What are the differences between Blue Cross/Blue Shield and Medicare?
By aprilmoe from Pensacola, FL
At 65 you are enrolled in Medicare. A few months before you turn 65 the government will send you a mailing. Plan A is mandatory. Plan B is optional. Plan A pays a portion of the hospital and Plan B pays a portion of the doctors bills.
Some folks decline the Plan B to their chargrin when they recieve big doctor bills.
Blue Cross is one of many insurance companies that offer a supplement insurance plan.
What Medicare covers is explained in their bulletin that every one recieves in the mail.
For more information on medicare go to www.medicare.gov or 1-800-633-4227.
For Blue Cross you should be able to find them in the phone book or at google.com
One has to apply for Medicare and no you do not have to have Medicare or Part B nor do you have to have Part D. I'm on Medicare but I do not have part D. If you decide to go on Medicare you must apply 3 months before, or 3 months after you become eligible or you will be charged a penalty for Part B (out of hospital) if you choose later to get it.
I've been on Medicare for 3 years and found that Blue Cross, Blue Shield (in my case) was the very most expensive supplemental carrier around. I pay $122 a month (as a healthy, non-smoking individual) and for my piece of mine it's well worth every penny. When it comes to Medicare and supplemental policies you really have to do your homework and it's very time consuming. I just finished another round of research helping my brother who just turned 65.
I agree with another. Consult with a good agent who deals with Medicare supplemental insurance carriers. I mentioned before that I pay $122 a month. I've with American National in the Plan F. All plan F's, by law, pay the same for procedures but monthly premiums can vary as much as a couple hundred dollars.
You do NOT apply for medicare. Medicare will send you a mailing with the medic care cards about 3 months before you are 65. With the mailing you will have the option of declining part B. You usually don't have to pay for part A but have to pay for part B. In my case I have both A and B. I only pay for part B which is $1,156.80 per year. I also have Blue Cross which is $87 per month. I do not have Plan D as I have CVS Caremark through my former employer for my prescriptions that offer me a big discount. I also get 20% off any regular health related CVS store brand items. I also have a dental plan through my former employer that gives me 50% off dental work. call Medicare at 1-800-486-2048 they will clear up your questions.
In most cases, once you retire or are disabled, Medicare will be your primary insurance carrier. B/C & B/S, if you choose them, will be a secondary insurance, covering most of what the primary one fails to pay. The boundaries are clear, but may not seem to be if you are just starting to handle insurance and are not familiar with it. To make matters worse, in some states, B/C & B/S handles all Medicare payments (in other states it's AEtna, or another company), so it can seem more confusing than it actually is.
I've been carrying Federal Blue Cross Standard for several years with Medicare as primary. I've had numerous hospitalizations, and I've not had to pay one penny in co-pays. My prescription drugs are $65 a name brand or $10 or less for generic for three month's worth. I see where in 2010 the cost of Standard will be (my share) $175 a month whereas Basic would be $100. Would I get the same 'no co-pay' coverage with Basic or would that not pay the full share that Medicare doesn't pay? I can phone Blue Cross to get an answer (maybe), but I thought I'd see if anyone on this forum has a Federal Basic Blue and can tell me there experience with it.
If you are paying for health insurance it's because we will all eventually get really sick and pay a lot for health care (and "eventually" will be sooner than later, now that we are at the age of talking about being eligible for Medicare). So, it makes sense to keep both Medicare and some form FEHB, even if it's basic coverage. They complement each other by paying for benefits the other does not (regular Medicare doesn't pay for meds/FEHB can; Medicare pays fully for approved durable medical equipment/FEHB provides only partial coverage; Medicare covers some NH days/many FEHB plans provide no coverage, etc. Like all insurance, consider investing in what you can afford.
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I will be 65 in Feb '08, my husband May '08. I'm retired Federal Civil Service and carried Blue Cross family into retirement. I'm confused about Medicare. Do we HAVE to have Medicare? That will mean we must pay our regular Blue Cross Ins. PLUS $96 each per month for Medicare?
