Frequently Asked Questions (FAQs)

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 equal to if not better than the Traditional plan offerings. 

These two plans are bundled together and serve as one of the available plan options. BlueSecure is a group retiree plan that works with Medicare Parts A and B to cover your medical and hospital 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. Blue Cross Group MedicareRx (PDP) is a Medicare Prescription Drug Plan that covers a broad range of prescription drugs.

For those who enroll in our BlueSecure medical plan option, HCSC also requires that you enroll in our Blue Cross Group MedicareRx (PDP) plan option.

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.

This is the other plan option available to 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. 

Our MAPD plan is an Open Access plan, 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.

With BlueSecure, you can choose any doctor or specialist who: 1) accepts Medicare; 2) agrees to see you as a patient; and 3) will send claims to the plan. Find providers who do at www.medicare.gov/care-compare. This website is run by the Federal government, which keeps track of all providers accepting Medicare patients.

The prescription drug coverage included in the MAPD and Blue Cross Group MedicareRx℠ 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 and Blue Cross Group MedicareRx plans can be found on the retiree website.

The monthly premiums are lower than those for the Traditional plans. Before the Open Enrollment period later this year, you will get an Open Enrollment package which will include your 2025 health plan contribution amounts.

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.

Yes, your enrollment in the HCSC Group Dental plan will remain active for you and your Medicare-eligible dependents.

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 until they become Medicare-eligible. The Medicare-eligible participant must be retired and at least 65 years of age as of January 1, 2025.

Your child(ren) will no longer remain on your health insurance as dependents once you move to one of the Group Retiree Medicare Plans. They will be termed from coverage on the Traditional plan. 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.

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 to not submit the claim on your 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 the following 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.

Yes. 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 in 2025.

When enrolling in one of the plan options offered for 2025, 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 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.

 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 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.