Medicare Supplement Insurance Plans

Medicare is a federal program to help older Americans and some disabled Americans pay for the high cost of health care. However, Medicare was never intended to cover all your healthcare costs. So even if you’re covered by Medicare, you are still responsible for a large portion of your healthcare costs. That’s where a Blue Cross and Blue Shield of Illinois Medicare Supplement Plan can help.

What Medicare Doesn’t Cover

Medicare does not cover all healthcare costs. Medicare coverage consists of:

Part A (which covers hospital and skilled nursing facility care), and;

Part B (which covers doctor bills and other medical expenses).

Even with Medicare Part A and Part B coverage, you’re responsible for some out-of-pocket expenses including:

2024 Deductibles

Part A hospital deductible ($1,632)

Part B deductible ($240)

Copayments for hospital stays over 60 days

Care in a skilled nursing facility after 20 days

Twenty percent coinsurance for doctor bills and other medical expenses

Medicare supplement plans pay for additional expenses. By law, Medicare Supplement Insurance Plans are standardized into twelve plans. That means Plan G from one company must include the same benefits as Plan G from another company. While the benefits must be the same, each company’s rates, reputation, membership features, and quality of service can vary. With Blue Cross and Blue Shield of Illinois, you don’t have to sacrifice comprehensive benefits or freedom of choice for affordability.

Benefits

Guaranteed acceptance with no health questions asked

Freedom to choose any doctors or specialists

Coverage with domestic travel

Guaranteed renewability regardless of changes in your health

Coverage guaranteed to match Medicare’s cost increases year after year

Blue Extras Member Discount Program includes discounts on wellness products and services including vision, fitness clubs, weight management, complementary alternative medicine, hearing, and more.

Hospitalization

Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.

Medical Expenses

Part B coinsurance (generally 20% of Medicare-approved expenses), or in the case of hospital outpatient department services under a prospective payment system, applicable copayments.

Blood

First three pints of blood each year.

Premier Plans

Of all available standardized plans, Medicare Supplement Insurance Plans F* and Medicare Supplement Insurance Plan G* offer the most complete protection for uncovered Medicare Part B excess charges. These are the most popular plans because they also pay the Medicare Part A hospital deductible and copayments, skilled nursing facility copayment, and foreign travel emergency care.

Budget-Conscious Plans

Medicare Supplement Insurance High Deductible Plan F*

Features a $2800 annual deductible (2024) before plan benefits begin

Medicare Supplement Insurance Plan N*

Features an office visit and emergency room copayment applicable to each visit

Medicare Supplement Insurance Plan K* and Medicare Supplement Insurance Plan L*

Feature cost-sharing for covered services under Medicare Part A and Part B. Once your annual out-of-pocket expenses reach the required limit, the plan pays 100% of covered expenses for the remainder of the calendar year.

Medicare Supplement Plan F and High Deductible Plan F are only available to those individuals who turned 65 before January 1, 2020.

Part B Medical Excess

Part B Medical Excess covers charges from your provider that exceed Medicare-approved amounts. Only Medicare Supplement Insurance Plan F, Medicare Supplement Insurance High Deductible Plan F, and Medicare Supplement Insurance Plan G cover these charges. For all other plans, you are responsible for paying excess charges. In no case can a provider charge more than 115% of the Medicare-approved amount.

Skilled Nursing

Medicare pays the first 20 days of treatment in a skilled nursing facility, and an annually adjusted per diem for the 21st through 100th day. Plans with this benefit pay an additional annually adjusted per diem for the 21st through the 100th day.

To receive any skilled nursing facility benefits, you must meet Medicare’s requirements:

You were admitted to a hospital for at least three days;

You were admitted to a Medicare-approved skilled nursing facility within 30 days of leaving the hospital.

Foreign Travel Emergency

Medically necessary, foreign travel emergency care services begin during the first 60 days of each trip outside of the United States. All plans offering this benefit require you to pay a foreign travel emergency deductible and a percentage of costs after the deductible is met.

Preventive Care

Preventive Care covers some annual physical and preventive tests and services administered or ordered by your doctor when not covered by Medicare.

Reduced Premium Med-Select Option

Medicare Supplement Insurance Plans F, G, K, L, and N Med-Select options offer the same solid benefits as the “standard” plans but cost less. You’ll save on premiums simply by agreeing to use any of the Med-Select participating hospitals for non-emergency elective admissions. If you do not use one of these hospitals for your non-emergency admissions, you pay the $1632 Part A deductible. Med-Select is not an HMO. With Med-Select, you are fully covered for emergency care at any hospital, and you can choose your doctors and specialists.

Med-Select is available in specific geographic areas only; you must live within a 30-mile radius of Medicare Select hospitals.

What Are My Plan Options and Coverage?

Medicare Supplement Insurance Plans offered by Blue Cross and Blue Shield of Illinois are outlined in the table below. Each plan offers a different set of benefits.

Plans F and High Deductible F5 are also available but only if you were eligible for Medicare before January 1, 2020.

Plans K and L are no longer available for new enrollees. Existing K and L members will be able to keep their plan.