Are there any other retired federal workers out there who could give me some insight (i.e. do we drop BC and pick up a "supplemental" coverage, or should we keep the BC "secondary" Ins.?). I can't believe the BC premium won't go down since Medicare will be the Primary Ins. and BC Secondary Ins. But BC says the monthly premium (taken from my retirement check) will be the same and not lowered at all. I'm afraid to drop BC because that's what pays for our medications.
Carolyn from Shreveport, Louisiana
Please don't quote me on this but what I understand is that Medicare will be your prime medical insurance, and Blue Cross will pick up what Medicare doesn't cover. Everyone who is retired has to pay into Medicare and that money is automatically taken out of your monthly social security check. To be on the safe side have your social security checks deposited directly into your bank account. My husband has all his pension checks directly deposited in our bank, much safer that way.
I have several more years to go until I can receive social security myself.
For more information call Medicare at 1-800-MEDICARE or (1-800-633-4227) and talk with a representative over the phone. They will be able to answer all of your questions. Also ask them to mail you a paperback booklet entitled, "Medicare and You 2008." (11/14/2007)
Everyone who has retired goes on medicare at 65 as their primary source of health care. You would have to sign up with Blue Cross or someone else as your second source. You will also be enrolled in plan D (the drug coverage) unless you have another source for your drug medications. (11/15/2007)
Medicare will be primary and you need a secondary to pick up the 20% that Medicare doesn't pay. Medicare has part A, hospital benefits, part B, Dr and outpatient benefits and now there is part D which is the prescription benefit. You need to make an appt. with Social Security people to explain all to you and how it all works. BC can be your secondary which will include the prescription benefits as prescribed by social security administration. It is really confusing for everybody. (11/15/2007)
I agree with Marge W. Also, sometimes you can ask your pharmacy to help you choose which insurance company would pay the most on your drugs with Medicare Part D. We do this every year or so for both my husband and my parents. They also have BC and medicare and medicare part D. But, their BC went down a couple of dollars for them when they took out the part D. (11/15/2007)
By Jean in GA
Medicare will become your prime insurance when you turn 65. I would keep the Blue Cross especially if you have a lot of prescriptions because Medicare doesn't cover these. Blue Cross will also pick up what Medicare doesn't. And Medicare does not include vision or dental. You may want to talk to your local Medicare office about your options. (11/15/2007)
Please check into Humana Insurance before you make a decision. I have Humana which takes the place of Medicare and it has a free drug plan with it. They will still take the 96.00 from your Social Security. That is how it is paid for. You will also have co-pays, but it may be a lot less expensive than the premiums on BCBS. Can't hurt to check it out and compare. (11/16/2007)
God Bless you, my friend. I receive a civil service annuity.
From what I can see about Medicare by looking at others in my state, the grey state, you must have supplemental insurance to go along with Medicare. I think for people who have no federal service, medicare is free. I wouldn't change insurance companies as someone here has suggested. If you've been with BC/BS, stay with that company.
Perhaps you can go to the OPM website and get the website for retirement. You should be able to find someone there who will or can help you. I know this is not easy.
I resent it that my social security will have the offset and I will not receive any on my own account because of that. I worked more than one job and worked under FICA as well as CSRS. But I am punished for my hard work. My former husband was a teacher and he has a pension AND SSA. Go figure.
Best of luck in your retirement. (11/16/2007)
By Carol in PA
If cost is an issue look at swapping out of B/C B/S into Kaiser Permanente but by all means keep Medicare -- it will be your primary insurer (they will pay most of your bill) AND a secondary insurer.
I believe that most Federal retirees in the Washington, D.C. area have the Medicare and B/C B/S combination believing it to be the best value and because of the prescription coverage.
Having gone through serious cancers with both my Federally retired parents I can say that if you do become ill it is a great value to have the Medicare and B/C B/S combination. (11/16/2007)
By carolyn from bullfrogcorner
Also, I think your B/C B/S cost would be substantially higher if you don't have Medicare as your primary insurer.
