Individual Medicare Plans
Medicare health coverage through Blue Cross and Blue Shield of Illinois includes Medicare Advantage with Prescription Drug plans (MAPD), stand-alone Medicare Prescription Drug Plans (PDP), and Medicare Supplement Insurance Plans.
Producers selling our Medicare products have a large variety of options to share with their clients and a host of marketing and sales tools at the ready when they work with us.
Medicare Advantage Plans
Our HMO, HMO-POS and PPO plans bundle cost-saving and value-added options with Original Medicare benefits. Here are some plan highlights.
| Plan Name | HMO | PPO | HMO-POS |
| Monthly Premiums | Typically lower or $0 | Tend to be higher | $0 option available |
| Primary Care Provider (PCP) | Required | Not required | Not required |
| Network Flexibility | Must use in-network | Can use out-of-network | Can use out-of-network |
| Referral for Specialists | May require referral from PCP | Not required | Not required |
| Cost Savings | Lower costs in-network | Higher costs for out-of-network | Predetermined copay rate for out-of-network |
| Prescription Drug Coverage | May or may not be covered | May or may not be covered | May or may not be covered |
Prescription Drug Plans
Prescription drug plans go beyond Original Medicare to offer coverage for prescription drugs. Whether your clients have a few prescriptions or a lot, BCBSIL offers plans that can work for their health care needs and budget. Here are highlights of each plan. (Producers must be certified to sell PDP plans.)
| Plan Name | Blue Cross MedicareRx Choice PDP | Blue Cross MedicareRx Value PDP | |
| Pharmacy Network | Nationwide | Nationwide | |
| Annual Deductible | $0 deductible for tiers 1 and 2 generic drugs Deductible applies to tiers 3, 4 and 5 | $0 deductible for tiers 1 and 2 generic drugs Deductible applies to tiers 3, 4 and 5 | |
| Formulary Type | Essential Formulary: geared for those who take no drugs or a few generic drugs | Broad Formulary: geared for those needing greater coverage for brand name and generic drugs |
Medicare Supplement Plans
We offer a wide variety of Medicare Supplement Insurance Plans. They fall into two main types:
- Medicare Supplement Insurance Guaranteed Issue Plans do not require underwriting.
- Medicare Supplement Insurance Secure Plans offer the same benefit as standard plans but have lower rates if you can pass a series of health-related screening questions.
