Discover a host of Medicare health care coverage choices for your retirees from Blue Cross and Blue Shield of Texas (BCBSTX). Options for employers and union groups include Medicare Advantage with Prescription Drug coverage (MAPD), stand-alone Prescription Drug Plans (PDP) and Medicare Supplement plans.
Blue Cross Group Medicare OptionsSM
Richer Benefits, Lower Costs
Our customizable group Medicare options deliver a richer design, better benefits, more flexibility and lower member costs to your retirees than individual Medicare plans. What’s more, existing BCBSTX members can easily move to their group retiree Medicare plan with little disruption.
Medicare Advantage Plans for Groups
Blue Cross Group Medicare Advantage Open Access (PPO)SM
- Provides freedom from network restrictions because members can seek care from any provider that accepts Medicare in and out of network across the nation with the same level of coverage.
- Members do not have to choose a primary care provider and can receive care from a specialist without referral.
- Offers the most benefits bundled together
- Includes Medicare Part D prescription benefits
Blue Cross Group Medicare Advantage (HMO)SM
- Members are covered when they seek care in network, and both in and out of network for emergencies.
- A primary care provider must refer a member to a specialist.
- Provider selection is limited but retiree costs may be lower.
- Includes Medicare Part D prescription benefits
Blue Cross Group Medicare Advantage (PPO)SM
- Members can seek care in and out of network across the nation. However, out-of-network visits have different cost sharing when compared with in-network providers.
- Members do not have to choose a primary care provider and can receive care from a specialist without referral.
- Traditional PPO that bundles benefits
- Includes Medicare Part D prescription benefits
Blue Cross Group MedicareRxSM
- Our stand-alone Medicare Part D Prescription Drug Plans (PDP) provide coverage for outpatient medications not covered by original Medicare.
- Robust pharmacy network consisting of retail locations throughout the country, national and regional chains and independent pharmacies. Multiple pharmacy network configuration options available.
- No deductible and supplemental drug buy-up options.
- Account can be set up with one bill for all retirees sent to the employer, with billing sent direct to retirees, or with billing split between employer and retirees.
BlueStagesSM Medicare Supplement Insurance Plan
- For expenses beyond what is covered by original Medicare Parts A and B, groups can offer group Medicare supplement insurance, also known as Medigap insurance.
- Members may continue to seek care from any provider that accepts Medicare.
- BlueStages does not include Medicare Part D prescription drug coverage. Often, BlueStages is packaged with a PDP plan.
- Members cannot be billed directly. The employer collects member premium payments. If BlueStages is combined with a PDP plan, an employer will be billed for each product separately.
Extra Health and Wellness Benefits
Our group MAPD plans have benefits above and beyond standard health insurance. However, the availability, cost and level of coverage can vary and be customized. They include:
- Dental
- Vision
- Hearing
- Over-the-counter allowance
- Discount programs
- Fitness program
- Transportation
- Member rewards program
- Post-discharge meals
Billing Options
Group account billing can be set up in one of the following ways:
- One bill for all retirees sent to the employer
- Billing sent direct to retirees
- Billing split between the employer and retirees