Plan Options

MedicareBlue PPO

Questions and Answers

Do I give up my Medicare benefits to join a Medicare Advantage plan?
No. You get all of your original Medicare benefits plus additional benefits.

What doesn't Original Medicare cover?
Medicare does not cover the Part A and Part B deductibles and coinsurance. It also does not cover items such as routine hearing, eye exams, and most outpatient prescription drugs.

Why is Part B optional?
Some people don't need Medicare Part B because they are still covered by an employer group plan or their spouse's health plan. However, if you do not join Part B right away and you are not covered under another health care plan, the Part B premium will increase 10 percent each year after you were first eligible to purchase it. Call 1-800-MEDICARE (1-800-633-4227) for more information, 24 hours a day, 7 days a week. TTY/TDD users should call 1-877-486-2048.

How do I choose between a Medicare Advantage plan and a Medicare Supplement plan?
There is no perfect answer. You need to select the plan that best meets your current financial and health care requirements. Many of these plans fill in gaps left by Medicare.

Original Medicare covers only those benefits listed under Part A (hospital care) and, when selected, Part B (doctor bills and other expenses), leaving you responsible for several out-of-pocket expenses, including the Part B deductible and Part A and Part B coinsurance. To enroll in either a Medicare Advantage plan or a Medicare Supplement plan, you must have Medicare Part A and Part B and continue to pay your Part B premiums (and Part A, if applicable) unless otherwise paid for by a third-party.

Medicare Advantage plans replace your Original Medicare benefits. If you join a Medicare Advantage plan (like MedicareBlue PPO), then you will use the health care card that you get from your Medicare Advantage plan for your health care. If you're in a Medicare Advantage plan, you don't need a Medicare Supplement policy.

Medicare Supplement plans allow you to enhance your Original Medicare coverage by selecting only those additional benefits that are important to you. You also maintain the freedom to visit any licensed doctor who accepts Medicare.

My income is very limited. It will be hard for me to pay the premiums and deductible under the Medicare prescription drug coverage. Is there any extra help for me?
You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call:

1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 877-486-2048, 24 hours a day, 7 days a week ;
The Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday; or
Your State Medicaid Office.

Learn what your monthly plan premium will be if you qualify for subsidies for people who need extra help.

May 13, 2008

Important Information

This page last updated and accepted by CMS January 2008.

MedicareBlue PPO and MedicareBlue Rx coverage is provided by only one of the following plans, depending on the state in which the policy is issued: Wellmark Blue Cross and Blue Shield of Iowa,* Blue Cross and Blue Shield of Minnesota,* Blue Cross and Blue Shield of Montana,* Blue Cross and Blue Shield of Nebraska,* Blue Cross Blue Shield of North Dakota,* Wellmark Blue Cross and Blue Shield of South Dakota,* and Blue Cross Blue Shield of Wyoming.*

*Independent licensees of the Blue Cross and Blue Shield Association.

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