Blue Cross Blue Shield of Michigan Medicare programs are one of the most post popular for Medicare beneficiaries in Michigan. In this article, we’ll review what Blue Cross Blue Shield offers and if it’s the best plan your your needs.
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An Introduction To Blue Cross Blue Shield Of Michigan
Blue Cross Blue Shield of Michigan offers Medicare Supplements (or Medigap plans), Medicare Advantage, and Medicare Part D programs. Structured as a non-profit organization, the company was founded in 1929.
BCBSMI and Blue Care Network are the largest insurer of private insurance in the state of Michigan, according to the Kaiser Family Foundation.
BCBSMI has an A Excellent rating with AM Best is considered an extremely financially stable company. JD Power also awarded the company the top Commercial Member Health Plan Satisfaction rating in 2018, and second highest in 2019.
Blur Cross Blue Shield of Michigan is part of the Blue Cross Blue Shield Association and is headquartered in Detroit, Michigan.
Blue Cross Blue Shield Of Michigan Medicare Supplement Plans
Blue Cross Blue Shield of Michigan Medicare Supplements come in two forms, Guaranteed Issue and fully underwritten.
- Guaranteed Issue/Medigap Open Enrollement – You have a qualifying event (such as enrolling during your first 7 months of Medicare Part B eligibility) where the insurance company cannot ask medical questions to determine underwriting. That means they can’t deny your application.
- Fully Underwritten- Any other time that you want a Medigap policy in Michigan, you are required to pass medical underwriting. This is considered a “fully underwritten policy and you can be denied coverage due to your health.
Blue Cross Blue Shield Of Michigan Medigap Plan F
Medicare Supplement Plan F has been known as the “Cadillac” of Medigap plans. It covers all Medicare approved coinsurance an deductibles. It’s the most popular plan with the largest market share because you only pay the Part B premium for Medicare and the Part F insurance premium. Medicare and your insurance cover 100% of all Medicare approved costs.
However, it tends to be the most expensive policy in the program with the largest annual increases. Furthermore, it’s no longer available to NEW Medicare beneficiaries as of 1/1/2020.
Plan F seems like a great deal, but if you’re willing to pay the Part B deductible, you can usually find a better overall value (even with the Part B costs) using Plan G instead.
Blue Cross Blue Shield Of Michigan Medigap Plan G
Plan G, hands down, is one of the best Blue Cross Blue Shield Medicare Supplement plans that the company offers. It offers all of the benefits of Plan F, except you pay for the Part B deductible. To put that into perspective, the 2020 Part B deductible is $198.
Medicare doesn’t pay any Part B costs until the deductible is met and neither will the insurance company. However, there’s likely a significant amount of savings annually AND in future increases by paying it yourself.
Check out the premium rates below to see if it’s beneficial for you to use Plan G instead of Plan F.
Blue Cross Blue Shield Of Michigan Medicare Supplement Rates
Below are sample rates from multiple Blue Cross Blue Shield of Michigan Medicare Supplement plans at different age ranges for Grand Traverse County. As of the publishing date of this article, these rates are accurate, but can and often due change over time.
To get a free, instant quote based on your age, location, and smoking status, fill out the form to the right OR if mobile press “Get Quote” button above.
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Female, Non-smoker 49686
|Age||Plan F||Plan G||Plan N|
Male, Non-smoker 49686
|Age||Plan F||Plan G||Plan N|
Blue Cross Blue Shield Of Michigan Medicare Advantage Plans
Blue Cross Blue Shield of Michigan also offers Medicare Advantage Plans, or Part C. Medicare Advantage offers the same basic benefits as Original Medicare but are administered by a private insurance company.
Medicare pays the private insurance company to manage your Medicare benefits instead of doing it themselves. This saves Medicare money by outsourcing their administrative costs.
On top of the basic Medicare benefits, most Medicare Advantage plans offer additional benefits that Medicare does not. This can be dental or vision insurance, gym memberships, and most have Part D built into them.
Usually, Medicare Advantage plans cost less up front, but more when you use them. Furthermore, Medicare Part C plans usually have provider networks where it’s cheaper when you use an in-network doctor or facility. In some plans, they won’t offer coverage at all if the provider is not in network.
