Blue Cross Blue Shield Of Michigan New Medicare Advantage PPO
Blue Cross Blue Shield of Michigan today announced a new Medicare Advantage PPO product that for many Michigan seniors provides benefits at lower premiums than Original Medicare coupled with Part D drug plans and supplementary coverage.
“Our new Medicare Advantage PPO provides the comprehensive coverage seniors want, including prescription drugs and benefits Original Medicare doesn’t provide,” said Mark Owen, BCBSM vice president for federal programs and individual business.
Blue Cross launched the PPO to replace two current Private-Fee-For Service (PFFS) Medicare Advantage products – Options C and D – whose premiums would have been most negatively affected by reductions in government funding for Medicare Advantage, coupled with medical cost increases for Michigan beneficiaries that in some cases are twice as high as the national average.
“We know that many seniors stay in the products they are enrolled in, without shopping around,” Owen said. “We decided that it would be better to replace these two products with an affordable PPO option, rather than impose large premium increases onto the people enrolled in them. All of the beneficiaries in our C and D plans are being notified by letter, we have briefed senior assistance agencies on our changes, and Blue Cross stands ready to assist beneficiaries with making the right product choice for their health care needs.”
BCBSM Medicare Advantage premiums and products for 2010 are changing due to federal government reimbursement cuts and increased medical costs.
Two other current BCBSM Private Fee for Service products, Medicare Plus Blue Options A and B, will remain in place for 2010. Their premiums also will be affected by reductions in government funding and increases in medical costs.
Called Medicare Plus Blue PPO, the new Medicare Advantage PPO product will have a network of more than 18,000 Michigan physicians and 136 Michigan hospitals and will be available in 75 out of 83 Michigan counties.
Medicare Plus Blue PPO also provides services that are not available in Original Medicare or Medicare Supplemental plans. The following are examples of some of these:
- preventive dental services
- routine physicals
- expanded home infusion therapy
- world wide coverage for emergency care
- prescription drug coverage
- total body skin exams
Care management tools and resources through BlueHealthConnection that help members navigate the complexities of our health care system and support them in regaining and maintaining their health and independence.
October 1 is the first day BCBSM and Medicare Advantage carriers across the nation can market their Medicare Advantage products for 2010. Beneficiaries in BCBSM Medicare Advantage products will receive letters in the next 10 days about the new product line-up.
“Blue Cross remains fully committed to providing products to Medicare beneficiaries and will continue to have the broadest array of Medicare Advantage products in the state,” said Mark Owen, BCBSM vice president for federal and individual business. “It’s important for Medicare beneficiaries to know that there is no immediate change to their coverage. They have until the end of the year to make their selection for 2010.”
In addition to the three BCBSM products for 2010, seniors also can select from three Medicare Advantage products offered by Blue Care Network, the BCBSM-affiliated HMO.
“We will be working with insurance agents and other groups across the state to reach out to Medicare beneficiaries to help them navigate these product and premium changes,” said Owen.
Seniors who meet low income guidelines can receive subsidies from the state and/or federal government to pay for all or part of their premiums.
Medicare Advantage premiums vary by product and region. The new PPO product is expected to provide beneficiaries with value for their premium. For example, the BCBSM Medicare Plus Blue PPO, which includes Part D prescription drug coverage, will cost between $61 and $141 a month (premiums vary by geographic region), while traditional BCBSM Medicare Supplemental (Medigap) Plan C plans cost $183 when combined with a stand-alone Part D BCBSM prescription drug program.
Medicare Advantage plans offer Medicare benefits through private health insurance plans and most include Part D prescription drug coverage. When you purchase a Medicare Advantage plan, you do not need to also purchase a Medigap policy. Medicare Advantage plans are regulated solely by the federal government, while Medigap plans are regulated by the state. The announced product changes are only for Medicare beneficiaries who directly purchase their Medicare Advantage products, not for beneficiaries enrolled in a group plan.
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