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What are the differences between Blue Cross/Blue Shield and Medicare?
By aprilmoe from Pensacola, FL
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.
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.
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.
I am 66 years old and retired from federal service with B/C B/S and receiving medicare. I have the standard option family plan.
I was wondering if I should change to the basic option family plan now that medicare is the primary. The Federal Blue Cross Blue Shield is my secondary.
Nope. Don't take that gamble. Don't take less coverage to save a few dollars. God willing, you'll age well and won't be in any accidents, but go with the higher coverage just in case. It's not that much different in price is it?
I would check with Blue Cross/Blue Shield. If you have Medicare, the supplement is whatever plan you buy - I have Plan F. Plan F is the same no matter what company you buy it through. Check with them to see which plan you have. I don't know how much you pay for it, but I do know that some companies are offering a sale on supplemental insurance this year.
I'm a retired Federal worker. I will be 65 in six months. I have Blue Cross Blue Shield Federal Family for health insurance. I pay about 500 dollars a month for that insurance. I understand that Medicare will be taken out of my Social Security check, and I will have to pay for supplement insurance for other parts of Medicare insurance.
BCBS is a great company and can give you all the answers you need.
Now is a good time to either visit their office or at least call them on the phone.
Be sure to do this before you reach 65 or you may end up paying more money for several months until it is corrected and you have just Medicare and BCBS.
BCBS has a special way to set up Medicare and everything else you will need.
Please do not delay as I am sure your insurance is being taken out of your bank account and that will have to be stopped.
If you have problems then you can also go to your Social Security office and your former employer as they can also give you information.
BCBS is the best place to start.
I'm on Social Security. I have BCBS thru my wife's work. Is it necessary to carry Medicare?
I'm not retired yet, but my human resources department told me that when I hit 65, Medicare is the primary insurance, and any other is secondary. I will have to take Medicare. The good news is that once you take Medicare, the premiums your wife will pay for you for Blue Cross/Blue Shield will go down considerably.
Medicare is your primary insurance. Contact BCBS and see about changing your insurance to a supplement. That way all of your costs will be covered. My friend had BCBS, Then she had Medicare when she turned 65. When ever she went to the Dr or hospital, she had a big amount to pay that wasn't covered. Come to find out they were basically the same coverage. So what ever was taken first the other didn't cover anything. She went 6 years before she would let me check it out. BCBS should have let her know she needed a supplement. Instead she over paid for that 6 years. Of course they wouldn't reimburse her. A supplement pays the 20% where Medicare pays 80%.
I have Blue Cross Blue Shield. I also have a pre-existing condition. Is Medicare (which I am eligible for) cheaper than continuing with Blue Cross? I am paying $500 a month for this coverage. My deductible is very high at the end of the year. My blood work is expensive and I have co-pays every time I visit my specialists. I spend around $8K a year in medical expenses.
As a retired federal employee, my Blue Cross Blue Shield payment is a mandatory deduction from my pension each month in the amount of $432.00 per month. Now that I am 65, the Medicare question is complicated by the overly high payment I have to make to Blue Cross/Blue Shield. What is the best way to proceed with Medicare in this situation?
When my husband retired, his insurance payment was also around $400.00. We told them we didn't want this insurance, but they also said it was mandatory, so we found an insurance advocate in our state (PA) who wrote a letter to my husbands employer. They immediately dropped our insurance policy, but at the same time they also dropped his life insurance policy of $37,000.00. To us it was worth it just to get out from under those high monthly payments. Now we get our Part D insurance through AARP Medicare Complete and our monthly premiums are zero.
Call Blue Cross Blue Shield directly and explain you are now on medicare and see how that changes your insurance. My individual policy premium with Anthem Blue Cross Blue Shield is $135 per month.
You don't have to pay that! Drop it and sign up with AARP supplemental insurance for about $125 a month for a policy that covers everything medicare does not. Sheesh, the way they try to cheat you.
I have a medgap policy from a private insurer. I have never found AARP to be cheaper on anything. Not only health insurance but auto and home as well. Find yourself a good insurance agent; they are worth your weight in gold. That $125 quote mentioned by one person more than likely has a lot of restrictions. I'm 71 and pay $122. per month, can go to any MD or hospital I choose. No copays and the only think I pay is the Part B yearly deductible which I think is still $166. per year.
Also, you may already know but just in case; the same policy and same coverage with different insurers can range greatly in the amount they charge.
