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. I also have Blue Cross which is $87 per month.
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.
Here are the questions asked by community members. Read on to see the answers provided by the ThriftyFun community.
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.
By DJ
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.
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. In fact, my husband's policy was rewritten to reflect the new sale price. We had been paying $168 and it was going to go up to $200. But with the re-write, we will now be paying $159 for his plan. That's the great thing about the supplement policies, they can be changed every year to a lower price with no change in coverage as long as you stay with the same plan.
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.
I'm going to stay with BCBS Federal for my supplement insurance. Self plus one insurance. My question is, what happens to the BCBS Family insurance. Will I still have to pay 500 dollars for that insurance, plus have money taken out of my Social Security and pay for supplement 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.
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 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.
You need a licensed insurance broker to answer your questions. Start with your pharmacy. Ask them if they have one they recommend or on staff (the one I work for does as a free service to our customers). At the same time, have them print off a list of your medications. Take that list to the insurance broker. They need to see what supplement you would need to cover the medications you are on, and any medical procedures you have and your various doctors.
I know a lot of doctors who don't take Medicare. If you need doctors who don't take Medicare, you might have to keep the Blue Cross.
I agree that an insurance broker can help you make a wise decision but you can do some checking on your own before you make any changes.
Have you been to your local BCBS office and discussed it with them? They do have knowledgeable people but you do not want to just talk to just any person so be sure you tell them you want to talk to one of their consultants. BCBS has programs that work with Medicare and they are much cheaper than just BCBS so take all your records and start there.
You must have regular doctors so be sure to ask them if they accept Medicare (most doctors do but MANY will no longer accept Medicaid). You can find out about this with a phone call to your doctors office.
Your situation is different than just a regular person asking for help/advice on choosing insurance polices so be sure you talk with knowledgeable insurance people before changing your coverage.
Medicare is cheaper! Again, just make sure that your DR accepts Medicare. Then you need a supplement. Shop around for the lowest cost. Where Medicare pays 80% a supplement pays the other 20%. But if Medicare doesn't approve payment the supplement won't either. Your BCBS also only pays the 80%. That is why you have co-payments and a large amount to spend.
Some places like Costco or Walmart will sell you the more common prescriptions for only $4. Ask at the pharmacy department for more information.
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%.
It may be possible for you to contact BCBS and obtain information but since you are on your wife's BCBS policy she may have to talk to whoever handles her insurance at her work place.
They should also be able to tell her if there is more than one option and also how much money it will save on her current policy.
Also, they will be able to start the change over if medicare is decided the way to go.
I believe Medicare Part B premium is $134.00 in 2017.
Your local Social Security may also be able to help you but it seems BCBS is the one to ask.
I have BCBS and Medicare. Medicare is primary. BCBS pays all my co-pays. Its a great combo.
If you have family coverage through your spouse's employee health plan, you should ask her HR department if you need Part B. If they tell you no, you don't need it that means her plan will remain primary coverage for you until she retires and you lose the coverage. So you tell social security you only want Part A, which for most people has a $0 premium. Then when your group plan ends, you pick Part B up (with no penalty) and make decisions about your secondary plan to cover what Parts A and B don't cover OR take a look at Part C (private insurance).
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?
By Peter
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 will be 65 and have applied for Medicare. I retired early, but am unsure if I will still have coverage by BSBC which was the insurance carried by my former employer.
Do I need to get another private insurance?
You would have to ask your employer. Where I work, once I hit 65, if I am still working, Medicare is the primary for just the hospital. My employer's insurance is primary for the doctors. Once I retire, Medicare is primary for everything. As long as I pay the premiums, which are greatly reduced, I can still keep my employer's insurance.
Medicare A&B are great but they will only cover 80% of your doctor's charges (A covers all covered hospital charges).
BCBS is a private insurance company.
Medicare can be pretty limited which is why lots of people opt to buy into some form of supplemental insurance or other
if you can affird BCBS probably best to keep that
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?
If you can afford it, keep the coverage you have. A lot of doctors don't take Medicare, at least where I live. If you need a lot of tests or visits to a non- Medicare doctor, you will be glad your secondary coverage with better benefits is in place.
This is a very important decision and many times cannot be reversed so be sure to check it out very carefully before making your decision. I do not know of any doctors in my area that do not take Medicare (but MANY are now refusing to take Medicaid patients).
Medicare only pays 80% and they have a high yearly deductible. Is the BCBS Federal PPO from your job (or spouse)? Would it be possible for you to go to your local BCBS office and ask them to help you with the difference in the standard and basic coverage since you have Medicare? Telephone does not always seem to work with this type of question.
Usually the policies have a place that you can compare the plans side by side and add Medicare - will your plans let you do that? Many of the BCBS federal plans have dental coverage and that may be valuable in the future. Also, you may want to be sure the plan you select will cover some rehab expenses as Medicare only covers a certain number of visits per year and if you have an accident or fall you may need more days/hours. Also, be sure they cover your Medicare deductible. A few extra dollars more a month may be a good investment.
Lots to consider so please do not take a general clerk's explanation - ask for a specialist.
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?
