About Medicare

Not sure what type of Medicare plan is best for you? To make an informed decision, it helps to understand the different types of plans available. These are the types of plans you can enroll in through the Blues.

Types of Medicare Advantage plans

Medicare Advantage plans roll all your medical benefits into one plan. Private companies contract with Medicare to provide these plans. They cover everything included in Original Medicare and may also include extra health care services. The company you choose provides all of your health care benefits and you present only your plan ID card when you need care. Companies contract with Medicare to offer different types of Medicare Advantage plans. Your Blues options include:

HMOs, or health maintenance organizations, let you select a primary care physician from their provider network to manage your care. Should you need to see a specialist or hospital care, your primary care physician refers you for this care. You are usually not covered for care you seek on your own. Blue Care Network offers a Medicare Advantage HMO called BCN AdvantageSM HMO-POS, with four plan options.

PPOs, or preferred provider organizations, also contract with physicians to build a network. However, you can visit any doctor who accepts Medicare, without a referral. You will usually pay more if you see a doctor who is not in the plan's network, with the exception of emergency or urgent care. Blue Cross Blue Shield of Michigan offers a Medicare Advantage PPO called Medicare Plus BlueSM PPO, with four plan options.

Medicare supplemental plans

Medigap plans, also called supplemental plans, have been around for a long time. With a Medigap plan, you continue to be covered by Original Medicare. Your Medigap policy pays for copays, deductibles and other benefits not covered by Original Medicare. The government establishes standard benefit plans that are offered by private companies, such as the Blues. When you seek care, you present both your Medicare card and the ID card for the Medigap coverage you've purchased. Learn more about MyBlueSM Medigap.

Prescription drug plans

Whether you select a Medigap plan or Medicare Advantage plan, it's important that you also get prescription drug coverage. If you don't get this coverage when you first become eligible, you'll pay more if you decide to enroll at a later date.

Private companies contract with Medicare to provide Medicare Part D coverage. Most Medicare Advantage plans build this coverage into their benefits so you pay one combined premium and get your medical care and prescription coverage together.

If you purchase a Medigap plan, you will also need to purchase a prescription drug plan and will have a separate ID card for your prescription drugs. Blue Cross Blue Shield of Michigan offers simple and affordable prescription drug coverage with Prescription BlueSM PDP.

For more information, visit About Prescription Drug Plans or Prescription Blue PDP, Blue Cross Blue Shield of Michigan's Part D prescription drug plan.

Still have questions? Call us!

Call 1-888-563-3307 from 8 a.m. to 9 p.m. Monday through Friday, Feb. 15 through Sept. 30, with weekend hours Oct. 1 through Feb. 14. TTY users call 711.

Current members

Call the Member Services number on the back of your ID card.

Prospective members

Call 1-888-563-3307 from 8 a.m. to 9 p.m. Monday through Friday, Feb. 15 through Sept. 30, with weekend hours Oct. 1 through Feb. 14. TTY users call 711.

Want us to call you? Just let us know!

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Important information about these plans

Medicare Plus Blue and Prescription Blue are PPO and PDP plans with a Medicare contract. Enrollment in Medicare Plus Blue and Prescription Blue depends on contract renewal.

Medicare Plus Blue PPO

Medicare Plus Blue PPO is available to all Medicare beneficiaries who are Michigan residents and are entitled to receive services under Medicare Part A and enrolled in Part B.

With the exception of emergency or urgent care, it will cost more to get care from non-plan or non-preferred providers. Your responsibility will be greater out-of-network when the out-of-network coinsurance is based on the Medicare-allowed amount and the contracted amount is lower. You may receive services from any provider who accepts Original Medicare. Your out-of-pocket costs will be lower if you choose a network provider. To find a network provider, visit http://www.bcbsm.com/medicare/find-a-doctor/.

Prescription Blue PDP

Prescription Blue PDP is available to all Medicare beneficiaries who are Michigan residents entitled to receive services under Medicare Part A and/or enrolled in Part B.

Medicare Plus Blue PPO and Prescription Blue PDP

Premiums vary by county. You must continue to pay your Medicare Part B premium. You may enroll in only one Part D plan at a time.

Limitations, copayments and restrictions may apply.

Our network includes approximately 2,400 Michigan retail pharmacies, representing approximately 98 percent of all Michigan pharmacies. Nationwide, most chain pharmacies are in our network, as well as long-term care and home infusion pharmacies and Indian/Tribal/Urban (Indian Health Service) pharmacies.

In general, benefits are only available at contracted network pharmacies. Plan drugs may be covered in special circumstances; for instance, illness while traveling outside of the plan's service area where there is no network pharmacy. You may have to pay more than your normal cost-sharing amount if you get your drugs at an out-of-network pharmacy. Quantity limitation and restrictions may apply. In addition, you will likely have to pay the pharmacy's full charge for the drug and submit documentation to receive reimbursement from Blue Cross Blue Shield of Michigan. For additional information on network pharmacies, please call Member Services at 1-877-241-2583, 8 a.m. to 9 p.m. Eastern time, Monday through Friday, Feb. 15 through Sept. 30, with weekend hours Oct. 1 through Feb. 14. TTY users call 711. Certain services available 24/7 through our automated telephone response system. You may also write to: Blue Cross Blue Shield of Michigan, 600 E. Lafayette Blvd., Mail Code X521, Detroit, MI 48226.

If you decide to have your plan premium withheld from your Social Security check or deducted from your checking or savings account, it may take up to three months for the automatic deduction to begin. If your premium amount is currently withheld from your Social Security check or deducted from your checking or savings account and you wish to receive a monthly bill instead, the change may also take up to three months to become effective. During this time, you will be responsible for paying your premium.

The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. Benefits, formulary, pharmacy network, premium and or copayments/coinsurance may change on Jan. 1 of each year.

Medicare beneficiaries may enroll in Medicare Plus Blue PPO or Prescription Blue PDP through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. BCBSM does not control Medicare's website and is not responsible for its content. You may only enroll in Medicare Plus Blue PPO or Prescription Blue PDP during specific times of the year.

For more information, please contact Blue Cross Blue Shield of Michigan at 1-888-563-3307. TTY users call 711. Hours are: 8 a.m. to 9 p.m. Eastern time, Monday through Friday, Feb. 15 through Sept. 30, with weekend hours Oct. 1 through Feb. 14.

LegacySM Medigap

Legacy Medigap offers access to any hospital, doctor or other health care provider in the U.S. or its territories that accepts Medicare assignment. The plan does not require members to use a specified provider network. Legacy Medigap is a Medigap health insurance policy administered by Blue Cross Blue Shield of Michigan. Neither Blue Cross Blue Shield of Michigan nor agents authorized to sell Blue Cross Blue Shield of Michigan policies are connected with Medicare.