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BCBSAZ Medicare Supplement Application
Fax completed applications to: (847) 220-9280 or email [email protected]
Medicare Supplement Plans
Why You Need Medicare Supplement Insurance
Medicare is a federal program to help older Americans and some disabled Americans pay for the high cost of health care. However, Medicare was never intended to cover all your health care costs. So even if you’re covered by Medicare, you are still responsible for a large portion of your health care costs. Without Medicare Supplement insurance, your out-of-pocket costs could add up to more than $51,700 this year alone.
By law, Medicare Supplement insurance is standardized into twelve plans (Plans A through L). That means Plan F from one company must include the same benefits as plan F from another company. While the benefits must be the same, each company’s rates, reputation, membership features and quality of service can vary. With Blue Cross and Blue Shield Arizona, you don’t have to sacrifice comprehensive benefits or freedom-of-choice for affordability. Their Medicare Supplement plans provide substantial benefits at rates that can save you money over other plans.
What Medicare Doesn’t Cover
Medicare does not cover all health care costs. Medicare coverage consists of Part A (which covers hospital and skilled nursing facility care), and Part B (which covers doctor bills and other medical expenses).
Even with Medicare Part A and Part B coverage, you’re responsible for some out-of-pocket expenses including:
- Part A hospital deductible ($1,556)
- Part B deductible ($233)
- Copayments for hospital stays over 60 days
- Care in a skilled nursing facility after 20 days
- Twenty percent coinsurance for doctor bills and other medical expenses
Get fit and be healthy with Silver&Fit®
BCBSAZ offers Silver&Fit® as a value-added fitness program at no cost to you. Once you enroll, you can sign up for Silver&Fit®. Your membership includes:
- Access to more than 16,500+ participating fitness centers or select YMCAs, many with exercise classes for older adults.
- 8,000+ Digital Workout Videos available at www.SilverandFit.com or download the Silver&Fit mobile app to view workout videos, perfect for all fitness levels.
- If you’re unable to get to a fitness location, you can pick your favorite home fitness kit (one per benefit year), including FitBit® Wearble Fitness Tracker Kit, Garmin® Wearbable Fitness Tracker Kit, pilates Kit, and more.
- Healthy Aging Coaching – coaches will help you meet your finess, nutrition, and lifestyle goals during scheduled phone sessions.
- Get Started Program – Answer a few online questions about your fitness level and goals to receive a personal exercise plan, including suggested workout videos.
Medicare Supplement Basic Benefits
Basic benefits included in all plans include:
- Hospitalization – Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.
- Medical Expenses – Part B coinsurance (generally 20% of Medicare-approved expenses), or in the case of hospital outpatient department services under a prospective payment system, applicable copayments.
- Blood – First three pints of blood each year.
*Plans K and L include benefits at different levels of cost sharing (see outline of coverage).
BCBSAZ Medicare Supplement Plans
BCBSAZ offers a choice of Medicare Supplement Insurance plans; Plan F, Plan G, and Plan N.
- Plan F and Plan G pay the Medicare Part A hospital deductible and co-payment(s), the skilled nursing facility copayment(s) and emergency care for foreign travel.
- Plan L is a low-cost, cost-sharing Medicare Supplement Insurance plan that requires you to pay a higher percentage of the costs in return for reduced premiums.
- BCBSAZ also offers basic Plan A, the plan with the lowest benefits.
| Plans | A | F, HD-F* | G | L** | N |
|---|---|---|---|---|---|
| Basic Benefits | X | X | X | X | X |
| Skilled Nursing Coinsurance | – | X | X | 75% | X |
| Part A Deductible | – | X | X | 75% | X |
| Part B Deductible | – | X | – | – | – |
| Part B Excess (100%) | – | X | X | – | X |
| Foreign Travel Emergency | – | X | X | – | X |
| At Home Recovery | – | – | – | – | – |
| Annual Out-of-Pocket Cost | – | – | – | $2,320 | $0 |
*Plan F also has an option called high deductible Plan F (HD-F). This high deductible plan pays the same benefits as Plan F after one has paid a calendar year $2,240 deductible. Benefits from high deductible Plan F will not begin until out-of-pocket expenses exceed $2,240. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. These expenses include the Medicare Part A and Medicare Part B deductibles, but do not include the plan’s separate foreign travel emergency deductible.
