Blue Cross Blue Shield of Minnesota
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2012 Plans for Medicare beneficiaries
Blue Cross and Blue Shield of Minnesota is a name you can count on for Medicare plans that provide protection, value and service. We’ve been helping Minnesotans with health care for over 75 years, and people with Medicare since the program began.
Plan options (more plans below):
- Platinum Blue(SM) (Cost)
- Senior Gold(SM) (Medicare supplement)
- MedicareBlue(SM) PPO
(Regional PPO) - MedicareBlue Rx (PDP)
| Platinum Blue | Senior Gold | MedicareBlue PPO | MedicareBlue Rx | |
|---|---|---|---|---|
| Key features: | A Medicare-approved Cost plan offering three plan options and the SilverSneakers® Fitness Program; our lowest priced plan for medical-only coverage | A Medicare supplement plan providing guaranteed renewable benefits and coverage that moves with you (may reside anywhere in U.S.) | A Medicare-approved PPO plan that provides the convenience of both medical and prescription drug benefits in one plan | A stand-alone prescription drug plan with a Medicare contract that can be paired with a Blue Cross medical plan (or your current medical plan); select the Standard or Premier option |
| Monthly plan premium: | $35, $79, $119 (depending on plan option) | $207 (tobacco-free) $273 (standard) Optional coverage for preventive screenings and services: $2.65 | $84.40 | $39.70 or $104.60 |
| Annual deductible: | $0 | $0 | $0 for medical, $155 for prescriptions | $0 |
| Doctor’s office visit (primary care and specialists): | 20% coinsurance, $15 copay or $0 (depending on plan option) | $0 | $25 copay (primary doctor) $35 copay (specialist) | Not applicable |
| Emergency care (in the U.S. and worldwide): | $0 to $50 copay (depending on plan option) | $0 in the U.S.; 20% coinsurance worldwide | $65 copay per visit | Not applicable |
| Travel coverage: | Plan benefits for up to 9 months outside the service area within the U.S. | Plan benefits for unlimited travel outside the service area within the U.S. | Plan benefits for up to 6 months outside the service area within the U.S. | Coverage for unlimited travel |
| Annual out-of-pocket maximum (for covered medical services): | $3,000 or $5,000 (depending on plan option) | Not applicable (minimal to no out-of-pocket costs for eligible services and supplies) | In-network: $3,400 Combined in- and out-of-network: $5,100 | Not applicable |
| Prescription drug coverage: | Not included; pair with MedicareBlue Rx | Not included; pair with MedicareBlue Rx | Included with plan | Yes |
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More plans:
- Extended Basic Blue – A Medicare supplement plan that offers the highest level of benefits available
- Basic Medicare Blue – Basic Medicare supplement protection for Medicare cost-sharing gaps
For information about plans available to residents of other states, please visit AskBlue Medicare .
How can I learn more?
You can also contact Blue Cross for plan information or to enroll: (651) 662-9949 or toll free 1-855-579-7658 or TTY 1-866-582-1158, daily from 8 a.m. to 8 p.m. Central Time. Service representatives and licensed sales representatives are available when you call this number.
Plans are available to residents of the service area. A Medicare-approved Part D sponsor and a health plan with Medicare contracts. Limitations, copayments and restrictions may apply. You must continue to pay your Medicare Part B premium (and Medicare Part A premium, if applicable). The benefits listed are for Medicare-eligible services and supplies received from in-network providers. Benefits, premiums and/or cost-sharing amounts for Platinum Blue, MedicareBlue PPO and MedicareBlue Rx may change on January 1, 2013. Premiums for Senior Gold may change on January 1, 2013. You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or Your Medicaid Office. The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan.
SilverSneakers® is a registered mark of Healthways, Inc., an independent company that provides fitness benefits. Blue Cross, Blue Shield, and the cross and shield symbols are registered marks of the Blue Cross and Blue Shield Association. Platinum Blue and MedicareBlue are service marks of the Blue Cross and Blue Shield Association. Senior Gold is a service mark of Blue Cross and Blue Shield of Minnesota.
Last updated October 1, 2011
H2461_092711_N10 CMS Approved 11/02/2011
Y0052_082411_K02_MN CMS Approved 09/09/2011
Plans are available to residents of the service area. A Medicare-approved Part D sponsor and a health plan with Medicare contracts. Limitations, copayments and restrictions may apply. You must continue to pay your Medicare Part B premium (and Medicare Part A premium, if applicable). The benefits listed are for Medicare-eligible services and supplies received from in-network providers. Benefits, premiums and/or cost-sharing amounts for Platinum Blue, MedicareBlue PPO and MedicareBlue Rx may change on January 1, 2013. Premiums for Senior Gold may change on January 1, 2013. You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or Your Medicaid Office. The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan.
SilverSneakers® is a registered mark of Healthways, Inc., an independent company that provides fitness benefits. Blue Cross, Blue Shield, and the cross and shield symbols are registered marks of the Blue Cross and Blue Shield Association. Platinum Blue and MedicareBlue are service marks of the Blue Cross and Blue Shield Association. Senior Gold is a service mark of Blue Cross and Blue Shield of Minnesota.
Last updated October 1, 2011
H2461_092711_N10 CMS Approved 11/02/2011
Y0052_082411_K02_MN CMS Approved 09/09/2011