It’s also important to know that if you go on a Medicare Advantage plan you can switch back to Original Medicare. However, if you become ill you may not qualify for a Medicare Supplement. This may leave you stuck in the Part C plan.
Blue Cross Blue Shield of Michigan Medicare Advantage Plans offer Silver Sneakers.
There are two common Medicare Advantage plan network types: PPO and HMO.
What Is A PPO?
PPO’s are Preferred Provider Organization.
These types of plans allow you to use any provider that will accept the Medicare Advantage plan. However, specific providers are deemed “in network” and are less expensive than “out of network” providers.
Furthermore, you do not need a referral to see a specialist in or out of network. As you can see, these plans allow you to have more flexibility in your healthcare choices, but you can expect to pay more to have access to these plans.
What Is An HMO?
HMO’s are Health Maintenance Organizations.
These types of plans focus on using a Primary Care Provider as a gatekeeper to your healthcare. You’ll need referrals to see specialists and get specialized tests. Furthermore, you’ll have to use the networks that the plan provides if you want coverage.
If you’re out of your network area, and it’s not deemed an emergency, you will be responsible for the entire bill.
HMO’s usually cost less due to these restrictions.
What is HMO-POS?
As above, an HMO is a Health Maintenance Organizations. POS stands for Point of Service.
This type of Medicare Advantage plan offers the flexibility of a PPO and cost saving measure of an HMO.
How does it work? Essentially, you have an “in-network” group of providers that offer services to you. You still have select a Primary Care Provider to help coordinate your healthcare.
However, you can also use “out of network” doctors and rarely need a referral to see a specialist. You’ll also pay a higher cost when going out of network.
Sounds like the best of both worlds, right?
The downside is that unlike a PPO, you’ll have two deductibles. One for “out of network” services and one for “in network” services. You cannot combine your deductible.
Many insurance companies, like Blue Cross Blue Shield are working in an HMO-POS system to ensure maximum flexibility while still offering cost cutting measures for the user.
Which Is Better?
That’s really up to you.
If you want more freedom in your healthcare and are willing to pay for it, a PPO may be right for you.
On the other hand, if who you see doesn’t matter to you and you don’t leave your network area very often, an HMO can save you money.
Since we’re talking about which is better, I feel required to let you know something Medicare Advantage plans and providers might not tell you.
Let’s say you have an emergency and have to go to the hospital and have surgery.
The hospital can be in network and your doctor can be in network. However, the lab or your surgeon may not be in network. While you can request an exception and get coverage, it can be quite startling to see a massive bill and exceptions aren’t always guaranteed.
Just some food for thought.
About Blue Cross Blue Shield Of Michigan Medicare Part D Plans
I’m not going to go into great detail about Blue Cross Blue Shield of Michigan Medicare Part D plans because insurance companies can offer multiple different plans and they may all have different formularies.
Basically, a formulary is the plans drug list and tier levels that you’ll pay.
What we’re going to cover here is just a few tips:
- Medicare Supplements do not have a Part D plan. You have to purchase or sign up for a stand alone plan.
- Medicare Advantage plans may or may not have a Part D plan available in them. If your plan does not, in most cases you cannot sign up for a stand alone Part D plan with disenrolling in your health plan. MAKE SURE YOUR MEDICARE ADVANTAGE PLAN HAS A PART D WITHIN IT.
- Total costs is more important than how much you pay a month. Premium plans can be better for you because the drug would be cheaper monthly than a free plan. Don’t compare plans based on premium, always total out of pocket costs.
- Check your drugs to make sure the plan covers them. Otherwise, your doctor may have to switch your prescription to a covered drug.
What's The Verdict On Blue Cross Blue Shield Medicare Plans?
Blue Cross Blue Shield of Michigan Medicare Advantage plans can over great coverage and additional services. However, their Medicare Supplement plans are rarely the best overall value in the market.
BCBSMI has a great reputation and strong financial stability. They’re definitely a strong contender for Medicare Advantage, I’d look elsewhere for Medicare Supplements.