Medicare Supplement Insurance Plans

Why You Need a Medicare Supplement Insurance Plan

Medicare is a federal program to help older Americans and some disabled Americans pay for the high cost of health care. However, Medicare was never intended to cover all your health care costs. So even if you’re covered by Medicare, you are still responsible for a large portion of your health care costs. That’s where a BCBS Medicare Supplement or senior Medicare Supplement Plan can help.

What Medicare Doesn’t Cover

Medicare does not cover all incurred health care costs. Medicare coverage consists of:

Part A (which covers hospital and skilled nursing facility care), and;

Part B (which covers doctor bills and other medical expenses).

Even with Medicare Part A and Part B coverage, you’re responsible for some out-of-pocket expenses including:

(Here are the 2021 deductibles):

Part A hospital deductible ($1,484)

Part B deductible ($203)

Copayments for hospital stays over 60 days

Care in a skilled nursing facility after 20 days

Twenty percent coinsurance for doctor bills and other medical expenses

Medicare supplement plans pay for additional expenses. By law, Medicare Supplement Insurance Plans are standardized into twelve plans. That means Medicare Supplement Insurance Plan F* from one company must include the same benefits as the same plan from another company. While the benefits must be the same, each company’s rates, reputation, membership features, and quality of service can vary. With Blue Cross and Blue Shield of Illinois, you don’t have to sacrifice comprehensive benefits or freedom of choice for afford-ability.

Benefits

Guaranteed acceptance with no health questions asked

Freedom to choose any doctors or specialists

Coverage with domestic travel

Guaranteed renewability regardless of changes in your health

Coverage guaranteed to match Medicare’s cost increases year after year

Blue Extras Member Discount Program that includes discounts on wellness products and services including vision, fitness clubs, weight management, complementary alternative medicine, hearing, and more.

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Medicare Supplement Insurance Plan Basic Benefits

Hospitalization

Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.

Medical Expenses

Part B coinsurance (generally 20% of Medicare-approved expenses), or in the case of hospital outpatient department services under a prospective payment system, applicable copayments.

Blood

First three pints of blood each year.

Premier Plans

Of all available standardized plans, Medicare Supplement Insurance Plans F and Medicare Supplement Insurance Plan G* offer the most complete protection for uncovered Medicare Part B excess charges. These are the most popular plans because they also pay the Medicare Part A hospital deductible and copayments, skilled nursing facility copayment, and foreign travel emergency care.

Medicare Supplement Insurance Plan F also covers the Medicare Part B deductible.

Budget-Conscious Plans

Medicare Supplement Insurance High Deductible Plan F*

Features a $2,370 annual deductible (2021) before plan benefits begin

Medicare Supplement Insurance Plan N*

Features an office visit and emergency room copayment applicable to each visit

Medicare Supplement Insurance Plan K* and Medicare Supplement Insurance Plan L*

Feature cost-sharing for covered services under Medicare Part A and Part B. Once your annual out-of-pocket expenses reach the required limit, the plan pays 100% of covered expenses for the remainder of the calendar year.

Medicare Supplement Plan F and High Deductible Plan F are only available to those individuals who turned 65 before January 1, 2020.

Part B Medical Excess

Part B Medical Excess covers charges from your provider that exceed Medicare-approved amounts. Only Medicare Supplement Insurance Plan F, Medicare Supplement Insurance High Deductible Plan F, and Medicare Supplement Insurance Plan G cover these charges. For all other plans, you are responsible for paying excess charges. In no case can a provider charge more than 115% of the Medicare-approved amount.

Skilled nursing coinsurance

Medicare pays the first 20 days of treatment in a skilled nursing facility, and an annually adjusted per diem for the 21st through 100th day. Plans with this benefit pay an additional annually adjusted per diem for the 21st through the 100th day.

In order to receive any skilled nursing facility benefits, you must meet Medicare’s requirements:

You were admitted to a hospital for at least three days;

You were admitted to a Medicare-approved skilled nursing facility within 30 days of leaving the hospital.

Foreign Travel Emergency

Medically necessary, foreign travel emergency care services beginning during the first 60 days of each trip outside of the United States. All plans offering this benefit require you to pay a foreign travel emergency deductible and a percent of costs after the deductible is met.

Preventive Care

Preventive Care covers some annual physical and preventive tests and services administered or ordered by your doctor when not covered by Medicare.

Reduced Premium Medicare Select Option

Medicare Supplement Insurance Plans F, G, K, L, and N Med-Select options offer the same solid benefits as the “standard” plans but cost less. You’ll save on premiums simply by agreeing to use any of the Med-Select participating hospitals for non-emergency elective admissions. If you do not use one of these hospitals for your non-emergency admissions, you pay the $1,484 Part A deductible. Med-Select is not an HMO. With Med-Select, you are fully covered for emergency care at any hospital, and you can choose your own doctors and specialists.

Med-Select is available in specific geographic areas only; you must live within a 30-mile radius of a Med-Select participating hospital.

 

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Basic Benefit Options Premier Plan Options Budget-Conscious Plan Options
Plan A Plan B Plan C Plan F Plan G High Deductible
Plan F
Plan K* Plan L* Plan N*
Reduced Premium Medicare Select Options Available (eligibility based on ZIP code)
Basic Benefits 100% 100% 100% 100% 100% 100% 100%/50% 100%/75% copay
applies
Skilled Nursing Coinsurance 100% 100% 100% 100% 50% 75% 100%
Part A Deductible 100% 100% 100% 100% 100% 50% 75% 100%
Part B Deductible 100% 100% 100%
Part B Excess 100% 100% 100%
Foreign Travel Emergency Care
Annual Out of Pocket Limit** $6,220 $3,110

 

Medicare Supplement Plan F and High Deductible Plan F are only available to those individuals who turned 65 before January 1, 2020.

