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Medicare Products
Due to the highly regulated nature of these plans, we can only provide general information on our website. If you are interested in learning more about these plans and our portfolio of other Medicare products, please call our team of licensed agents.
Medicare Advantage Plans (known as MA or Medicare Part C plans)
A type of Medicare plan offered by a private company that has a contract with Medicare to provide you with all of your Medicare Part A (hospital) and Part B (health) benefits. Your services are covered through the plan and are not paid for under Original Medicare. Most plans offer extra benefits and lower co-payments than Original Medicare. Many plans include prescription drug coverage and are sometimes referred to as MA-PD plans.
To join a plan, you must be entitled to Medicare Part A and Part B. You must also live in the service area serviced by the plan. Some plans also require a monthly premium. Following are the most common types of MA and MA-PD plans:
- Medicare Health Maintenance Organization (HMO)
These plans are available in only specified areas. In most HMO’s, you can only go to providers in the approved network – except for emergencies.
- Preferred Provider Organizations (PPO)
These plans are available in a local or regional areas in which you pay less if you use a network provider. You can use providers outside the network for an additional cost.
- Private Fee-For-Service (PFFS)
You may go to any Medicare approved provider that is willing to provide care and accepts the plans payment terms. You should check to make sure each of your providers accepts the plans payments prior to enrolling. You may pay more or less than Medicare approved benefits because the insurance plan, not Medicare, determines payment amounts.
MA and MA-PD plans have been around for several years. In order for a plan to be approved by Centers for Medicare and Medicaid (CMS), they must agree to provide coverage for a full year. If a plan leaves the area, you will be given a 90-day notice and a list of other options in your area.
Enrollment
There are specific guidelines set forth by the Centers for Medicare and Medicaid (CMS) regarding enrollment and disenrollment in a Medicare Advantage plan. Some of the major guidelines are outlined below. There may be other times and situations when an individual can enroll in a Medicare Advantage plan. Please call us for more information.
- Initial Coverage Election Period (ICEP)– Individuals can enroll in a MA or MA-PD plan when they first become eligible for both Medicare Part A and Part B. An individual can sign up anytime during the 3 months before their effective date with Medicare and up to 3 months after their effective date.
- Annual Election Period (AEP) – November 15 through December 31 of each year. You can change to a different MA, MA-PD or go back to Original Medicare with a Part D stand alone plan.
- Open Enrollment Period (OEP) – January 1 through March 31 of each year. If you have a MA-PD plan, you can change to another MA-PD plan or return to Original Medicare with a stand-alone Part D plan. You cannot switch from a MA only plan that does not provide Part D benefits to a MA plan that does offer Part D benefits. If you have Original Medicare and a Part D plan, you can enroll in a MA-PD plan.
Blue Medicare Supplement℠
For North Carolina beneficiaries enrolled in Medicare Part B
Choose the plan that’s right for you
Savings and peace of mind
See the doctor you want
Value-added discounts
Control of your care
Savings and peace of mind
Medicare only covers some of your medical costs. That’s why Blue Cross and Blue Shield of North Carolina (BCBSNC) offers dependable Medicare supplement plans for Medicare beneficiaries, to help lessen the worries over costs that Medicare doesn’t cover. Choose from our 101 Blue Medicare Supplement℠ plans to find the plan that best fits your needs and your budget.
- Wide selection of plans
- Protection against unexpected events
A local company you can trust
With the largest market share2 of Medicare supplement policyholders in the state, BCBSNC serves more than 125,0003 North Carolina Medicare beneficiaries with over 75 years4 of experience in the health care industry.
- Largest market share2 of Medicare supplement policyholders in the state
- One of the most trusted Medicare supplement plans in the state
See the doctor YOU want
No matter which Blue Medicare Supplement℠ plan you choose, you’re free to select your own Medicare participating doctor or visit any Medicare-participating hospital. And in most cases, your Part A and Part B Medicare claims and supplement claims are handled automatically by BCBSNC.
- Choice of Medicare-participating doctors
- Easy to use, virtually no claims to file
Value-added discounts
You’ll also have access to Blue Values℠, our value-added discount programs available to you at no extra cost.5 You’ll be eligible for discounts on health-related products and services, such as eyeglasses, hearing aids and more. You can also earn rewards for being more physically active and participating in wellness activities.
- Discounts on eyeglasses, hearing aids and more!
- Discount programs exclusive to BCBSNC members
Incentives for early enrollment
Lock in your entry age6
There are many advantages to enrolling in Blue Medicare Supplement℠ coverage within the first six months of enrolling in Medicare Part B. When you enroll, you lock in your entry age forever.6 Rate increases are only due to medical inflation or claims experience.6 So, if you enroll when you’re 65, you’ll always pay the rate of a 65 year old, even when you’re 80!
- Lock in your entry age6
- Convenient costs
No waiting periods
If you enroll early, you may be eligible for this plan without medical underwriting and waiting periods for pre-existing conditions. Pre-existing conditions are conditions for which medical advice was given or treatment was recommended by or received from a physician within six months before the effective date of coverage. If you wait until after the deadline to enroll, you may have a waiting period for pre-existing conditions and may have to complete a medical questionnaire.
- No medical underwriting
- No waiting periods for pre-existing conditions
Guaranteed acceptance by enrolling early
You cannot be turned down for Blue Medicare Supplement℠ if you meet the following:
- You are age 65 or older, or under age 65 and are eligible for Medicare by reason of disability (Plans A, C, and J) 7
- You enroll within 6 months of enrolling in Medicare Part B
- You are not covered by certain Medicaid programs
- You are a resident of North Carolina
For costs and further details of the coverage, including exclusions, any reductions or limitations and terms under which the policy may be continued in force, contact your agent or the company.
1 Plan A: BMS A, 07/08, Plan B: BMS B, 07/08 Plan C: BMS C, 07/08, Plan D: BMS D, 07/08, Plan E: BMS E, 07/08, Plan F: BMS F, 07/08, HI DED Plan F: BMS HDF, 04/09. Plan H: BMS H, 07/08, Plan I: BMS I, 07/08, Plan J: BMS J, 07/08.
2 “Medicare Supplement Loss Ratios in 2007.” National Association of Insurance Commissioners (NAIC), 2008.
3 Based on BCBSNC enrollment data, 2008.
4 Based on BCBSNC internal data, 2008 and Crossing the Centuries, Committed to Care: Blue Cross and Blue Shield in North Carolina, 1933-2008. Diana J. Newton. BW&A Books, Inc., 2007.
5 Blue Values programs may change or be discontinued at any time. BCBSNC provides these programs for member convenience and is not liable in any way for the goods and services received. These programs are not part of a member’s policy or benefits, but are value-added discounts available for their use. BCBSNC does not profit from the Blue Values programs.
6 When members enroll, they will lock in their entry age forever as long as they stay in the Blue Medicare Supplement plan in which they initially enrolled. Any rate adjustments will only be due to medical inflation or overall claims experience. Rates are subject to change April 1st of each year and are guaranteed for 12 months, but you alone will not be singled out for a premium increase based on health or age. Any change in your rate will be preceded by a 30-day notice.
7 Guaranteed acceptance is limited to (Plans A, C and J) for those under age 65 who have Medicare due to disability.
Form# (U4093, 4/09)
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