extra benefits, like; dental, vision, hearing and gym memberships.
Medicare Advantage plans are annual plans and you must either renew, choose another plan or return to original Medicare at years end. An Annual Enrollment Period is available from October 15th through December 7th.
Plans also differ from one area to another. A Blue Cross Medicare plan in California will most likely be different than a Blue Cross Advantage plan in Florida or Illinois. Many plans are network-based plans, like a HMO or PPO.
Considering Medicare Advantage? Read This Before You Enroll
Blue Cross Medicare supplements (Medigap)
Shopping for a Blue cross Medigap policy is a fairly simple process. Supplements are standardized plans. Blue Cross Medigap plan F will offer the same benefits as an AARP Medigap plan F or a Humana Plan F. This makes comparing plans easy.
If you have decided on Blue Cross you will want to compare the plans available. Medicare supplement Plan F has been the most popular choice for people looking for the most comprehensive coverage. In June 2010, new Modernized Medicare supplement plans were introduced. Medicare supplement plan N has proven to be very popular due to the lower monthly premium. This is accomplished by shifting some cost sharing to the policy holder.
The benefits of a Blue Cross Medigap policy include:
- May have no, or very little out-of-pocket after monthly premium.
- Medicare supplements have no network restrictions.
- No Annual Enrollment Period to bother with, change any time.
- Less uncertainty about your share of ongoing medical expenses.
If you are able to afford the monthly premiums for a Blue Cross supplemental plan you will have more freedom as to how and when you use it. A supplement fills the gaps left by Medicare so don’t expect extra benefits or coverage for non-Medicare medical expenses.
You will also need to purchase a separate Medicare Part D drug plan. Medigap does not include Part D coverage. The Annual Enrollment Period will apply to your Part D purchase.
Which Blue Cross Medicare plan is right for you?
First, look at your budget. Some Advantage plans do not require a monthly premium and include the Part D coverage. This may be a good choice if a supplement is not affordable. If a supplement is financially feasible you may want to weigh whether or not the loss of the extra benefits included in an Advantage plan is acceptable.
Which ever option you choose Blue Cross Medicare Advantage plans or Medigap policies are usually readily available across the country. Shop online for Blue Cross Medigap or Advantage plans to learn which is best for you.
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Thanks for the kind words Marilyn!
Hi: I will be 65 yr’s in Nov,2 . I trying to find the right Medicare . We use to have Blue Cross with my husband work. He’s retired now. He still has coverage with them and Medicare. Mostly for me because I don’t work. But now we can both go on Medicare. We were thinking of going with an Adventage plan and a secondary plan to take over where Medicare left off. What can you do for us.
Revia, If you want coverage other than the employer group you currently have or only Medicare you will have to choose between an Advantage plan and a Medicare supplement. These are two different types of plans and you are not allowed to have both at the same time. No products are offered on this site as it is only for educational purposes.
Dave,
I’m power of attorney over my 92 year old father. He currently has a BCBS Medicare Advantage which he pays for out of his own pocket. Ford Motor company contributes 1800.00 towards his coverage annually, having severed insurance through Fords. My dad pays $244.00 per month for this coverage. I have been told repeatedly by many, including hospital billing offices that he would be much better off with straight Medicare A&B with a supplemental insurance instead of the BCBS Advantage. He would need Part D – RX coverage as well, and supposedly it should still prove less costly that his current BCBS Advantage coverage. Is this really possible? If so, why does anyone over 65 use Advantage programs?
Richard, By way of getting to your last question, the majority of people enrolled in a Medicare Advantage plan either do not pay a monthly premium (except for Part B) or pay a very low premium. $244 is one of the highest I’ve heard of. Premiums for Medicare supplement (Medigap) policies vary widely and policies are underwritten. If your father could pass underwriting he would likely have a monthly premium at least as high as the Advantage Plan. Age is a major determining factor for Medigap premiums.
So why would billing offices steer you toward original Medicare and a supplement? They would likely be paid more. I’m guessing the BCBS Medicare Advantage Plan is either an HMO, HNO-POS or a PPO. These plans negotiate rates with provider networks. Providers accept lower payment in return for access to the plan’s members. The reason many people use Advantage Plans is that they cannot afford the premiums for Medicare supplemental policies and don’t want to be exposed to the high out-of-pocket costs with original Medicare. And marketing plays a big part in it! Many people don’t know their options, do their homework or even attempt to understand the topic. Along comes an Advantage Plan with a $0 premium, extras like vision and dental, low copays…. and their hooked.
If I was in your position, I would meet with a local agent who can help you assess your options.