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Many companies provide employer-sponsored Medicare coverage options to their retirees. These retiree options can include Medicare Advantage, prescription drug, and supplemental health care plans.
Employer-sponsored plans are often custom designed with rich benefits and lower retiree expenses than individual Medicare plans, and they are usually offered to both retirees and their Medicare-eligible spouses. Many employers help their retirees by providing subsidies to reduce premiums and cost sharing.
Blue Cross Group Medicare Advantage Open Access (PPO)℠ Plan
Choose providers that accept Medicare nationwide without network restrictions at the same benefit levels for in- and out-of-network providers. Providers must Providers must (1) accept Medicare, (2) agree to see you as a patient, and (3) agree to bill Blue Cross and Blue Shield of Illinois (BCBSIL). You must continue to pay your Part B premium.
We recommend that you confirm with providers that they will accept your Medicare Advantage Open Access Plan (PPO) Plan and bill us directly. At your appointment, give the provider a copy of the Open Access Provider Notice letter that was included in your welcome kit. The information in the letter will help the provider understand your benefits. You can also download the Open Access Provider Notice letter and print copies as needed.
Please note that even Medicare-assigned providers can decide what patients they want to see. Out-of-network/non-contracted providers are under no obligation to treat BCBSIL members, except in emergency situations. See your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services.
If you have any questions, please call the number on the back of your member ID card.
Blue Cross Group Medicare Advantage (PPO)℠ Plan
See providers both in and out of network. Care provided by a network provider will likely cost less than if you see an out-of-network provider. You do not have to choose a primary care provider (PCP) and can get care from a specialist without a referral. You must continue to pay your Part B premium.
Blue Cross Group MedicareRx (PDP)℠ Plan
Get coverage for your prescription drugs. Part D plans enhance Original Medicare and BlueSecureSM policies and provide members with access to over 64,000 pharmacies. The drug list, or formulary, includes the most commonly prescribed medications, and the plan offers low copays for generic drugs.
This supplemental medical plan helps to pay for expenses beyond what is covered by Medicare Parts A and B but does not include prescription drugs. You can seek care from any provider that accepts Medicare. You must continue to pay your Part B premium.
BCBSIL members can easily move from their employee plan to their employee plan to their retiree group Medicare plan. If you are retiring soon or becoming eligible for your retiree group Medicare plan, please contact your Human Resources department or benefits administrator to learn about your plan options and how to enroll.
Last Updated: Jan. 24, 2023
Last Updated: 103122