A Guide to Blue Cross Blue Shield Medicare Advantage Plans in 2024
One of the most trusted names in health insurance, Blue Cross Blue Shield offers Medicare Advantage plans throughout the United States. They also have some robust plan extras on their Medicare Advantage options, such as free fitness memberships and dental coverage, making them one of our top Medicare Advantage providers.
FYI: If you’re new to the world of Medicare Advantage, check out our comprehensive guide to Medicare Part C.
Blue Cross Blue Shield Medicare Advantage Pros and Cons
Pros
- $0 premiums in many areas: Blue Cross Blue Shield Medicare Advantage plans have low to no monthly premiums in many national areas.
- SilverSneakers: Blue Cross Blue Shield offers SilverSneakers, a free gym membership with classes catered to Medicare beneficiaries.
- Extra benefits: Most BCBS plans include additional items such as an Over-the-Counter allowance that allows you to buy things like toothpaste and aspirin. Many of their plans also offer coverage for routine dental, hearing, and vision services.
Cons
- Most plans will require referrals: Most Medicare Advantage plans are HMOs, which require referrals to see specialists.
- Networks: Since most Medicare Advantage plans are HMO or PPO-styled plans, staying in the network is important. To use the benefits of an HMO plan, you must use in-network healthcare providers unless it’s an emergency.
- Plan authorization by a non-medical plan administrator: Since these plans take over for your Original Medicare, they are not in charge of plan authorization for service. They will have a plan administrator that decides if a particular treatment or procedure is approved or if a lower-cost or different treatment should be tried first.
Pro Tip: If you’re looking for a Medicare Advantage plan with no monthly premiums, check out our rundown of free Medicare Advantage plans.
Alternatives to Blue Cross
Blue Cross Blue Shield plans are not offered everywhere. If you live outside of their regions, then we'd recommend checking out plans from our top-rated carriers.
Blue Cross Blue Shield Medicare Advantage Costs
Many factors determine your monthly costs, including your location, age, and gender. Below, we’ve compiled estimates from several states.
Blue Cross Blue Shield HMO Pricing
| Location | Monthly Premium | Deductible | Maximum Annual Out of Pocket |
|---|---|---|---|
| California | $0.00 | $0.00 | $4,200 |
| Florida | $0.00 | $50.00 | $6,700 |
| New York | $0.00 | $290.00 | $7,550 |
| Texas | $0.00 | $0.00 | $3,400 |
Blue Cross Blue Shield PPO Pricing
| Plan | Monthly Premium | Deductible | Maximum Annual Out of Pocket |
|---|---|---|---|
| California | $99.00 | $400.00 | $6,700 |
| Florida | $0.00 | $150 | $4,500 |
| New York | $26.00 | $350.00 | $7,550 |
| Texas | $0.00 | $480.00 | $7,550 |
Blue Cross Blue Shield Current Medicare Advantage Plans
Health Maintenance Organization
HMO plans only allow in-network coverage. Except for in an emergency, you must use in-network doctors and facilities. You will have a primary care doctor that you choose who manages your healthcare.
These managed care plans are designed to focus on wellness and to help maintain your health. This allows your healthcare provider to catch and treat potential health concerns. This allows them to be treated and potentially avoided.
Preferred Provider Organization
PPO plans to allow you to receive services for your health care from both in and out-of-network providers. You typically don’t need referrals.
You can expect to pay more for services provided out of network. Sometimes, you may be required to pay the total amount upfront and get a reimbursement from the plan.
Private Fee For Service
PFFS comes with or without prescription drug coverage. With a PFFS, you can see any doctor nationwide participating with Medicare. The healthcare provider must agree to take the plan before each visit.
You may add a standalone Part D plan if you have a PFFS without drug coverage. This is the only MAPD that allows the addition of a Part D Prescription Drug Plan.
Special Needs Plan
SNPs are designed for Medicare beneficiaries with specific situations such as certain health conditions, Medicaid, or living in an institutionalized setting.
These plans have benefits that cater to the beneficiaries in this situation. These plans are typically set up as HMO plans and will all include drug coverage.
All Medicare Advantage plans are contracted based on the calendar year, and unless you make a change in a valid enrollment period, the contract renewal will occur automatically.
Additional Benefits
Plan extras can vary depending on where you live and which plan you enroll with. These are some of the benefits that could be included in your Medicare Advantage plan through BCBS.
