Please be aware that the Medicare Supplement rates provided are subject to change and are only guaranteed through March 31, 2024.
This is our most affordable Medicare supplement plan. It offers less coverage than other supplement plans, but it does pay most of your costs for preventive services.
Network Size
Part A Deductible
$1,600
Part B Deductible
$226
Coverage Level
• Pays 100% of your Medicare coinsurance and copays for medical, hospital and hospice services covered by Original Medicare.
• Pays 100% of your hospital costs for up to 365 days after you've used up your Medicare benefits.
• Includes discounts on products and services through Blue365®.
You may get outpatient surgery at a hospital, ambulatory facility or a doctor's office.
After you pay your Medicare Part B deductible, you pay $0 for services covered by Original Medicare.
If your injury or illness doesn't require a visit to the emergency room and you can't get to your doctor's office, you can go to an urgent care facility.
After you meet your Medicare Part B deductible, you pay $0 for services covered by Original Medicare.
Original Medicare only covers chiropractic visits for manual manipulation of the spine to correct subluxation — a displacement or misalignment of a joint or body part.
After you meet your Medicare Part B deductible, you pay $0 for services covered by Original Medicare.
Original Medicare covers medically necessary foot care.
After you meet your Medicare Part B deductible, you pay $0 for services covered by Original Medicare.
Original Medicare covers:
• Individual therapy visits
• Group therapy visits
• Individual therapy visits with a psychiatrist
• Group therapy visits with a psychiatrist
After you meet your Medicare Part B deductible, you pay $0 for services covered by Original Medicare.
Use this document to:
• Learn more about A, C, D, F, HD-F, G, HD-G, and N
• See the prices for each plan
• Apply if you're ready
• Pays 100% of your Medicare coinsurance and copays for medical, hospital and hospice services covered by Original Medicare.
• Pays 100% of your hospital costs for up to 365 days after you've used up your Medicare benefits.
• Includes discounts on products and services through Blue365®.
You may get outpatient surgery at a hospital, ambulatory facility or a doctor's office.
After you pay your Medicare Part B deductible, you pay $0 for services covered by Original Medicare.
If your injury or illness doesn't require a visit to the emergency room and you can't get to your doctor's office, you can go to an urgent care facility.
After you meet your Medicare Part B deductible, you pay $0 for services covered by Original Medicare.
Original Medicare only covers chiropractic visits for manual manipulation of the spine to correct subluxation — a displacement or misalignment of a joint or body part.
After you meet your Medicare Part B deductible, you pay $0 for services covered by Original Medicare.
Original Medicare covers medically necessary foot care.
After you meet your Medicare Part B deductible, you pay $0 for services covered by Original Medicare.
Original Medicare covers:
• Individual therapy visits
• Group therapy visits
• Individual therapy visits with a psychiatrist
• Group therapy visits with a psychiatrist
After you meet your Medicare Part B deductible, you pay $0 for services covered by Original Medicare.
Use this document to:
• Learn more about A, C, D, F, HD-F, G, HD-G, and N
• See the prices for each plan
• Apply if you're ready
For $17.25 a month you can add dental, vision and hearing coverage to your Medicare supplement plan. This package is available to all Blue Cross Medicare Supplement members. It gives you:
Current Blue Cross Medicare Supplement and Legacy Medigap members can choose to enroll in the new Dental Vision Hearing Package between Feb. 1 and April 30 of each year. Read our help page to learn more.
Important information about Medicare supplement plans
This is a solicitation of insurance. We may contact you about buying insurance. Blue Cross Medicare Supplement plans aren't connected with or endorsed by the U.S. government or the federal Medicare program.