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Blue Cross Blue Shield Medicare Advantage Plans Review

Great coverage and a variety of plan types at a low cost

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HMO, PPO, and SNP plans
Available in 47 states
SeniorLiving.org Rating:
4 of 5
Dedicated customer service team
Great supplemental benefits and perks

Blue Cross Blue Shield (BCBS) Medicare Advantage plans are available in 47 states as well as Puerto Rico and offer different plan options, like HMOs, PPOs, and SNPs. These plans are great options if you're looking for one that's cost-effective with additional perks/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.

What We Like About Blue Cross Blue Shield Medicare Advantage

  • Prescription drug coverage generally included
  • Nationwide coverage in 47 states
  • Numerous plan types to choose from
  • Supplemental benefits as well as the Blue365 discount program available with some plans

Things to Keep in Mind 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 providers

Available Blue Cross Blue Shield Medicare Advantage Plans

BCBS offers a variety of HMO and PPO plans. Depending on which plan you choose, you may have access to supplemental benefits like transportation, telehealth, and meal delivery.

HMO

BCBS offers health maintenance organization (HMO) plans, in which you're obligated to choose from a specific network of doctors and hospitals. These plans generally require you to obtain a referral from your primary doctor to see a specialist. Additionally, out-of-network benefits are typically limited.

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.

PPO

If provided in your area of residence, preferred provider organization (PPO) plans have the most freedom, 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.

Quick Tip: Visit this year's guide to Medicare enrollment for more details on signing up for a Medicare Advantage plan.

D-SNP

Some BCBS plans provide dual special needs plans (D-SNPs). To qualify 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 per state. These benefits cover all of Original Medicare as well as additional services/support if you have more complex needs.

PFFS

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/specialist wherever you go.

SNP

An SNP is a great choice if you have a specific disease or characteristic, as the benefits, network, and drug formularies are tailored to your needs. BCBS offers three types:

  • 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 are 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 (typically around $170) and possibly a separate Medicare Advantage premium. Overall, the plan cost will depend on your geographic location and health needs. 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 can cost up to $301. If you have an SNP, premiums can be between $0 and $59.

There are additional out-of-pocket expenses to review:

  • 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 each 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 seek them for care
  • If you need extra benefits and if the plan expenses for it

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 provider 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 provider 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, which is based on customer satisfaction.

Customer Service

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. Keep in mind that if you're looking for an SNP, BCBS doesn't offer as many as other providers. However, coverage is widely accepted, customer service is exceptional, there are a variety of plan options, and the additional perks/benefits are substantial.