Explore Blue Cross Blue Shield Medicare Advantage Plans

Updated: Jul 17, 2022

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What Options Does Blue Cross Blue Shield Medicare Advantage Offer?

Original Medicare coverage is a great resource, but it does not cover everything. Blue Cross Blue Shield (BCBS), a leader in health insurance, offers plenty of Medicare Advantage plans that provide more coverage than you can get from Original Medicare. 

Medical insurance kit

BCBS offers a selection of Advantage plans that include all Part A and B coverage, along with additional coverage and services.

Other coverage options like Health Maintenance Organization (HMO) PlansPreferred Provider Organization (PPO) plans, or Private Fee-for-Service plans (PFFS) each have their own unique pros and cons to consider. Blue Cross Blue Shield offers coverage in almost every state in the country. There are a variety of plans to choose from that offer everything from basic coverage to full coverage to suit the needs of individuals looking for an alternative to Original Medicare and supplemental insurance plans.

Available Blue Cross Blue Cross Medicare Advantage Plans

Each state has its own specific policies and plans available, but the basics of the costs are shared between most plans. These basics include:

  • Premiums: You may or may not have an additional premium for your Medicare Advantage plan, depending on the one that you choose and what is available in your state.
  • Deductibles and copayments: Some plans and services will require copayments or deductibles, but usually this is limited to higher-tier plans that have better coverage for those who need or want it.
  • Out-of-pocket maximums: Unlike Original Medicare, all of the plans from BCBS include a maximum out-of-pocket limit on how much you will have to pay for your medical expenses under the policy.

BCBS offers a selection of Advantage plans that include all Part A and B coverage, along with additional coverage and services.

Blue Cross Blue Shield also offers a dual-eligible Special Needs plan that is designed to provide coverage for those who receive both Medicaid and Medicare coverage. These HMO plans offer prescription benefits and have $0 premiums with no deductibles and copayments, making it easy for people to get the care that they need.

Parade angle

Prescription, Dental, and Vision Benefits

Blue Cross Blue Shield Medicare Advantage plans also include prescription drug coverage, and policies are available with optional vision and dental benefits. Included services are things like preventive care, routine screenings and testing, basic corrective or restorative care (such as tooth extractions or a pair of glasses), and similar services.

Blue Cross Blue Shield Medicare Advantage plans also include prescription drug coverage, and policies are available with optional vision and dental benefits.

BCBS also has Advantage plans with wellness programs built directly into the plan, along with other features and services like smoking cessation assistance, transportation assistance, and more. Again, each state has different offerings, but there are several plans available with these extra services and health solutions.

How to Choose Your Coverage

When choosing Medicare Advantage plans, there are some elements that you need to consider, and some that will be a matter of personal preference. The most significant factors in choosing your plan include considerations like:

  • Coverage offered, including additional services like wellness programs or transportation assistance
  • Required premiums, copayments, or other expenses
  • Type of network (HMO, PPO, etc.)

Although several Medicare Advantage plans have low or no additional expenses, some higher-level plans do require a premium or copayments but will offer better coverage as a result. The choice of network is generally a matter of personal preference.

HMO plans offer lower rates on coverage, but you have to use in-network services. For this reason, some Medicare Advantage enrollees will opt for a PPO or another type of plan that offers more flexibility in providers, even if they do so at a higher cost.

Plans Vary By State Or Coverage Area

Like traditional insurance plans, Medicare Advantage plan coverage varies based on the state you live in. Most plans are offered in most states, but some coverage will be limited to certain regions or networks.

Provider Network or Service

HMO plans offer a network of service providers and require you to receive all care from in-network providers in order for it to be covered. These plans provide various copays and premiums, which are usually lower because you are getting in-network services at all times. Also of note with these plans, referrals may be required for specialist care.

PPO plans are a little more flexible, allowing BCBS members to choose between in-network and out-of-network providers. Coverage is offered for both, although out-of-network care will typically include a premium charge. Most plans won’t require a specialist referral, but some will.

There is also an option known as a PFFS plan, which is a plan that allows you to negotiate a little more on medical costs. In this plan, you will not have to choose a primary care provider, and referrals are not needed for specialist care. The PFFS plans allow the insurance company to determine what they will cover and how much an individual will have to pay out of pocket for care.

If you choose to enroll in a Blue Cross Blue Shield plan, you will find plenty of Advantage plans to pick up where Medicare leaves off.

The Bottom Line

If you choose to enroll in a Blue Cross Blue Shield plan, you will find plenty of Advantage plans to pick up where Medicare leaves off. It is important to speak with a Medicare specialist, as they can help guide you through the enrollment process and address any questions you might have as you figure out what plans best fit your health and budget needs.