What Medicare Plans Does Blue Cross ® and Blue Shield ® of Illinois Offer?
This article was updated on: 10/21/2018
If you live in Illinois and are eligible for Medicare coverage or will soon be eligible, you may be interested in learning about your Medicare coverage options through Blue Cross and Blue Shield of Illinois. Once you’re enrolled in Original Medicare Part A and Part B, some of the choices that may be available to you include Medicare Advantage plans and stand-alone Medicare Part D Prescription Drug Plans.
Here’s an overview of how these plans from Blue Cross and Blue Shield of Illinois work, so you can better understand the type of coverage that may work for your needs.
Can I get Medicare Advantage plans from Blue Cross and Blue Shield of Illinois?
As an Illinois beneficiary, you may be familiar with Medicare Advantage (also known as Medicare Part C). Medicare Advantage plans are simply another way to get your Original Medicare (Part A and Part B) benefits, except you’ll get your coverage directly through your plan instead of through Medicare. These plans are required by law to cover everything in Original Medicare (Part A and Part B), except for hospice care (which remains covered under Part A). In addition, they may offer extra benefits for routine vision, dental, and hearing care, and wellness programs. Many plans, known as Medicare Advantage Prescription Drug plans, include prescription drug coverage.
Blue Cross and Blue Shield of Illinois offers the following types of Medicare Advantage plans:
- Medicare Advantage Health Maintenance Organization (HMO) plans: These plans from Blue Cross and Blue Shield of Illinois often include prescription drug coverage. You select a primary care provider to oversee your health care and you must get care in the plan’s network, with the exception of medically necessary emergency services, which will still be covered even if you go out of network. You’ll need referrals before you can see a specialist.
- Medicare Advantage HMO-POS (Point-of-Service) plans: These plans function like HMOs, but they offer you the opportunity to get certain services out of the Blue Cross and Blue Shield network, often for a higher cost. This may be an option if you frequently travel outside of your service area.
- Medicare Advantage Preferred Provider Organization (PPO)* plans: You may like this option if you want the flexibility to see any provider you choose. PPOs do have preferred provider networks, and you generally pay less out-of-pocket if you get your care in-network. However, you may have the option to use non-network providers as well. These plans may also provide prescription drug coverage. Referrals aren’t needed for specialist care.
A few notes about Medicare Advantage plans:
- You may have out-of-pocket costs like copayments, coinsurance, and deductibles with these plans.
- You must continue to pay your Part B premium, plus any additional premium required by your plan.
- Most of the above plan types can include prescription drug benefits, but not every Medicare Advantage plan does. Check with the specific plan if you want prescription drug coverage to be sure this is included.
- Not all plans may be available in all areas of the state, and plan options, benefits, and premiums may vary depending on where you live.
Does Blue Cross and Blue Shield of Illinois offer Medicare Part D Prescription Drug Plans?
Medicare prescription drug coverage (Part D) is available to Original Medicare beneficiaries through stand-alone Medicare Prescription Drug Plans. These plans work alongside your Original Medicare Part A and Part B coverage to help with certain medication costs.
Blue Cross and Blue Shield of Illinois offers several types of Medicare Prescription Drug Plans known as Blue Cross MedicareRx® plans. These plans use a formulary, or list of approved medications, to determine benefits; plans may change their formularies at any time, but they must give you written notice before they do. Depending on the MedicareRx® plan, you may have different copayments, coinsurance amounts, and deductibles, and not all plan options may be available in all parts of the state. Check with the specific Medicare Prescription Drug Plan from Blue Cross and Blue Shield of Illinois to make sure your prescription drugs are covered by the plan before enrolling.
Stand-alone Medicare Prescription Drug Plans may not be combined with most types of Medicare Advantage plans (such as HMOs and PPOs). You can consult with your plan for more information on restrictions and details. If you want prescription drug coverage under Medicare, it’s important to enroll as soon as you become eligible to avoid paying a late-enrollment penalty with your monthly premiums for as long as you are enrolled in a Medicare Prescription Drug Plan. This late-enrollment penalty may apply any time that you go without Part D after you’re first eligible and don’t have creditable prescription drug coverage (insurance that is as good as the Part D benefit) for 63 days in a row or more.
As you can see, Illinois beneficiaries may have a variety of Medicare coverage choices available beyond Original Medicare. If you’d like to browse offerings from Blue Cross and Blue Shield of Illinois, just click on the Find Plans button to view plan options in your location from the convenience of your home. Would you prefer to discuss your Medicare questions with a live person? You can always call us at the phone number below to reach me or another eHealth licensed insurance agent.