Fax completed applications to: (847) 220-9280 or email [email protected]

BCBSTX Medicare Supplement Plans

Medicare Supplement Plans

 

Why You Need Medicare Supplement Insurance

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. Without Medicare Supplement insurance, your out-of-pocket costs could add up to more than $71,700 this year alone.

By law, Medicare Supplement insurance is standardized into twelve plans (Plans A through L). That means Plan G from one company must include the same benefits as plan G 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 Texas, you don’t have to sacrifice comprehensive benefits or freedom-of-choice for affordability. Their Medicare Supplement plans provide substantial benefits at rates that can save you money over other plans.

What Medicare Doesn’t Cover

Medicare does not cover all 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:

  • Part A hospital deductible ($1,632 )
  • Part B deductible ($240 )
  • 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

BCBSTX Member Benefits

All BCBSTX Medicare Supplement plans give you:

  • Freedom to choose any doctors or specialists
  • Coverage with domestic travel (Plans F, HD-F, Plan G, and HD-G cover foreign travel emergency)
  • 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 include discounts on wellness products and services including vision, fitness clubs, weight management, complementary alternative medicine, hearing and more
  • No claim forms, in most cases

Medicare Supplement Basic Benefits

Basic benefits included in all plans include:

  • 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.

*Plans K and L include benefits at different levels of cost sharing (see outline of coverage).

Blue Cross Blue Shield of Texas Medicare Supplement Plans

BCBSTX offers a choice of 6 Medicare Supplement Insurance plans; Plan A,  Plan F, Plan G, Plan N, Plan K, and Plan L.

  • Plan F and Plan G pay the Medicare Part A hospital deductible and co-payment(s), the skilled nursing facility copayment(s) and emergency care for foreign travel.
  • Plans K and L are low-cost, cost-sharing Medicare Supplement Insurance plans that require you to pay a higher percentage of the costs in return for reduced premiums.
  • BCBSTX also offers basic Plan A, the plan with the lowest benefits.
Plans A F, HD-F* G K** L** N
Basic Benefits X X X X X X
Skilled Nursing Coinsurance X X 50% 75% X
Part A Deductible X X 50% 75% X
Part B Deductible X
Part B Excess (100%) X X X
Foreign Travel Emergency X X X
At Home Recovery
Annual Out-of-Pocket Cost $4,640 $2,320 $0

*Plan F also has an option called high deductible Plan F (HD-F). This high deductible plan pays the same benefits as Plan F after one has paid a calendar year $2,490 deductible. Benefits from high deductible Plan F will not begin until out-of-pocket expenses exceed $2,490. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. These expenses include the Medicare Part A and Medicare Part B deductibles, but do not include the plan’s separate foreign travel emergency deductible.

**Plans K and L provide for different cost-sharing than plans A-F. 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 will be responsible for paying excess charges.

Medicare-Select Options

Plan F, Plan G, Plan K, Plan L, and Plan N Med-Select options offer you the same benefits as the “standard” plans, but cost less. You 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 $1,632 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 Medicare-Select participating hospital.

Plan F
Plan F is the most popular Blue Cross Blue Shield of Texas Medicare Supplement plan. No other standardized Medicare Supplement plan offered in Texas offers more complete protection for your uncovered Part B medical expenses than Plan F.
Plan F covers:
  • Your Part A deductible and coinsurance
  • The cost of 365 extra days of hospital care during your lifetime after Medicare coverage ends
  • Your Part B coinsurance and the cost of the first three pints of blood
  • Medicare Part A hospital deductible and copayments
  • Skilled nursing facility copayment
  • Foreign travel emergency care
  • $240 Part B Medicare deductible
  • Part B doctor charges that are in excess of Medicare-approved amounts

There is also a BCBSTX Medicare-Select Plan F that offers the same benefits as Standard Plan F but provides costs savings by agreeing to use a Medicare Select participating hospital for non-emergencies. You may still see any doctor you choose with Medicare-Select plans. If your hospital is part of the Medicare Select network, the Med-Select plan is a good option to consider.

