Is Blue Cross Blue Shield a Medicare Plan?

Blue Cross Blue Shield and Medicare: What You Need to Know

Blue Cross Blue Shield is not itself a Medicare plan. It is a network of independent health insurance companies that operate in different states and regions. However, many Blue Cross Blue Shield companies do offer Medicare Advantage plans and Medigap policies — these are products sold to people who are already on Medicare, not Medicare itself.

The confusion happens because Blue Cross Blue Shield is so large and well-known. When you turn 65 and become may be able to access for Medicare, you will deal with Medicare (run by the federal government) first. Then, if you want extra coverage beyond what Original Medicare provides, you can choose a Blue Cross Blue Shield Medicare Advantage plan or Medigap policy if your state's Blue Cross Blue Shield company offers one.

Key Takeaways

Blue Cross Blue Shield companies sell Medicare Advantage and Medigap plans to people already on Medicare, but they do not run Medicare itself.
Each state has its own Blue Cross Blue Shield company, and not all of them offer Medicare plans in all areas.
If you choose a Blue Cross Blue Shield Medicare Advantage plan, you get your hospital and doctor coverage through them instead of Original Medicare.
If you choose a Blue Cross Blue Shield Medigap policy, you keep Original Medicare and the Medigap policy fills in some of the costs Medicare does not cover.
You enroll in Medicare through Medicare.gov, and then you can shop for Blue Cross Blue Shield plans during the annual enrollment period.

How Blue Cross Blue Shield Fits Into Medicare

When you turn 65, you enroll in Medicare through the federal government. This gives you Part A (hospital insurance) and Part B (doctor and outpatient care). At that point, you have a choice: stay with Original Medicare as your main coverage, or switch to a Medicare Advantage plan offered by a private company like Blue Cross Blue Shield.

If you choose a Blue Cross Blue Shield Medicare Advantage plan, that company becomes your main insurer. You pay Blue Cross Blue Shield your monthly premium (in addition to your Medicare Part B premium), and they handle your hospital and doctor claims. If you choose Medigap instead, you keep Original Medicare and add a Blue Cross Blue Shield Medigap policy on top to cover some of the deductibles, copays, and coinsurance that Original Medicare leaves you responsible for.

Medicare Advantage Plans From Blue Cross Blue Shield

A Blue Cross Blue Shield Medicare Advantage plan is a managed care plan. It typically includes prescription drug coverage (Part D), dental, vision, and hearing benefits that Original Medicare does not cover. In exchange, you usually have a network of doctors and hospitals you must use, and you may need referrals to see specialists.

The monthly premium for a Blue Cross Blue Shield Medicare Advantage plan varies by state, county, and the specific plan. Some plans have a zero premium, meaning you pay only your Medicare Part B premium and the plan's copays and deductibles. Others charge an additional monthly amount. You can compare plans and their costs on Medicare.gov during the annual enrollment period, which runs from October 15 to December 7 each year.

Medigap Policies From Blue Cross Blue Shield

A Blue Cross Blue Shield Medigap policy is supplemental insurance. You keep Original Medicare as your main coverage and use the Medigap policy to cover some of the out-of-pocket costs Medicare leaves you responsible for. For example, if Original Medicare covers 80 percent of a doctor visit, your Medigap policy may cover the remaining 20 percent.

Medigap policies are standardized by the federal government, so a Plan G from Blue Cross Blue Shield covers the same things as a Plan G from any other company. The difference is price. Blue Cross Blue Shield Medigap premiums vary by state and age, and they may increase over time. You can shop for Medigap policies during your initial enrollment period (the six months after you turn 65 and enroll in Medicare Part B) or during the annual enrollment period.

Availability by State and Region

Blue Cross Blue Shield operates through independent companies in different states and regions. Not every Blue Cross Blue Shield company offers Medicare plans, and those that do may not offer them in every county. Some states have multiple Blue Cross Blue Shield companies, each with different service areas.

