Frequently Asked Questions (FAQS)
This is a list of the most frequently asked questions that Medicare-eligible retirees have had about their benefits. If you have questions not covered here, please call the Enrollment Helpline at 1-877-448-4522 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.
HealthSpring℠ Rx (PDP)
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If I am currently enrolled in the Blue Cross Group MedicareRx (PDP)℠, do I need to take action to move to the HealthSpring Rx PDP?
No action is required; your coverage will transition to the HealthSpring Rx (PDP) as of January 1, 2027. You will receive an Annual Notice of Change (ANOC) which will provide details about the plan.
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How can I learn about my 2027 HealthSpring Part D plan?
Please visit www.healthspring.com/retiree-medicare-hcsc to learn about your HealthSpring Rx (PDP) coverage and benefits. HealthSpring will also provide an Informational Kit featuring a Member Handbook with more details on how your plan works. HealthSpring will also reach out by mail later this year if there are any drug list (formulary) or pharmacy network changes and explain what that will mean for you. Watch your mail for important plan information from HealthSpring.
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Does HealthSpring have a member portal or online account? Do I have to register for it?
Yes. myHealthSpring is a secure online portal for your HealthSpring Part D plan. You can view claims, download your digital ID card, manage prescriptions, and more. Starting January 1, 2027, you can log in to myHealthSpring.com or download the myHealthSpring mobile app.
Note: myHealthSpring only gives you access to your 2027 HealthSpring plan information. You will continue to have access to the member portal you use today with your group retiree medical plan administered by BCBSIL, mybam.bcbsil.com, and be able to see your explanation of benefits (EOBs) and documents for claims prior to January 1, 2027.
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When will I get my HealthSpring ID card?
A new HealthSpring ID card will be mailed in December 2026. Starting January 1, 2027, you can log in to your account at myHealthSpring.com to view or download your digital HealthSpring ID card. Your member ID will stay the same at HealthSpring, so the member ID that appears on your 2027 ID card will be the same as the member ID that appears on your 2026 Part D plan ID card.
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Will I be able to access my Explanation of Benefits (EOB) online for my HealthSpring plan?
Starting January 1, 2027, you can log in to myHealthSpring.com to access your EOBs in the Claims section.
To enable this feature, you will need to follow these steps: 1.) Log in to myHealthSpring.com and go to the Pharmacy page. 2.) Click the link to go to Express Scripts® Pharmacy so you can select the PDP Paperless preference for your PDP EOBs.
This will allow you to access your EOBs directly from Express Scripts® Pharmacy by clicking the link on the Pharmacy page.
Note: myHealthSpring only gives you access to your 2027 HealthSpring plan information. You will continue to have access to the BAM member portal you use today and be able to see your 2026 claims and documents.
General Medicare
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Why is HCSC requiring that Medicare-eligible retirees and spouses move to one of the Group Medicare plans?
HCSC is proud to be one of the few large employers to still offer retiree health benefits. Most employers no longer offer this costly benefit and have chosen to focus on giving health benefits to their active employees. The HCSC Group Medicare plans are a good option for Medicare-eligible retirees because they are customized with generous health and wellness benefits at a lower cost for both HCSC and retirees. These plans are generally equal to, if not better than, the Traditional plan offerings.
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What is BlueSecure ℠ and Blue Cross Group MedicareRx (PDP) ℠?
These two plans are bundled together and serve as one of the available plan options. This plan option is similar to a Medigap or Medicare supplemental plan. This plan works together with Medicare Parts A and B to cover your medical, hospital, and prescription drug costs. Medicare Parts A and B generally cover 80% of your hospital and medical costs. BlueSecure fills some of the gaps for medical and hospital care that Medicare doesn’t cover, like coinsurance, copays, and deductibles. You will not be subject to copays, deductibles or coinsurance for Medicare-approved medical services received in the U.S. or its territories. You can see any doctor in the U.S. who accepts Medicare and you don’t need a referral. Your prescription drug benefits cover common outpatient medications, like those used to treat blood pressure, cholesterol, depression, and arthritis.
Note: The Blue Cross Group MedicareRx (PDP) is effective through December 31, 2026. Effective January 1, 2027, retirees enrolled in the BlueSecure plan must also be enrolled in the HealthSpring Rx (PDP). Enrollment in both the BlueSecure plan and PDP is required to maintain coverage under the HCSC Group Retiree Health Plan.
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What is Blue Cross Group Medicare Advantage Open Access (PPO) ℠ Plan?
This is another option available to Medicare-eligible retirees. This plan option is generally referred to as a Medicare Advantage plan, which is a government-authorized plan offered by private health insurance companies like Blue Cross and Blue Shield of Illinois 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, and hearing benefits. Additional ‘extras’ include enrollment in the SilverSneakers® Fitness Program and wellness programs that reward you for healthy activities such as vaccinations and screenings. Your prescription drug benefits cover common outpatient medications, like those used to treat blood pressure, cholesterol, depression, and arthritis. To lower costs, most Part D vaccines are available at no cost to you and insulin products are limited to $35 for a one-month supply, even if you haven’t met your deductible.
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How does an Open Access plan work?
Our MAPD and BlueSecure Plans are both Open Access plans, which is a ‘non-differentiated’ or ‘passive’ PPO, meaning you can go to any doctors who: 1) accept Medicare; 2) agree to see you as a patient; and 3) will send claims to the plan. Doctors do not need to be part of any Blue Cross and Blue Shield Network. Members’ coverage levels are the same inside and outside their plan service area nationwide for covered benefits. Referrals aren’t required for office visits. Pre-approval may be required for certain services from doctors who are Medicare Advantage-contracted with BCBSIL. We recommend you confirm with your doctor if they agree to bill according to Medicare’s fee schedule and submit claims to the plan.