One other thing to consider -- are either one (or both) of you eligible for Medical benefits under the VA system? (11/16/2007)
By carolyn from bullfrogcorner
Keep Medicare. It will be your primary insurer. I believe B/C B/S will increase in cost at 65 if you don't have Medicare. I believe the cost of having B/C B/S without Medicare will be MORE than the cost of Medicare AND B/C B/S. Ask B/C B/S how much will your premium be if you don't have Medicare.
If cost if an issue look at replacing B/C B/S with Kaiser Permanente.
The Medicare B/C B/S combination was a blessing for both my Federally retired parents as they aged and became ill.
Also, I think I was told by B/C B/S that if you have B/C B/S as your primary insurer at age 65 and DON'T have Medicare at age 65 -- that B/C B/S has the option to drop you.
The last consideration to check into if either one of you (or both) are Veterans be sure to get into the VA health care system as well. VA does not work as a secondary insurer to Medicare but VA does offer some nursing home benefits beyond what Medicare offers, should a nursing home ever become necessary for the Veteran (again, if applicable).
I learned this trying to help my Federally retired parents (VA eligible father) manage their health care options. Hopefully all info I've provided is up to date. (11/16/2007)
There is a link to the 2008 Medicare and You booklet.
Another thing to think about is long term care insurance. Medicare will pay for care needed as a result of a one time event, like for an elderly person who falls and breaks their hip for example, but they don't pay for the gradually increasing need for care and daily living assistance that occurs during the normal aging process. (11/18/2007)
I am an insurance agent. Your BCBS is a retirement plan I am assuming. If so you can certainly keep it. Medicare Part A (hospitalization) is free. Part B (doctor visits) is 93.50 this year but goes up a few dollars every year. If you elect to enroll in part B you trigger a limited time frame where you can pick up a supplement without health questions being asked. You should really consult with a local agent. Also, depending on where you live, there are Medicare Advantage plans. They are not right for everyone. Ask your friends to refer you to someone ethical. There are MANY choices and you should weigh them carefully. I hope this helps. (12/01/2007)
If you are contemplating another company other than Medicare and Blue Cross, please research their standings. By all means, DO NOT consider Kaiser. They are blasted all over the internet as a fraudulent company. They are very unprofessional and petty. They sent me to the credit bureau for $50 I don't owe, and disputed it to no avail. Kaiser lies all the time. I have several stories from Kaiser I could tell. I suffered a great deal for 2 years when I had them. Kaiser is absolutely useless.
I do have Blue Cross and Medicare. I can choose any doctor I want. Most of the doctors take Medicare and Blue Cross Supplement. Blue Shield is also good. I don't take prescriptions, so I don't know about Humana with prescription coverage. I have Blue Cross Senior Classic I, and no one has refused me or limited any services and have not paid a cent out of pocket when I go to medical doctors. (11/01/2008)
If Medicare is Primary does BCBS pick up the deductible from Medicare? I have yet to pay a doctor or hospital in 15 years then all of a sudden my physical therapist is wanting my 2009 deductible. They didn't ask for it in 07 or 08. I've never been asked for it elsewhere. I cannot locate on any EOB where I owe anything to them. (02/06/2009)
I retired from federal government service on 2/27/2009 at age 65 and 6 months. My wife (age 66) and I carefully considered our insurance options and chose to retain our Blue Cross Blue Shield coverage, which currently costs us $356.59 per month (the government pays $763.88) for family coverage and I was told that the cost would not be reduced if Medicare becomes the primary provider.
We elected to not subscribe to either Medicare Part B or Part D (the drug plan). The Medicare coverage for only Part B would have added an additional $192.80 per month ($96.40 x 2 = $192.80) to our health insurance costs. We believe we would not be able to save $192.40 per month by enrolling in Part B. Our remaining concern is that if we decide later to enroll in Medicare Part B we will be required to pay an additional 10% per year for each year that we did not enroll. (04/07/2009)