What Medicare Plans Does Blue Cross ® and Blue Shield ® of Texas Offer?
This article was updated on: 10/20/2018
Blue Cross and Blue Shield (BCBS) of Texas is a private insurance company approved by Medicare to offer Medicare Advantage plans and Medicare Part D Prescription Drug Plans in the state. Depending on where you live, you may be eligible to enroll in the following types of Blue Cross and Blue Shield of Texas plans.
Does Blue Cross and Blue Shield of Texas offer Medicare Advantage plans?
The Medicare Advantage program is an alternative way to get your Original Medicare (Part A and Part B) benefits. Most Medicare Advantage plans offered by Blue Cross and Blue Shield of Texas combine your Part A and Part B coverage with Medicare Part D prescription drug coverage, so you get all your coverage through one convenient plan. These plans are known as Medicare Advantage Prescription Drug plans. In addition, most plans offer benefits for routine vision, dental, and hearing services. All Medicare Advantage plans must cover everything that Original Medicare covers, except for hospice care, which remains covered by Part A.
Medicare Advantage plans come in a few different varieties. Any of the types listed below may include prescription drug coverage, but you should check with the specific plan you’re interested in to make sure this coverage is included if you want it. Some of the Medicare Advantage plan types that Blue Cross and Blue Shield of Texas might offer in your area include:
- Medicare Advantage Health Maintenance Organization (HMO) plans from Blue Cross and Blue Shield of Texas: Your health care is managed by a primary care physician and you must get all of your care, except for medically necessary urgent and emergency care, within the plan’s network in order to be covered. You’ll need a referral before you can see a specialist.
- Medicare Advantage HMO-POS (Point-of-Service) plans from Blue Cross and Blue Shield of Texas: These plans function similarly to a traditional HMO, but you may be able to get certain services outside the plan’s network (typically with higher cost-sharing). If you frequently travel out of the plan’s service area, you may prefer the flexibility of this plan.
- Medicare Advantage Preferred Provider Organization (PPO)* plans from Blue Cross and Blue Shield of Texas: These plans offer flexibility when it comes to choosing a doctor. You’re generally allowed to use any provider of your choice, but your out-of-pocket costs are typically lower if you use in network providers. You don’t need referrals for specialist care.
- Medicare Advantage Special Needs Plans (SNP) from Blue Cross and Blue Shield of Texas: This plan limits enrollment to individuals who meet certain eligibility criteria. There are three types of SNPs that target those with certain chronic or disabling conditions; live in institutions; or have dual eligibility (have both Medicare and Medicaid in the state of Texas). SNPs always include prescription drug coverage. BCBS of Texas offers Dual-Eligible Special Needs Plans in certain locations.
You may be responsible for premiums, copayments, coinsurance amounts, and deductibles, which may vary depending on the plan you choose. Not all plans may be available in all parts of the state, and plan benefits and premiums may vary depending on where you live. You must continue to pay your Part B premiums when you are enrolled in a Medicare Advantage plan.
Can I get a stand-alone Medicare Part D Prescription Drug Plan from Blue Cross and Blue Shield of Texas?
Stand-alone Medicare Prescription Drug Plans may help with medication costs if you’re enrolled in Original Medicare, Part A and Part B. Unlike Medicare Advantage Prescription Drug plans, these plans work alongside Original Medicare and provide your prescription drug benefits through a separate plan.
For those interested in stand-alone prescription drug coverage, Blue Cross and Blue Shield of Texas offers Blue Cross MedicareRx® plans. Every Medicare Part D Prescription Drug Plan uses a formulary (list of covered medications) to determine benefits. Plans may change their formularies at any time, but they will notify you in writing before they do. Before enrolling in a Blue Cross and Blue Shield Prescription Drug Plan, it may be a good idea to check that the plan includes all of your current medications in its formulary; otherwise, your out-of-pocket costs could be much higher.
Blue Cross MedicareRx® plans may have different copayments, coinsurance, deductible amounts, and premiums, and you may be required to use network providers to access benefits. Keep in mind that stand-alone Medicare Prescription Drug Plans generally cannot be combined with Medicare Advantage plans that include prescription drug benefits.
Blue Cross and Blue Shield of Texas offers a variety of Medicare plan options for Texas beneficiaries, and the type of coverage that may work for you will depend on your specific situation, budget, and preferences. To get started, you can use the Find Plans button on this page to view plan options in your area; it’s easy to filter by plan type, premium cost, and more. Would you like help finding coverage? You can call us at the phone number below to reach me or another eHealth licensed insurance agent; we’d be happy to assist.