Blue Cross Blue Shield Medicare Advantage Review

 Blue Cross Blue Shield MA Plan Types

BCBS offers all types of Medicare Advantage, including:

Health Maintenance Organization (HMO)

Operates within a network of doctors and hospitals

Includes more benefits than Original Medicare or Medicare Supplement policies

Care may not be covered for out-of-network doctors

HMO With Point of Service Option (HMO-POS)

A sub-plan under the HMO umbrella

Operates with a provider network

Patients may pay additional fees for visiting out-of-network providers

Preferred Provider Organization (PPO)

Offers access to a network of doctors and hospitals

Out-of-network access is allowed, but you’ll likely have to pay a higher copay or coinsurance

Private Fee-for-Service (PFFS)

Plan determines how much it pays your doctor or other healthcare provider for services

Typically operates within a provider network, where doctors agree to accept the plan’s terms

Costs will be higher if you choose an out-of-network doctor

Special Needs Plans (SNPs)

Individualized health plans for people with specific or chronic conditions such as dementia, diabetes, or end-stage renal disease (ESRD)

Again, most BCBS Medicare Advantage health plans offer dental, vision, and hearing coverage. Some plans also provide access to the national SilverSneakers fitness program.

Blue Cross Blue Shield 2020 MA Plans and Prices

In 2020, the average Medicare Advantage plan premium costs around $23, according to CMS estimates. Blue Cross Blue Shield competes with this by offering $0 monthly premiums on many of its PPO and HMO policies. The insurance provider also offers benefit-heavy plans with premiums of less than $100 per month.

Regardless of which plan you choose, all MA members must pay a Medicare Part B premium, which is $144.60 per month in 2020. You pay this in addition to the premium you pay for your Medicare Advantage plan. Exact premium prices will vary depending on where you live and which plan you choose.

Here are some examples of select 2020 Medicare Advantage plans offered by BCBS and affiliate companies in select service areas.

Plan*

Zip Code/Service Area

Monthly Premium

Medical Deductible

Annual Out-of-Pocket Maximum

Inpatient Hospital Stay Copay

Copay for Primary Care Provider Visits

Copay for Specialist Visits

Medicare HMO Blue SaverRx 2020

02176 (Melrose, MA; Middlesex County)

$0

None

$6,700

$350/day for days 1–5; $0/day for days 6–91 and beyond

$15

$45

Blue Medicare Choice (HMO)

20202 (Charlotte, NC; Mecklenburg County)

$0

None

$3,900

$310/day for days 1–6; $0/day for days 7–90 and beyond

$0 for “Tier 1” providers; $35 for all others

$40

Blue Advantage Complete (PPO)

Alabama

$0

—

$5,100 (in-network)

$225 per day for days 1–7; $0 for days 8–90 and beyond

$10

$40

BCN Advantage HMO-POS Basic

48127 (Detroit, MI;  Wayne County)

$0

$280 (in-network)

$4,500

Varies

$0 after deductible

$45 after deductible

* Based on 2020 benefits

In Summary …

Blue Cross Blue Shield’s Medicare Advantage options cover the same benefits offered by Original Medicare (Medicare Part A hospital insurance and Medicare Part B medical insurance). They also offer coverage for dental, vision, and hearing services, as well as prescription drug benefits.

Before choosing a specific type of coverage, consider your health needs and the likely costs you’ll incur in the upcoming year, including how much your prescriptions cost, how often you visit your primary care doctor, and other essentials.

Remember: Benefits and prices will vary depending on the zip code or county you live in and the plan you choose. Use Medicare’s Find a Plan tool to check out available options in your local area.