Anthem Blue Cross Ppo Summary of Benefits and Coverage 2019
Blue Cross and Medigap: What to know
Private insurance companies, such as BlueCross BlueShield, offer Medigap policies to new enrollees. These policies help with Medicare out-of-pocket expenses, such as deductibles, copays, and coinsurance.
According to America's Health Insurance Plans, more than 13.5 million people in the United States had Medicare supplement insurance in 2017.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Private companies offer optional Medigap policies to help people with original Medicare (Part A and Part B) pay for out-of-pocket expenses. This includes copays, coinsurance, and deductibles that Medicare does not cover. Some Medigap plans cover health care for travel outside the US.
Learn more about original Medicare (Parts A and B) here.
Individuals with Medicare Advantage plans cannot have Medigap plans.
There are 10 different Medigap plans, labeled by letter: A, B, C, D, F, G, K, L, M, and N, and each plan offers varying coverage levels.
Medicare standardizes the policies, so each plan of the same letter provides the same benefits, no matter the provider or location. However, the premium differs between providers.
Medigap companies can choose which plans they offer, but they must all offer Medigap Plan A. Since January 1, 2020, Medigap plans sold to new people with Medicare cannot cover the Part B deductible.
In Massachusetts, Minnesota, and Wisconsin, insurance companies standardize Medigap plans differently.
Exceptions
Medigap does not cover:
- long-term care or private-duty nursing
- dental and vision care
- hearing aids or eyeglasses
- prescription drugs
Learn more about Medigap plans here.
BlueCross BlueShield (BCBS) is not one single entity. Instead, it is an association of 36 separate, locally operated BlueCross BlueShield companies. BCBS offers all ten Medigap plans across the United States.
Plans may vary by premium cost and enrollment eligibility. This online tool can help people find Medigap plans in their zip code and each plan's costs. The State Health Insurance Program (SHIP) offers free and impartial advice about Medicare plans.
Each of the 10 Medigap plans must offer the same coverage, as shown in the table below. For example, none of the Medigap Plan As have a deductible, no matter the provider. Similarly, all Plan Cs must provide 80% coverage for foreign travel.
To compare coverage among the 10 plans, please scroll the table.
The BCBS Medigap plans have associated costs, including premiums, deductibles, copays, and coinsurance. There may also be out-of-pocket costs for services that original Medicare (parts A and B) or a person's Medigap plan do not cover.
A person can check with the BCBS online search tool to make sure they are getting the right plan for their healthcare needs,
As an example only, the table below shows monthly premiums for some BCBS Medigap plans in three different locations across the U.S. Some premiums may include optional vision and dental coverage.
The notes below explain some of the features of the premiums found in the chart below.
- Monthly premiums for Medigap policies in Beaverhead, Montana, in ZIP code 59725, vary among people from age 65 to age 80. The premiums shown in the chart are for a female person born on January 1, 1955, and who is now 65.
- The example premiums for Medigap plans for Desha County in Arkansas, in ZIP code 71639, are for a person born on January 1, 1955, and eligible for Medicare Part A on January 1, 2021.
- Available plans and monthly premiums for Medigap plans in Los Angeles County, in ZIP code 90011, are for a female person born on January 1, 1955, and who is now 65 and eligible for Medicare Part A on February 1, 2021.
BCBS is an association of 36 locally-based insurance companies that offer Medigap plans across the country. Although the BCBS portfolio has a range of Medigap plans, people may not find all plans, nor all policies in their area.
Medigap policies cover the out-of-pocket original Medicare (Parts A and Part B) expenses. Medicare standardizes Medigap plans, so each plan of the same letter has the same coverage level. However, costs such as premiums may vary among different plans.
The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.
Last medically reviewed on January 28, 2021
- Health Insurance / Medical Insurance
- Medicare / Medicaid / SCHIP
Source: https://www.medicalnewstoday.com/articles/blue-cross-blue-shield-medicare-supplement
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