Frequently Asked Questions (FAQS)

Medicare Advantage plans are government-authorized plans offered by private health insurance companies like Blue Cross and Blue Shield of Illinois (BCBSIL) that expand upon the benefits offered by Medicare Parts A and B.

Also known as 'Medicare Part C' plans, they include some medical benefits not traditionally covered by Original Medicare Parts A and B, such as prescription drug coverage, dental benefits, vision benefits and hearing benefits. Additional 'extras' include enrollment in the SilverSneakers® fitness program and wellness programs that reward you for performing certain tests and screenings.

Also, the monthly premiums for Medicare Advantage plan are lower than those for the traditional HCSC plans.

Even though Medicare Advantage plans combine Medicare Parts A and B and Part D prescription drug coverage, you must continue to pay your Part B premium to the federal government.

Yes. Medications and drug copays in the Medicare Advantage plan are significantly lower. For example, a one-month supply of a Tier 1 Preferred Brand drug requires a $60 copay under the traditional PPO. The same drug under Medicare Advantage would have a $25 copay.

Additionally, the average annual out-of-pocket cost for medical care and services to our members in the Medicare Advantage plan were under $500 annually compared to nearly $2,000 for members enrolled in the traditional PPO.

And a Medicare Advantage plan makes it easy for you to get medical help when you travel. As long as you visit any provider that accepts Medicare, you will not be charged out-of-network fees or penalties. So, if you have a “winter” or “summer” home in another state — you’re covered!

All Medicare-based plans are individual plans, even when offered under our HCSC Retiree Group Health Plan. A retiree and their eligible spouse/partner would each enroll as individuals in one of our Retiree Group Medicare plan options.

If you are both in the same eligibility group, you must be in the same plan option.

For example, if:

• You and your spouse are both under age 65: unless one of you is eligible for Medicare you will both remain in the same traditional plan.
• You and your spouse are both over age 65 and enroll in the plan as individuals, you must both select the same plan option of either MAPD or BlueSecure + PDP.
• You are over age 65 and your spouse is under age 65: you would do a split enrollment (your spouse in the traditional plan, you in the Medicare plan).

BlueSecure is an optional, retiree group supplemental medical plan to accompany your Original Medicare Part A and B coverage. You must retain Medicare Parts A and B coverage if you select the BlueSecure + PDP option.

As a retiree group supplemental medical plan, BlueSecure pays what is typically owed by members who use Original Medicare Parts A and B, such as deductibles, copayments and coinsurance. BlueSecure also pays for skilled nursing coinsurance and emergency care when travelling overseas. Under the BlueSecure plan you have no out-of-pocket costs for covered medical services. You would be responsible for deductibles, copayments and coinsurance under the traditional PPO plan or the Medicare Advantage plan. 

If you enroll in BlueSecure, you must also enroll in HCSC’s Retiree Group Medicare Part D, Prescription Drug Plan. Part D has a separate premium and contribution from Medicare Part B and BlueSecure premiums or contributions. You will receive separate invoices for BlueSecure and your Part D contributions, if enrolled in this plan.

You must continue to pay your Part B premium.

Here are some things we suggest you consider:

• Are any of your current providers part of the Medicare Advantage network and/or willing to accept payment under Medicare? If they are, the 'extra benefits' of the Medicare Advantage plan may be right for you. Remember, certain things that are covered under the Medicare Advantage plan are not covered under Medicare Parts A and B and BlueSecure.
• Medicare Advantage members also have access to BCBSIL Disease and/or Case Management Nurses who can help you navigate the complexities of the health care system to manage your disease. This benefit is not available through BlueSecure.
• BlueSecure is not tied to a network, allowing you to visit any provider who accepts Medicare.
  
• With BlueSecure and Medicare Parts A and B — along with Part D for prescription drugs — you will not have any copayments, deductibles or coinsurance for covered medical services and will only be responsible for copayments on prescription drugs.
  

Yes, Parts A and B are required if you are age 65 or older. The HCSC traditional plan coverage and BlueSecure plan will pay secondary to Medicare, so regardless of which plan you are enrolled in, you must also be enrolled in Medicare Parts A and B.

IMPORTANT: If you’re receiving Social Security benefits, you will be automatically enrolled in Medicare Part A and Part B at the start of your Initial Enrollment Period.

If you don’t enroll for Medicare Parts A, B and D, when you are first eligible you can be subject to late enrollment penalties.

If your provider does not accept Medicare assignment of benefits, BCBSIL will still handle your claim. The claim will be processed using the Medicare-approved allowance for the specific service. The claim will then be paid to you, the member. You may be responsible for any dollar amounts over the Medicare-approved amount and any copay or coinsurance under your plan.

Also, your provider may require you to pay for the services before leaving their office. And some providers may choose to not submit the claim on your behalf.

