Is Blue Cross Blue Shield Private Insurance or Medicare? What You Need to Know

Blue Cross Blue Shield is private insurance, not Medicare itself

Blue Cross Blue Shield (BCBS) is a private insurance company. It is not Medicare, and Medicare is not Blue Cross Blue Shield. However, BCBS does sell Medicare plans — so you can have both a BCBS plan and Medicare coverage at the same time. The confusion happens because BCBS offers several different types of plans, and some of them work alongside Medicare while others do not.

When you turn 65, you become may be able to access for Medicare, which is a federal program run by the Centers for Medicare & Medicaid Services (CMS). You can choose to stay with Original Medicare (the government plan), or you can choose a private plan from BCBS or another insurance company. If you pick a BCBS plan, you are still on Medicare — BCBS is just the company handling your claims and managing your coverage.

Key Takeaways

Blue Cross Blue Shield is a private insurance company that offers Medicare plans, employer plans, and individual plans — it is not the same as Medicare itself.
If you buy a Medicare Advantage plan from BCBS, you are still covered by Medicare, but BCBS handles your claims and sets your copays and deductibles.
BCBS also sells Medigap (supplemental insurance) plans that work alongside Original Medicare to cover costs that Medicare does not pay.
You can have BCBS coverage and Medicare at the same time — in fact, most people with BCBS Medicare plans must have Medicare to use them.
BCBS employer plans and individual plans are completely separate from Medicare and do not require you to be on Medicare.

The three types of BCBS plans and how they relate to Medicare

BCBS sells three main categories of insurance. The first two are tied to Medicare; the third is not. Understanding which type you have matters because it changes what you pay and which doctors you can see.

Medicare Advantage plans from BCBS are private plans that replace Original Medicare. You must be on Medicare to use them. BCBS receives a payment from Medicare for each person enrolled, and in return BCBS becomes your insurance company — you use BCBS doctors and hospitals, pay BCBS copays, and BCBS handles your claims. Most Medicare Advantage plans include prescription drug coverage (Part D) built in. You still pay your Medicare Part B premium to the government, but BCBS collects any additional premium their plan charges.

Medigap plans from BCBS are supplemental insurance that works with Original Medicare, not instead of it. You keep your Original Medicare coverage and add a BCBS Medigap plan on top. The Medigap plan pays some of the costs that Medicare does not cover — like copays, coinsurance, and deductibles. You have two insurance companies: Medicare handles the main claim, and BCBS pays their share afterward. Medigap plans do not include prescription drug coverage, so you buy Part D separately.

Employer plans and individual plans from BCBS are private insurance with no connection to Medicare. These are the plans people under 65 buy, or people over 65 who are still working and covered through their job. If you have one of these plans, you do not need Medicare to use it, though you can have both.

How to tell which type of BCBS plan you have

Check your insurance card or your welcome packet from BCBS. Medicare Advantage cards usually say "Medicare Advantage" or "MA" on them and show a Medicare logo. They also list a plan name like "BCBS Medicare Advantage PPO" or "BCBS Medicare Advantage HMO." Medigap cards say "Medigap" or "Supplement" and show which letter plan you have (Plan A, Plan B, Plan C, and so on). Employer and individual plans do not mention Medicare at all.

You can also call BCBS directly. The phone number is on your card. Tell them you want to confirm what type of plan you have, and they will tell you whether it is Medicare Advantage, Medigap, or a commercial plan.

What happens to your BCBS coverage when you turn 65

If you have a BCBS employer plan or individual plan before age 65, you do not automatically lose it when you turn 65. However, you become may be able to access for Medicare, and you have a choice to make. You can keep your current BCBS plan if your employer still offers it, or you can switch to a BCBS Medicare Advantage plan, or you can switch to Original Medicare and add a BCBS Medigap plan.

If you have an employer plan through work, your employer may require you to switch to Medicare when you turn 65, or they may let you stay on their plan. Ask your benefits department what the rules are for your specific plan. If you have an individual plan, BCBS will contact you before your 65th birthday to explain your options.

The key point: turning 65 does not force you off BCBS. It gives you new options, and BCBS can help you with any of them.

Medicare premiums you pay regardless of which BCBS plan you choose

If you are on any BCBS Medicare plan — whether Medicare Advantage or Medigap — you pay a Medicare Part B premium directly to the government each month. This is separate from any premium BCBS charges. In 2024, the standard Part B premium is $164.90 per month, though it may be higher if your income is above a certain level. You also pay Medicare Part A premiums if you did not pay into Medicare through payroll taxes for at least 10 years (most people do not pay Part A premiums).

On top of the Medicare premium, BCBS may charge an additional monthly premium for their plan. Medicare Advantage plans sometimes have zero additional premium, or they may charge $20 to $100+ per month depending on the plan and your location. Medigap plans have their own premium, which varies by plan letter and by state. BCBS sends you one bill that includes both the Medicare premium and the BCBS premium, or they may bill separately — check your welcome packet to see how your plan works.

When to contact BCBS versus when to contact Medicare

If you have a question about your coverage, your copays, which doctors are in your network, or whether a service is covered, call BCBS. The number is on your card. BCBS handles the day-to-day running of your plan.

If you have a question about your Medicare may be able to access, your Part B premium, or whether you are enrolled in Medicare correctly, contact Medicare directly at 1-800-MEDICARE (1-800-633-4227). If you have a complaint about how BCBS is handling your claim or denying a service, you can file a complaint with Medicare, and Medicare will investigate. BCBS must follow Medicare rules, and Medicare oversees them.

If you are trying to decide which type of plan to choose — Medicare Advantage versus Medigap versus staying on your current plan — you can talk to a BCBS representative, but you can also call your State Health Insurance information Program (SHIP). SHIP is a free counseling service run by your state, and they help people compare Medicare plans without pushing you toward any particular company.

Frequently Asked Questions

Can I have BCBS coverage and Medicare at the same time?

Yes. If you have a BCBS Medicare Advantage plan or a BCBS Medigap plan, you have both BCBS coverage and Medicare at the same time. Medicare is the foundation, and BCBS is the private company managing your benefits. If you have a BCBS employer or individual plan and you are also on Medicare, you have both, though they work separately.

If I switch from BCBS to Original Medicare, do I lose my BCBS coverage?

If you have a BCBS Medicare Advantage plan and you switch to Original Medicare, your Medicare Advantage plan ends. However, you can buy a BCBS Medigap plan to go with your Original Medicare, so you can stay with BCBS if you want to. If you have a BCBS employer or individual plan, switching to Medicare does not affect it — you can keep both.

Does BCBS charge the same premium in every state?

No. BCBS premiums vary by state, by county, and by plan. A Medicare Advantage plan in one county may cost $30 per month, while the same plan in a neighboring county may cost $50 per month. Medigap premiums also vary by state. When you are comparing plans, always check the premium for your specific zip code.

What if I do not want BCBS anymore and want to switch to a different insurance company?

You can switch during the Annual Enrollment Period, which runs from October 15 to December 7 each year. Changes take effect January 1. If you have a may have access to life event — like losing employer coverage or moving to a new state — you may be able to switch outside the enrollment period. Call BCBS or Medicare to ask whether you may have access to for a special enrollment period.

Is BCBS owned by the government?

No. Blue Cross Blue Shield is a private company. It is not part of Medicare or the government. However, BCBS must follow all Medicare rules and regulations when it offers Medicare plans, and Medicare monitors BCBS to make sure it is treating customers fairly.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.