Blue Cross Blue Shield Medicare Advantage Plans Review
Great coverage and a variety of plan types at a low cost
Blue Cross Blue Shield (BCBS) Medicare Advantage plans are available in 47 states as well as Puerto Rico and offer different plan types, like HMOs, PPOs, and SNPs. These plans are great options if you’re looking for one that’s cost-effective with additional perks and benefits. Keep reading to learn more about what you can expect to pay each month, an overview of which Medicare Advantage plan types BCBS offers, which supplemental benefits you may receive, and where these plans are offered throughout the U.S.
Pros About Blue Cross Blue Shield Medicare Advantage
- Prescription drug coverage generally included
- Nationwide coverage in 47 states (plus Puerto Rico)
- Numerous plan types to choose from
- Supplemental benefits as well as the Blue365 discount program available with some plans
Cons About Blue Cross Blue Shield Medicare Advantage
- Varying levels of customer service quality depending on location and affiliates
- Prescription drug coverage not offered on all Medicare Advantage plans
- Not as many SNP plans compared to other carriers
Available Blue Cross Blue Shield Medicare Advantage Plans
BCBS offers a variety of HMO and PPO options to choose from, plus a few SNP and PFFS plans. Depending on which plan you choose, you may have access to supplemental benefits like transportation, telehealth, and meal delivery.
BCBS offers health maintenance organization (HMO) plans, in which you’ll need to choose from a specific network of doctors and hospitals. These HMO plans generally require you to obtain a referral from your primary doctor to see a specialist. Additionally, out-of-network benefits are typically limited to emergency or urgent care.
You may also have the option of choosing an HMO-POS plan, through which you can receive out-of-network services, but you’ll have to pay more.
If provided in your area of residence, preferred provider organization (PPO) plans offer more freedom than HMOs, so you can visit any provider that is in the network. Moreover, you might not need a referral to see a specialist or pick a primary doctor. You’re welcome to seek out-of-network care, but it may be more expensive with a PPO plan.
Quick Tip: Visit this year’s guide to Medicare enrollment for more details on signing up for a Medicare Advantage plan.
In certain locations, you may be able to access dual special needs plans (D-SNPs). To be eligible for this plan, you need to be eligible for both Medicare and Medicaid. A D-SNP may be an option if you have a low income or are older than 65 and/or disabled. Keep in mind that D-SNP eligibility varies by state. These benefits cover all of Original Medicare as well as additional services and support if you have more complex needs.
BCBS also offers private fee-for-service (PFFS) plans, so you can see any Medicare-approved provider who accepts your plan. A PFFS may be for you if you prefer to choose your doctor or specialist wherever you go.
An SNP is a great choice if you have a specific disease or condition, as the benefits, network, and drug formularies are tailored to your needs. BCBS offers three types of SNP plans:
- Chronic condition: If you have a chronic condition like diabetes, congestive heart failure, or cardiovascular disease, this plan is designed to suit your needs.
- Dual-eligible: You’re eligible for this plan if you have Medicare and qualify for assistance from a Medicaid program.
- Institutional: This plan is a great choice if you live in a BCBS network nursing home or assisted living community.
Extra Perks and Benefits
BCBS offers a select menu of extra perks and benefits, such as discounts and rewards, virtual visits, chronic condition management, and fitness memberships. If your plan offers the MyBlue Concierge program, you’ll have a dedicated member to help you schedule appointments, contact BCBS customer service, and reach a care management team if you have a chronic condition. Virtual well-being weekly webinars are live so you can stay up-to-date on how to best improve your health. Advantage dollars work on a preloaded debit card that you can use to purchase healthy foods or over-the-counter items like vitamins or allergy products.
How Much Do Blue Cross Blue Shield Medicare Advantage Plans Cost?
With a BCBS Medicare Advantage plan, you’ll continue paying your Part B premium ($164.90 as of 2023) and possibly a separate Medicare Advantage premium. It’s very important to consider the plan’s premium. BCBS offers a plan with a $0 premium in 45 states and Puerto Rico, but premiums in some locations could cost more than $300 per month. If you have an SNP, premiums may vary between $0 and $59. Overall, the plan cost will depend on your geographic location and health needs.
There are also a few out-of-pocket expenses to consider:
- If the plan covers any portion of your monthly Part B premium
- If the plan has a yearly or drug deductible
- Any copayments and/or coinsurance per visit or service
- If the plan has in- and out-of-network out-of-pocket maximums
- If your Medicare providers are in-network or out-of-network, and how often you see them for care
Pro Tip: If you need assistance finding a plan, use Medicare.gov’s tool to help compare plans available to you.
Where Are Blue Cross Blue Shield Medicare Advantage Plans Available?
Blue Cross Blue Shield is the third-largest Medicare Advantage carrier in the country, with plans in 2,190 counties across 47 states and Puerto Rico. The company’s Medicare prescription drug plans are available in 42 states.
Pro Tip: If this is your first time choosing a Medicare Advantage plan, check out our 2022 guide to Medicare Advantage.
Reviews and Ratings
It’s always a good idea to read reviews and ratings from trusted sources when shopping for a Medicare Advantage plan so that you can evaluate the company’s reputation, customer satisfaction ratings, and other important criteria.
- AM Best: While not all BCBS affiliates are AM Best-rated, those that are range between A and B++, indicating the carrier is well positioned to meet its financial obligations.
- NCQA: Basing ranks on customer satisfaction, BCBS affiliates received between a 2.5 to 4.5 score out of 5.
- CMS: BCBS received 4.1 out of 5 points based on customer satisfaction.
If you need to reach a BCBS customer service representative, you can call (888) 630-2583 or the toll-free number on the back of your member ID card. Use the BCBS website to file claims, request a new member ID, and estimate costs. Keep in mind that hours of operation depend on plan type.
Final Thoughts on Blue Cross Blue Shield Medicare Advantage Plans
Overall, Blue Cross Blue Shield is an excellent choice for Medicare Advantage plans. Just remember that if you’re looking for an SNP, BCBS doesn’t offer as many options as other carriers. However, coverage is widely accepted, customer service is exceptional, there are a variety of plan options, and the additional perks and benefits are substantial.