 

High Deductible F

High Deductible Plan F has the same benefits as Plan F after you pay an annual [HD-F Ded] deductible. The deductible amount represents the annual out-of-pocket expenses (excluding premiums) that you must pay before the policy begins paying benefits. By having a high deductible, your premiums are significantly lower than Standard Plan F. High Deductible Plan F covers:

  • Your Part A deductible and coinsurance
  • Your Part B coinsurance and the cost of the first three pints of blood
  • Benefits from High Deductible Plan F will not begin until your out-of-pocket expenses total [HD-F Ded]
  • Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy.
  • These expenses include the Medicare deductibles for Part A and B.
  • These expenses do not include Plan F’s separate foreign travel emergency deductible.
  • Medicare Part A hospital deductible and copayments
  • Skilled nursing facility copayment
  • $240 Part B Medicare deductible (The Part B deductible is included in the HD-F [HD-F Ded] deductible)
  • Part B doctor charges that are in excess of Medicare-approved amounts
  • The cost of 365 extra days of hospital care during your lifetime after Medicare coverage

Plan G
Plan G covers:
  • Your $1,632 Part A deductible and coinsurance
  • The cost of 365 extra days of hospital care during your lifetime after Medicare coverage ends
  • Your Part B coinsurance and the cost of the first three pints of blood
  • 80% of Part B physician charges that are in excess of the Medicare-approved amount (By law no physician may charge more than 115% of Medicare-approved amounts).
  • Skilled nursing facility copayment
  • Foreign travel emergency care

Plan G does NOT cover:

  • Your $240 Medicare Part B deductible

There is also a BCBSTX Medicare-Select Plan G that offers the same benefits as Standard Plan G but provides costs savings by agreeing to use a Medicare Select participating hospital for non-emergencies. You may still see any doctor you choose with Medicare-Select plans. If your hospital is part of the Medicare Select network, the Med-Select plan is a good option to consider.

Plan N

Online Application

Plan N is identical to Plan G except there is a $20 copay for office visits and a $50 copay for emergency room visits. Like Plan G, Plan N does not cover the Medicare Part B deductible. Plan N covers:

  • Your Part A deductible and coinsurance
  • The cost of 365 extra days of hospital care during your lifetime after Medicare coverage ends
  • Your Part B coinsurance and the cost of the first three pints of blood
  • 80% of Part B physician charges that are in excess of the Medicare-approved amount (By law no physician may charge more than 115% of Medicare-approved amounts).
  • Skilled nursing facility copayment
  • Foreign travel emergency care

Plan N does NOT cover:

  • Your $240 Medicare Part B deductible
  • Part B Medical Excess Charges; charges from your provider that exceed Medicare-approved amounts. Only Plan F, High Deductible Plan F, and 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.
Compare Rates

Eligibility

• Texas Resident age 65 and over

• Must have Medicare Parts A & B

• May not duplicate an in-force Medicare Supplement policy

Rating Areas are determined by the first 3 digits of your zip code.

Area 1: 754-759; 763-769; 778-792; 795-799; 885

Area 2: 750-753; 760-762; 770-777; 793-794

Area 3: out-of-state

Plan Ages Area 1 Area 2 Area 3
Plan A
65-66 $224.00 $240.00 $266.00
67-69 $258.00 $279.00 $306.00
70-74 $304.00 $330.00 $359.00
75-79 $339.00 $365.00 $407.00
80-84 $385.00 $419.00 $458.00
85+ $414.00 $446.00 $492.00
Plan F
65-66 $150.00 $161.00 $178.00
67-69 $170.00 $185.00 $203.00
70-74 $201.00 $217.00 $237.00
75-79 $225.00 $246.00 $269.00
80-84 $255.00 $276.00 $305.00
85+ $276.00 $298.00 $330.00
Plan High Deductible F
65-66 $49.00 $53.00 $58.00
67-69 $56.00 $60.00 $66.00
70-74 $65.00 $71.00 $77.00
75-79 $74.00 $80.00 $89.00
80-84 $82.00 $91.00 $99.00
85+ $90.00 $97.00 $107.00
Plan G
65-66 $137.00 $146.00 $163.00
67-69 $156.00 $168.00 $185.00
70-74 $183.00 $197.00 $217.00
75-79 $204.00 $222.00 $244.00
80-84 $231.00 $250.00 $279.00
85+ $250.00 $272.00 $299.00
Plan K
65-66 $76.00 $82.00 $91.00
67-69 $85.00 $96.00 $103.00
70-74 $102.00 $110.00 $122.00
75-79 $115.00 $126.00 $137.00
80-84 $130.00 $140.00 $155.00
85+ $141.00 $151.00 $168.00
Plan N
65-66 $107.00 $118.00 $130.00
67-69 $126.00 $135.00 $149.00
70-74 $147.00 $159.00 $174.00
75-79 $165.00 $179.00 $197.00
80-84 $186.00 $202.00 $222.00
85+ $201.00 $219.00 $240.00
Ryan Kennelly authorized agent for Blue Cross and Blue Shield of Texas Blue Cross and Blue Shield of Texas: A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.