*Plans K-N provide for different cost-sharing than plans A-G.
Plans K and L pay 100% of hospitalization and preventive care Basic Benefits. All other Basic Benefits are paid at 50% (Plan K) and 75% (Plan L). Once you reach the annual limit, the plan pays 100% of the Medicare copayments, coinsurance and deductibles for the rest of the calendar year. The out-of-pocket annual limit does NOT include charges from your provider that exceed Medicare-approved amounts, called “excess charges.” You are responsible for paying excess charges.
Plan N covers Basic Benefits after a $20 copay for office visits and a $50 copay for emergency room visits.
**The out-of-pocket annual limit may increase each year for inflation. (2021 limits shown)
† Network restrictions apply

What is Medicare Supplement Insurance?

Medicare Supplement Insurance is a private health insurance policy designed to help pay some or all of the costs that are not covered by Medicare Parts A and B.

Who is eligible?

Anyone who is covered under both Medicare parts A and B is eligible for Medicare Supplement Insurance coverage. This includes disabled individuals who are under 65.

Can I be turned down?

No, Blue Cross and Blue Shield of Illinois are guaranteed issue policies, meaning they will accept you regardless of your health history and cover any pre-existing conditions.

When can I apply?

You can apply for Medicare Supplement Insurance during open enrollment. Open enrollment includes a six-month period from the date you enrolled in Medicare Part B if age 65 or older, or up to six months after you turn 65 if you were eligible for Part B benefits before age 65. If you become eligible for Medicare Part B benefits before age 65 due to disability or ESRD (permanent kidney failure), you are guaranteed the Medicare Supplement Policy of your choice during the first six months you are age 65 and enrolled in Medicare Part B.

What if I apply and change my mind?

If you apply today, Blue Cross and Blue Shield of Illinois will send you an ID card and a policy to review for 30 days. Purchase your first premium only after you are convinced the insurance protection is right for you. Even after you send your first premium payment and your coverage is in effect, you can still change your mind. Simply return your policy and ID card within 30 days of the effective date. As long as you have not filed any claims, you are under no obligation, and any premiums paid will be refunded.

Does Medicare Supplement Insurance coverage include prescription drug benefits?

No, Medicare Supplement Insurance is designed to fill in the “gaps” with Medicare Plans such as Part A (which covers hospital and skilled nursing facility care) and Part B (which covers doctor bills and other medical expenses). For prescription drug coverage, you can select a separate Medicare Part D Prescription Drug Plan.

Can I enroll if I do not have Medicare Parts A or B?

No, you must be entitled to Medicare Part A and/or enrolled in Medicare Part B to be eligible for Medicare prescription drug coverage.

To learn how to get Medicare Part A and/or Part B, please call Medicare at 1-800-MEDICARE (1-800-633-4227), 24 hours a day/7 days a week. For the hearing or speech impaired, please call 1-877-486-2048.

You may also contact your State Medicaid Office or the Social Security Administration at 1-800-772-1213, Monday – Friday, 7 a.m. – 7 p.m. CST. For the hearing or speech impaired, please call 1-800-325-0778.

Does Everyone Need a Policy?

Not everyone needs a Medicare Supplement Policy. If you have certain other types of health coverage, the gaps in your Medicare coverage may already be covered. You may not need Medicare supplement insurance if:

You belong to a Medicare Advantage plan;

Medicaid or the Qualified Medicare Beneficiary (QMB) Program pays your Medicare premiums and other out-of-pocket costs;

You are covered under an employer group health plan.

What if I (or my spouse) plan to work after age 65 and continue to receive group health care benefits?

Check with your group plan administrator. You may be able to choose either your group plan or Medicare Plus Medicare Supplement coverage. If you stay with your group health care plan, a Special Enrollment Period lets you delay purchasing Part B until you need it.

Can I go to any hospital or doctor I choose?

As a member, you are free to go to any doctor or hospital you choose for care. Your coverage will be recognized across the country. If you are a Med Select member you must go to a participating hospital for all non-emergency admittance.

How do the Blue Cross and Blue Shield of Illinois Medicare Select Plan differ from the standard plan?

A Medicare Select Plan works just like a standard Medicare Supplement Plan with one difference. With Medicare Select, all scheduled inpatient hospital stays must be at a Med-Select participating hospital in order to have coverage for the Medicare Part A deductible.

If you do not go to a Med-Select participating hospital for a scheduled non-emergency hospital stay, you must pay the Medicare Part A deductible. However, for emergency admission, you are covered at any hospital, regardless of whether it is a Med-Select participating hospital.

To qualify for a Med-Select Plan, you must live within 30 miles of one of our Med-Select hospitals.

Do Medicare Supplement plans cover prescriptions drugs?

No. For your prescription drug coverage needs, Blue Cross and Blue Shield of Illinois offer BlueCross MedicareRxSM, affordable Medicare-approved prescription drug coverage plans.

Will I need to switch doctors?

No. You may continue to see your own doctor. Medicare Supplement Plans are convenient and flexible, giving you freedom of choice.

Can I see a specialist whenever I want?

Yes. Just remember that your out-of-pocket costs will be less if you choose a physician who accepts Medicare assignments.

 

Medicare Select Network

View Medicare Select Network Hospitals

 

 

 

 

 

**Med-Select hospital list is subject to change. Always verify the network status with Blue Cross and Blue Shield of Illinois or the hospital before receiving treatment.

*Not connected with or endorsed by the U.S. Government or Federal Medicare Program