BCBS Medicare Advantage Plans 2024

HMO and PPO plans differ in terms of network access and flexibility. Here are the key differences:

• HMO plans generally have a more restricted plan’s network of providers
• PPO plans have a wider network
• HMO plans require members to select a primary care physician (PCP) and obtain referrals for specialist care within the network
• PPO plans allow members to visit any doctor or specialist without a referral.

HMO plans tend to have lower costs compared to PPO plans, offering fixed copays for physician visits and outpatient laboratory tests, low deductibles, and additional benefits such as dental, vision, and fitness coverage.

However, PPO plans provide greater flexibility and the freedom to visit any healthcare provider, both in-network and out-of-network, without needing a referral.

The coverage of out-of-network services and prescription drugs by PPO plans makes them a compelling option for individuals seeking greater flexibility in their healthcare choices.

Health Maintenance Organizations (HMOs)

HMO plans typically getting your services from a primary care doctor that is within the plan’s network. 

If you require emergency care or urgent care outside of the plan’s network then you are likely covered (check with plan rules). Often HMOs may include prescription drug coverage built into the plan.  

Enrollment and eligibility for BCBS Medicare Advantage Plans depend on factors such as age, residency, and current Medicare coverage.

To be eligible, one must have both Medicare Part A and Medicare Part B, reside in one of the service areas covered by BCBS Medicare Advantage Plans, and continue to pay their Part B insurance premium.

The minimum age requirement for enrollment is 65 years and above, and applicants must be U.S. citizens or permanent legal residents who have resided in the United States.

Managing Costs with BCBS Medicare Advantage Plans

Managing costs with BCBS Medicare Advantage Plans is a primary concern for many individuals.

By comparing premiums, copays, and out-of-pocket expenses, you can find the most affordable option for your healthcare needs.

The anticipated average monthly plan premium among all Medicare Advantage enrollees in 2024 is $18.50.

Premiums will vary across different BCBS Medicare Advantage Plans based on the specific plan, hence contacting BCBS or referring to their website for plan information and premiums is advised.

Copays also play a significant role in the total cost of BCBS Medicare Advantage Plans, as they are often required for services and can contribute to out-of-pocket expenses. Grasping the out-of-pocket expenses like:

• deductibles
• copayments
• coinsurance for medical services
• prescription drugs

Understanding the details of your contract renewal can aid in making an informed decision while choosing a plan.

Telehealth Services and BCBS Medicare Advantage Plans

Telehealth services are increasingly available in BCBS Medicare Advantage Plans, providing convenient access to healthcare professionals and improving patient outcomes.

In 2020, Medicare Advantage plans were authorized to include telehealth benefits in their basic benefit package. This exceeds what was permissible under traditional Medicare before the outbreak of the COVID-19 pandemic.

To access telehealth services under BCBS Medicare Advantage Plans, beneficiaries can avail themselves of the telehealth coverage provided by BCBS companies.

Healthcare providers offering telehealth services must ensure they are providing appropriate medical services and using HIPAA-compliant platforms.

Traveler Network and Personal Choice

The Traveler Network and Personal Choice options in BCBS Medicare Advantage Plans provide added flexibility for those who frequently travel or desire more liberty in selecting healthcare providers.

The Traveler Network provides access to a broad range of medical providers, hospitals, and clinics, ensuring members can receive medical care and services even when they are outside their local area.

Personal Choice, on the other hand, allows beneficiaries to:

• Select their healthcare providers and services from within the plan’s network
• Have more control and flexibility in managing their healthcare requirements
• Access healthcare services from providers of their choice, without being restricted to a particular network

Chronic Condition Support in BCBS Medicare Advantage Plans

Chronic condition support is a key feature of BCBS Medicare Advantage Plans, providing tailored care and resources for individuals with specific health needs. BCBS Medicare Advantage plans cover a range of chronic conditions, including:

• Diabetes
• High blood pressure (hypertension)
• Chronic obstructive pulmonary disease (COPD)
• Heart failure

among others.

BCBS Medicare Advantage offers Chronic Special Needs Plans (SNPs) specifically designed for individuals living with the following conditions:

• Diabetes
• Lung disorders
• Cardiovascular disorders
• Chronic heart failure
• End-stage conditions

These plans provide specialized services, treatments, and benefits to assist in managing and supporting patients with chronic diseases, including Medicaid services.