**Plan L provides for different cost-sharing than plans A-F. Once you reach the annual limit, the plan pays 100% of the Medicare copayments, coinsurance and deductibles for the rest of the calendar year. The out-of-pocket annual limit does NOT include charges from your provider that exceed Medicare-approved amounts, called “excess charges.” You will be responsible for paying excess charges.
Plan F
Plan F is the most popular Blue Cross Blue Shield of Indiana Medicare Supplement plan. No other standardized Medicare Supplement plan offered in Indiana offers more complete protection for your uncovered Part B medical expenses than Plan F.
Plan F covers:
- Your Part A deductible and coinsurance
- The cost of 365 extra days of hospital care during your lifetime after Medicare coverage ends
- Your Part B coinsurance and the cost of the first three pints of blood
- Medicare Part A hospital deductible and copayments
- Skilled nursing facility copayment
- Foreign travel emergency care
- $233 Part B Medicare deductible
- Part B doctor charges that are in excess of Medicare-approved amounts
High Deductible F
High Deductible Plan F has the same benefits as Plan F after you pay an annual $2,200 deductible. The deductible amount represents the annual out-of-pocket expenses (excluding premiums) that you must pay before the policy begins paying benefits. By having a high deductible, your premiums are significantly lower than Standard Plan F. High Deductible Plan F covers:
- Your Part A deductible and coinsurance
- Your Part B coinsurance and the cost of the first three pints of blood
- Benefits from High Deductible Plan F will not begin until your out-of-pocket expenses total $2,200.
- Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy.
- These expenses include the Medicare deductibles for Part A and B.
- These expenses do not include Plan F’s separate foreign travel emergency deductible.
- Medicare Part A hospital deductible and copayments
- Skilled nursing facility copayment
- $233 Part B Medicare deductible
- Part B doctor charges that are in excess of Medicare-approved amounts
- The cost of 365 extra days of hospital care during your lifetime after Medicare coverage
Plan G
Plan G covers:
- Your Part A deductible and coinsurance
- The cost of 365 extra days of hospital care during your lifetime after Medicare coverage ends
- Your Part B coinsurance and the cost of the first three pints of blood
- 80% of Part B physician charges that are in excess of the Medicare-approved amount (By law no physician may charge more than 115% of Medicare-approved amounts).
- Skilled nursing facility copayment
- Foreign travel emergency care
Plan G does NOT cover:
- Your $233 Medicare Part B deductible
Plan N
Plan N is identical to Plan G except there is a $20 copay for office visits and a $50 copay for emergency room visits. Like Plan G, Plan N does not cover the Medicare Part B deductible. Plan N covers:
- Your Part A deductible and coinsurance
- The cost of 365 extra days of hospital care during your lifetime after Medicare coverage ends
- Your Part B coinsurance and the cost of the first three pints of blood
- 80% of Part B physician charges that are in excess of the Medicare-approved amount (By law no physician may charge more than 115% of Medicare-approved amounts).
- Skilled nursing facility copayment
- Foreign travel emergency care
Plan N does NOT cover:
- Your $233 Medicare Part B deductible
- Part B Medical Excess Charges; charges from your provider that exceed Medicare-approved amounts. Only Plan F, High Deductible Plan F, and Plan G cover these charges. For all other plans, you are responsible for paying excess charges. In no case can a provider charge more than 115% of the Medicare approved amount.
Apply Now
Or Call 312-726-6565
Paper Application
Fax completed applications to: (847) 220-9280 or email [email protected]