To find out whether Blue Cross Blue Shield offers Medicare plans where you live, go to Medicare.gov and enter your zip code. The site will show you all Medicare Advantage and Medigap plans available in your area, including any offered by Blue Cross Blue Shield. You can also call 1-800-MEDICARE to ask which Blue Cross Blue Shield plans are sold in your county.

How to Enroll in a Blue Cross Blue Shield Medicare Plan

First, you must be enrolled in Medicare Part A and Part B. You enroll in Original Medicare through Medicare.gov or by calling Social Security. Once you have Original Medicare, you can then choose a Blue Cross Blue Shield plan during the annual enrollment period (October 15 to December 7) or during your initial enrollment period if you are newly may be able to access for Medicare.

To enroll in a Blue Cross Blue Shield Medicare Advantage or Medigap plan, you can go to Medicare.gov, call 1-800-MEDICARE, or contact Blue Cross Blue Shield directly. When you enroll, your coverage usually starts on the first day of the following month. If you enroll between October 15 and December 7, your coverage will begin January 1 of the next year.

Questions to Ask Your Doctor or Medicare Counselor

Before you choose a Blue Cross Blue Shield plan, ask your current doctors whether they accept that plan. Ask whether you need a referral to see a specialist, and whether the plan covers the medications you take. If you are considering Medigap, ask your doctor's office which Medigap plans they accept, because some doctors may not take certain Medigap policies.

You can also speak with a free Medicare counselor through your State Health Insurance information Program (SHIP). SHIP counselors know the plans available in your area and can help you compare costs and coverage. To find your state's SHIP, call 1-800-MEDICARE or visit Medicare.gov.

When to Contact Blue Cross Blue Shield or Medicare

Contact Blue Cross Blue Shield directly if you have questions about a specific plan they offer, such as copays, deductibles, or which doctors are in their network. Contact Medicare (1-800-MEDICARE) if you have questions about how Medicare works, when you can enroll, or whether you are may be able to access for Medicare.

If you are already enrolled in a Blue Cross Blue Shield Medicare plan and have a claim problem or billing question, call the customer service number on your Blue Cross Blue Shield insurance card. If you believe Blue Cross Blue Shield has treated you unfairly, you can file a complaint with your state's insurance commissioner or with Medicare.

Frequently Asked Questions

Can I switch from Original Medicare to a Blue Cross Blue Shield plan anytime?

No. You can switch during the annual enrollment period (October 15 to December 7) or during your initial enrollment period if you are newly may be able to access for Medicare. Outside these windows, you can switch only if you have a may have access to life event, such as moving out of your plan's service area or losing other health coverage.

Do I have to use Blue Cross Blue Shield doctors if I have a Medicare Advantage plan?

In most cases, yes. Blue Cross Blue Shield Medicare Advantage plans have a network of doctors and hospitals. If you go to an out-of-network provider, you may pay more or the plan may not cover the visit at all. Check the plan's provider directory on Medicare.gov before you enroll.

What happens to my Blue Cross Blue Shield plan if I move to a different state?

Your plan may not be available in your new state, because each state has its own Blue Cross Blue Shield company. When you move, you can switch to a different Medicare plan without waiting for the annual enrollment period. Contact Medicare or your new state's Blue Cross Blue Shield company to find out what plans are available where you are moving.

Is Blue Cross Blue Shield Medigap more expensive than Original Medicare alone?

Yes, Medigap policies cost extra money each month. However, Medigap can save you money overall if you use a lot of health care, because it covers some of the copays and deductibles that Original Medicare leaves you responsible for. Compare the monthly premium against your expected out-of-pocket costs to decide whether Medigap makes sense for you.

Can I have both a Blue Cross Blue Shield Medicare Advantage plan and a Medigap policy?

No. You can have either a Medicare Advantage plan or Original Medicare with Medigap, but not both. If you have a Medicare Advantage plan and buy a Medigap policy, the Medigap policy will not pay anything because it is designed to work only with Original Medicare.

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.