Over-The-Counter Allowance
The over-the-counter allowance gives you an allotment to spend on items you can buy without a prescription. You can buy a variety of items. Some products you can purchase with this allowance include toothpaste, knee braces, bandages, and aspirin. You’ll receive a catalog in the mail and an order form to place your order.
Gym Membership
SilverSneakers is included with Medicare insurance policies offered by Blue Cross Blue Shield Association members. Medicare beneficiaries can take advantage of the SilverSneakers fitness program to keep their health in check. These gym memberships are included at no cost and have various classes catering to Medicare beneficiaries who want a healthy lifestyle.
Dental Coverage
It's not just about preventing cavities; routine dental care can also be very important. Unfortunately, Original Medicare does not cover routine dental care. With preventative benefits such as cleanings and x-rays, Medicare Advantage plans through BCBS provide coverage that goes beyond just routine. These benefits can range from preventative benefits such as cleanings and x-rays to comprehensive services that can sometimes include dentures.
Vision Coverage
Original Medicare does not cover routine vision care. Thankfully, vision coverage is included in most Blue Cross Blue Shield Medicare Advantage plans. In addition to routine services such as eye exams, your plan will include an allowance for eyeglasses so you can get the perfect pair without paying a lot out-of pocket.
Hearing Coverage
Since Medicare doesn’t consider hearing coverage medically necessary, many beneficiaries look for another way to receive these benefits. BCBS Part C plans can include the following benefits:
- Routine hearing exam
- Up to two hearing aids per year of the following types.
- In the ear
- In the canal
- Completely in the canal
- Behind the ear
- Receiver in the ear
- One consultation
- Two-year supply of batteries
- Three-year extended warranty
If you’re looking for a specific benefit, review the evidence of the coverage document that’s included in the plan information.
Customer Service
Since each company is an independent Blue Cross and Blue Shield Association licensee, your customer service numbers may depend on which company you’re enrolled with. Your plan's customer service phone number and contact information will be listed on the back of your Medicare Advantage ID card.
You can contact customer service via phone, email, online through your client portal, or the phone app for your insurance carrier.
Blue Cross Blue Shield Medicare Advantage Service Area
BCBS Medicare Advantage plans are available nationwide. However, the name of the BCBS affiliate may differ depending on where you live.
Currently, Blue Cross Blue Shield services the following areas:
- Alabama
- Alaska
- Arizona
- Arkansas
- California
- Colorado
- Connecticut
- Delaware
- District of Columbia
- Florida
- Georgia
- Hawaii
- Idaho
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Mississippi
- Missouri
- Montana
- Nebraska
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Vermont
- Virginia
- Washington
- West Virginia
- Wisconsin
- Wyoming
Blue Cross Blue Shield Financial Strength
The financial strength ratings for Blue Cross Blue Shield can vary depending on which member of the Blue Cross and Blue Shield Association you are comparing. Most BCBS subsidiaries have an A or better rating from AMBest. The National Committee for Quality Assurance rates most Blue Cross plan affiliates with a 3.5-star rating or better.
To learn more about our favorite Medicare providers, check out our other guides:
Frequently Asked Questions
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Which Medicare Advantage plans does Blue Cross Blue Shield offer?
BCBS offers each type of Medicare Advantage plan available. The plan types include:
- Health Maintenance Organization – HMO
- Preferred Provider Organization – PPO
- Private-Fee-For-Service – PFFS
- Special Needs Plan – SNP
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How many states have Blue Cross Blue Shield Medicare Advantage plans?
Blue Cross Blue Shield offers plans throughout the United States. Their plan offerings will vary depending on where you live and the Blue Cross and Blue Shield Association company you enroll with.
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What does Blue Cross Blue Shield Medicare Advantage cover?
Medicare Advantage plans cover your Medicare Part A inpatient Hospital and Medicare Part B outpatient medical services. Many plans also include Medicare Part D prescription drug coverage. These plans services will also include:
- Emergency Care
- Doctor Office Visits
- Telehealth
- Preventive Care
- Prescription drugs on your plan’s formulary
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Which is better: Blue Cross Blue Shield Medigap or Medicare Advantage?
There is no way to say one is better than the other. These coverages work differently, and your situation will determine which is better. Medicare Supplements work as gap coverage to help cover your out-of-pocket costs associated with Original Medicare. Medicare Advantage plans take over your benefits from Original Medicare. These health plans have a Medicare contract with the federal government to administer your Medicare benefits. Your carrier pays your healthcare costs instead of Medicare.