	Basic Benefit Option	Comprehensive Plan Option	Innovative Plan Option		Budget-Conscious Plan Options
	Plan A	Plan G	Plan G Plus	High Deductible Plan G Plus 5	High Deductible Plan G 5	Plan N
Reduced Premium Medicare Select Option Available 1,2 (eligibility based on ZIP code)
Basic Benefits						copay applies 4
Skilled Nursing Coinsurance
Part A Deductible
Part B Excess 3
Foreign Travel Emergency Care 4
SilverSneakers®
24/7 Nurseline
Dental Benefits 7
Hearing Benefits 7
Vision Benefits 7

Network restrictions apply. Only certain hospitals are network providers under this policy. Check with your physician to determine if he or she has admitting privileges at the network hospital. If he or she does not, you may be required to use another physician at time of hospitalization or you will be required to pay for all expenses.
You must live within 30 miles of a participating Medicare Select hospital to be eligible.
Not to exceed any charge limitation established by the Medicare program or state law.
Plans cover medically necessary emergency care services needed immediately because of an injury or illness of sudden and unexpected onset, beginning during the first 60 days of each trip outside the USA. There is a deductible of $250 and a lifetime maximum benefit of $50,000.
High-deductible plans pay the same benefits as Plans F and G after one has paid a calendar-year $2,800 deductible. Benefits from High Deductible Plans F and G will not begin until out-of-pocket expenses are $2,800. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. This includes the Medicare deductibles for Part A and Part B, but does not include the separate foreign travel emergency deductible.
Plan N requires a copayment of up to $20 for office visits and a copayment of up to $50 for ER.
For a detailed explanation of dental, hearing and vision benefits for Plan G Plus options, refer to the Outline of Coverage.
Source: Medicare AEP Survey 2022; SPH Analytics, BCBSIL.
Discounts cannot be combined; only one type of discount per enrollee permitted

What is a Medicare Supplement?

A private health insurance policy designed to help pay some or all of the costs that are not covered by Medicare Parts A and B.

Who is eligible?

Anyone who is covered under both Medicare Parts A and B is eligible for coverage. This includes disabled individuals who are under 65.

Be Turned down?

No, Blue Cross and Blue Shield of Illinois are guaranteed to issue policies, meaning they will accept you regardless of your health history and cover any pre-existing conditions.

When to Apply?

You can apply during open enrollment. This includes a six-month period from the date you enrolled in Part B if age 65 or older, or up to six months after you turn 65 if you were eligible for Part B benefits before age 65. If you become eligible for benefits before age 65 due to disability or ESRD (permanent kidney failure), you are guaranteed the plan of your choice during the first six months you are age 65 and enrolled in Part B.

Change Mind?

If you apply today, Blue Cross and Blue Shield of Illinois will send you an ID card and a plan to review for 30 days. Pay your first premium only after you are convinced the protection is right for you. Even after you send your first payment and your coverage is in effect, you can still change your mind. Simply return your policy and ID card within 30 days of the effective date. As long as you have not filed any claims, you are under no obligation, and any premiums paid will be refunded.

Prescription Coverage?

No, for prescription coverage, you can select a separate Medicare Part D Prescription Drug Plan.

Medicare Parts A and B?

No, you must be entitled to Part A and/or enrolled in Part B to be eligible for prescription coverage.

To learn how to get Part A and/or Part B, please call Medicare at 1-800-MEDICARE (1-800-633-4227), 24 hours a day/7 days a week. For the hearing or speech impaired, please call 1-877-486-2048.

You may also contact your State Medicaid Office or the Social Security Administration at 1-800-772-1213, Monday – Friday, 7 a.m. – 7 p.m. CST. For the hearing or speech impaired, please call 1-800-325-0778.

Everyone Need?

If you have certain other types of coverage, the gaps in your Medicare coverage may already be covered.

May not Need if:

Belong to a Medicare Part C Medicaid or the Qualified Medicare Beneficiary (QMB) Program pays your Medicare premiums and other out-of-pocket costs; You are covered under an employer group health plan.

What if I (or my spouse) plan to work after age 65?

Check with your group plan administrator. You may be able to choose either your group plan or Medicare plus Medicare Supplement coverage. If you stay with your group plan, a Special Enrollment Period lets you delay purchasing Part B.

Any Hospital or Doctor?

You are free to go to any doctor or hospital you choose for care. Your coverage will be recognized across the country. If you are a Med Select member you must go to a participating hospital for all non-emergency admittance.

Med-Select Plan different from the Standard Plan?

A Med-Select Plan works just like a standard plan with one difference. With Med-Select, all scheduled inpatient hospital stays must be at a participating hospital in order to have coverage for the Medicare Part A deductible.

If you do not go to a participating hospital for a scheduled non-emergency hospital stay, you must pay the Medicare Part A deductible. However, for emergency admission, you are covered at any hospital, regardless of whether it is a participating hospital.

You must live within 30 miles of one of our Med-Select hospitals.

Cover Prescription Drugs?

No. For your prescription drug coverage needs, Blue Cross and Blue Shield of Illinois offer BlueCross MedicareRx^SM

Need to switch Doctors?

No. You may continue to see your doctor.

See a Specialist whenever?

Yes. Just remember that your out-of-pocket costs will be less if you choose a physician who accepts Medicare.