If you completely drop any coverage you will not be able to elect coverage again.

If both you and your spouse are not age 65 or older, the member who is 65 or older may enroll in one of the Medicare-based plans while the other member enrolls in the traditional medical plan. The Medicare-eligible participant must be retired and at least 65 years of age as of January 1, 2024.

 

Your HCSC health coverage is creditable drug coverage, so do NOT elect an individual Medicare Part D drug plan while enrolled in the HCSC plan. (NOTE: if you enroll in the BlueSecure plan, you MUST enroll in the Retiree Group Part D plan offered.)

The earliest someone who is turning age 65 can sign up for Parts A & B is three months before the month they will turn age 65. 

However, you have an Initial Enrollment Period (IEP) of 7 months to sign up;

• The three months leading up to the month you turn age 65
• The month during which you turn age 65
• The three months following the month you turn age 65 

If you are becoming eligible for the Retiree Group Medicare options, MAPD and BlueSecure + PDP, you will receive an email from HCSC’s Corporate Benefits team. This email will provide you the rates for the Retiree Group Medicare plans. 

You have until the end of the month in which you turn age 65 to call the BCBSIL Medicare Enrollment line to enroll in either the MAPD or BlueSecure + PDP.  Call the BCBSIL Medicare Enrollment line at 1-877-842-7564 TTY 711.

We are open October 1 – March 31: Daily, 8:00 a.m. to 8:00 p.m. local time;
and April 1 – September 30: Monday - Friday, 8:00 a.m. to 8:00 p.m. local time.
Alternate technologies (for example, voicemail) will be used on weekends and holidays.

Coverage will be effective on the first day of the month following the date the application was processed or the Medicare Parts A & B effective date, whichever is later (When enrolling in the HCSC Group Medicare Plan, you will need your 11-character Medicare Beneficiary Identifier (MBI), located on your red, white and blue card along with your effective date.) 

Retirees who are electing their Retiree Group Medicare plan for the first time will choose either the MAPD plan or the BlueSecure + PDP plan. New retirees will not have the option to stay with the traditional plan.

You will no longer receive an invoice if you do not have a monthly retiree contribution.  In some cases, you may have a credit when switching from the HCSC Traditional plan to the Medicare plan. 

You will receive a courtesy call from our billing team confirming if you would like the credit refunded or applied to future billing such as dental, if applicable.  

New medical ID cards will be provided to you. You will receive one card for MAPD. If you enroll in the BlueSecure + PDP, you will receive one ID card for BlueSecure and one ID card for PDP. Within 10–14 days of receiving your enrollment, we’ll send you an acknowledgment letter. After your enrollment is approved by Medicare, you’ll get a confirmation letter, followed by your member ID card. 

Temporary Blue Secure cards may be accessed on Blue Access for Members (BAM).

No, once you move to one of the Retiree Group Medicare Plans you cannot move back to the Traditional plan.  However, you can change from one Medicare plan to another during the Open Enrollment period (i.e. Change from MAPD to BlueSecure + PDP or vice versa). 

No, your children must remain covered with you and unfortunately, they cannot move to the Retiree Medicare plans. If you choose to move to one of the Group Retiree Medicare Plans, your child(ren) will be termed from coverage. However, your spouse may stay on the Traditional plan coverage if they are under 65 and not Medicare eligible. 

It’s possible. If your income is limited, Medicare might pay for 75% or more of your drug costs including monthly prescription drug plan premiums, annual deductibles, coinsurance, and copays.

Four kinds of Medicare Savings Programs are available that may help pay Medicare Part A and Part B deductibles, coinsurance, and copays. Explore the benefits and limitations of these Medicare Savings Programs.

To learn if you qualify for Extra Help, Medicare’s low-income subsidy program, call Medicare at 1-800-MEDICARE (1-800-633-4227). Hearing or speech impaired call 1-877-486-2048, 24 hours a day, 7 days a week. Or call the Social Security Administration at 1-800-772-1213. TTY 1-800-325-0778. 7 a.m. to 7 p.m., Monday – Friday. You can also visit Social Security.

Watch your mailbox for these items:

• Acknowledgment Letter: Within 10-14 days of getting your enrollment form, we will send an acknowledgment letter.
• Confirmation Letter: After your enrollment is approved by Medicare, we will send a confirmation letter. This can be used as proof of insurance if you have not received your member ID card by your effective date.
• Member ID card: Your member ID card(s) will be mailed next. Show your new card(s) when you get services, so you are giving the right information.
• Welcome Guide: You will get this helpful kit a couple of weeks after your member ID card. It includes plan documents and other useful information.

If your ID card hasn’t come in the mail, you can still use your plan benefits. Just show your confirmation letter as proof of insurance if you have not received your member ID card by your effective date.