I would definitely check with an insurance agent. The first year you're getting a supplement, no one can turn you down. After that, one has to go through underwriting and companies do have the option to not insure someone. AARP's underwriting is not as strict as other companies. My mom had to go with AARP because of her medical history. My husband and I are with two other supplemental insurance companies.
Never, never, never get rid of your Fed Emp health benefit plan. Is this a family plan? During open season you can switch to a cheaper premium plan since medicare becomes your primary insurance.
My hubby and I were both fed employees so we each qualified for the single rate which is about $105 per month (for blue cross/blue shield basic) for each of us - combined with the medicare B premium of 99.00 (eff 2012) comes to $200 for each of us for a no co-pay, no deductible, no hassle health insurance coverage.
Obviously you and your spouse and both healthy and not using doctors right now, but in the future when a large bill comes due for surgery, heart attacks, strokes, cancer - whatever, you will be glad you still have your Fed employee plan. That is the gold standard of health insurance plans.
Why should I buy Medicare in addition to my federal govt. health insurance if I am fully covered under Blue Cross Blue Shield when I retire? I live a very healthy lifestyle and have inherited excellent genes!
By Dianne from Washington, DC
I was in the same situation you describe: full paid BCBS, good health, good longevity genes, healthy lifestyle. When I reached 65 last year, Medicare became mandatory for me, with BCBS as my secondary insurance. If you are on Social Security, you will not have a choice. If you are not on it, I do not know if you have a choice or not.
Medicare is not mandatory. For most people, it is advisable. Medicare Part A (which covers 80 percent of most hospital costs) is free if you sign up for it. Plan B (which covers 80 percent of most doctor charges and some tests) is voluntary and costs a monthly premium (presently $97.40 a month for most of those on Medicare) deducted from your Social
Security benefit. When I retired from my company I was covered under the company plan until I turned 65. After 65 the company no longer would cover me so I had to go to medicare but they carry me on blue cross as a supplement plan. Maybe, in the future your federal ins.
I also live a healthy life style and take very good care of my self but was totally shocked when I developed cancer. So one never knows.
Medicare with either a supplement plan or a medicare advantage plan can provide excellent and cheaper coverage than BCBS. These plans can also provide dental, prescription, & vision coverage. Since they're competitive, they offer lower or no deductibles. Also, if you join a plan that you're unhappy with, you're only locked into the plan until the next annual enrollment period.
I was told by bcbs that they can cancel you if you don't take medicare as a first insurer when you are eligible. (they usually don't but I was told they could.) Ask BCBS if this is still true. I was asking for my parents who are both retired federal government employees.
I was told to my parents should take the minimum medicare plan in their early retirement and grow the coverage as they age. That is to sign up for Medicare Plan A and grow to include Medicare Plan B as they age, or when it became necessary.
This was a few years ago, make sure that you can still sign up for Plan A and then grow your plan to include Plan B.
I became Medicare eligible due to disability six years ago. Thinking it unnecessary because - in spite of the incident that left me permanently visually impaired - I was essentially healthy, I initially opted out. Imagine my shock when, only a year or two later, I saw the necessity of opting back in and learned I'd owe an additional 10% of the basic premium. That was my penalty for my short-sightedness (pardon the pun.)
While that $97 a month for basic Medicare Part B doesn't seem like much, it can mean the difference for many of us between living in reasonable comfort and barely scraping by.
If you're absolutely certain (and have it in writing) that your current health insurance will cover your medical costs for the rest of your life, by all means opt out. Relieve the strain on the Medicare budget. And don't forget to count your blessings that your job took such good care of you into your "golden years!" Otherwise, I beieve you'd be wise to retain your Part B coverage and let any other insurance you have act as a supplement, what the insurance-savvy would call your Medicare Part C.
I just got Medicare Parts A & B and it will be starting soon. My secondary insurance is BCBS Federal PPO. My question is should I keep standard coverage or get basic coverage?
I'm 64 and will be 65 on January 24 and have a wife born in 1953. I am covered under BCBS and Medicare plan B. Should I keep BCBS and let my wife apply for her Medicare when she's 65 and should I call Medicare to make sure I'm enrolled?
Thanks for the help.
By Mike from Panama City, FL
Hi I believe you should have received something from Medicare I would call them. Also, it is my understanding if you've worked 10 years you don't pay for Part A. Truly, I would contact my local Senior association so they can look at all the details of the situation and help you come to a decision. I'm a medical biller at a hospital.
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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)
By Tina Mendoza
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)
By Bill Whitt