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How do I know if my prescription drug is covered on the Group Medicare Plan and if there is a change in my out-of-pocket costs?
The prescription drug coverage included in the BlueSecure and MAPD plans have lower copayments than the Traditional plans. To understand what your copays will be on the Medicare plans, the drug lists (formularies) for both the MAPD plan and HealthSpring Rx (PDP) can be found on the retiree websites - www.bcbsil.com/retiree-medicare-hcsc/coverage and www.healthspring.com/retiree-medicare-hcsc/coverage.
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How do the premiums on BlueSecure and Blue Cross Group Medicare Advantage Open Access (PPO) compare to the Traditional plans?
The monthly premiums are lower than those for the Traditional plans. Even though these Group Retiree Medicare Plan options 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. This is often deducted from your Social Security benefit.
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When I move to BlueSecure or Blue Cross Group Medicare Advantage Open Access (PPO), can I stay enrolled in the HCSC Group Dental Plan?
Yes, your enrollment in the HCSC Group Dental plan will remain active for you and your Medicare-eligible dependents.
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If I am the retiree and under age 65 but my spouse is over age 65, may I remain on the Traditional plan?
If either you or your spouse are not age 65 or older, the member who is 65 or older must enroll in one of the Group Retiree Medicare plans while the other member remains in the Traditional medical plan (HSA1 or HSA2) until they become Medicare-eligible. The PPO and HMO plans are no longer available. The Medicare-eligible participant must be retired and at least 65 years of age as of January 31, 2027.
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Can I add a spouse to my coverage?
A spouse may be added within 31 days of a loss of coverage but only if the following criteria is met:
- You were married to this spouse on the day you retired
- Your spouse has lost coverage
- You notify Employee Services that you want to enroll your spouse in coverage within 31 days of the loss of their coverage and provide proof of loss of coverage
- Your monthly contribution may change, and you will be required to provide supporting documentation for proof of loss of coverage
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If I am over 65 and carry children on my coverage, can I continue to cover my children?
Your child(ren) will no longer remain on your health insurance as dependents once you move to one of the Group Retiree Medicare Plans. Their Traditional plan coverage will be terminated. Please visit https://enroll.bcbs-inmot.com to find a health plan for your child(ren). There is an exception: If your covered dependent is disabled and they are currently covered on the Group Retiree Medicare Plan, they may retain the same coverage as the retiree.
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What if my doctor does not accept the Medicare fee schedule but accepts Medicare?
This means that your doctor accepts the Medicare-approved amount for services on a case-by-case basis. This doctor is viewed as ‘non-participating.’ The doctor can also charge you up to 15% over the Medicare-approved amount for a service. This is called ‘the limiting charge.’ If your doctor does not accept the Medicare fee schedule but accepts Medicare, 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 doctor may need you to pay for the services before leaving their office. And some doctors may choose not to submit the claim on your behalf.
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What if my doctor will not submit a claim on my behalf?
If your doctor does not accept the Medicare fee schedule and refuses to bill BCBSIL, you may need to pay the full amount of the services directly to the doctor at the time of service and then submit the bill to BCBSIL for reimbursement. There is no form to complete, but you can submit a claim for reimbursement in writing to: Blue Cross Medicare Advantage (Claims) PO Box 4195 Scranton, PA 18505-6195. For BlueSecure Claims, mail to: Blue Cross and Blue Shield of Illinois PO Box 805107 Chicago, IL 60680-4112. Please include this documentation:
- Copy of receipt showing payment was made
- Member name and complete ID listed on the card including all letters and numbers
- An invoice showing services made OR another form of documentation that includes:
- Diagnosis (or DX codes if available)
- Procedure (or CPT codes if available)
- Name and address of servicing doctor
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Do I need to have Medicare Parts A & B?
Enrollment in Medicare Part A and Part B through the federal government is required to be eligible for any Medicare plans, including our group retiree plans. To have full coverage, you must sign up for Medicare Parts A and B and continue to pay any required Part A or Part B premiums. You will need to do this first and get your 11-character Medicare Beneficiary Identifier before you can enroll in either of the plan options offered. When enrolling in one of the plan options offered, you will give your Medicare Beneficiary Identifier located on your red, white, and blue Medicare card, along with your effective date.
IMPORTANT: If you’re already receiving Social Security benefits, you will be automatically enrolled in Medicare Part A at the start of your Initial Enrollment Period. However, you will need to call the Social Security Administration to sign up for Part B. If you do not get instructions from the SSA, please call 1-800-772-1213 (TTY 1-800-325-0778) or go to www.ssa.gov to enroll in Medicare. If you don’t enroll in Medicare Parts A, B and D when you are first eligible, you can be subject to late enrollment penalties.
NOTE: If you turn 65 but you or your spouse are still working and have health insurance through HCSC or other employer, you have 8 months to sign up for Part B without penalty. This 8-month period begins the month after your employment (or employer coverage) ends, whichever happens first.
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When should I sign up for Medicare Part A and Part B?
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 of 7 months to sign up. The Initial Enrollment Period includes the below measurement window:
- 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
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If I am enrolled in the BlueSecure + PDP, will I be billed separately for these plans?
These plans will continue to be billed separately. The BlueSecure coverage will be billed from Health Equity WageWorks and the PDP coverage will be billed from HealthSpring (Medco).
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Is the prescription drug coverage offered considered creditable coverage?
HCSC's prescription drug coverage is considered creditable coverage. Members who are eligible for Medicare can keep this coverage and should not enroll in an individual Medicare Part D plan while covered.
HealthSpring Part D Plan Notice:
Subsidiaries of Health Care Service Corporation and their affiliates contract with Medicare to offer Part D Prescription Drug Plans (PDP) in select states. Enrollment in these plans depends on contract renewal.
