In addition to covering Original Medicare, our group retiree Medicare Advantage plans can also include these medical benefits.
Retiree Coverage
Group Medicare Options
Whether you’re moving retirees from a commercial plan to a Medicare solution, or seek a retiree-only health plan, the Benefit of Blue® translates to superior service for you and your retirees.
Clients across all sectors value our approach
Financial Savings Through Product Innovation
Our product suite includes Medicare Advantage with and without Part D prescription drug, and Part D-only solutions.
Fully insured plans are tailored to meet employer needs. Expert consultation around plan design and a robust clinical model improve retiree health and wellness.
Strong Provider Relationships and Clinical Expertise
Robust national provider and pharmacy networks ensure access.
Clinical expertise and long-standing provider relationships reduce retiree disruption and create avenues for best-in-class, value-based care. It’s our mission to provide health care that treats the whole person.
Exceptional Retiree Experience
Retiree communications are key so we invest in member outreach and education initiatives.
Our dedicated customer service and account teams focus on group retiree needs, address questions and concerns thoroughly, and ensure a smooth transition.
Retirees participating in Blue Cross Group Medicare Advantage Open Access (PPO)℠ enjoy the flexibility to see any provider in the United States that accepts Medicare and will submit claims to the plan.
Group Retiree Medicare Plans
Group Retiree Medicare Solutions are employer and other group-sponsored Medicare plans that can be customized for retirees. Plans often provide benefits like vision, dental and hearing that are not included with Original Medicare (Medicare Part A and B).
Retirees may enjoy lower out-of-pocket costs and coverage that’s comparable or better than the coverage they had while working. Many employers help their retirees by covering part of the costs for premiums, copays or coinsurance. They may be offered to both retirees and their dependents who qualify for Medicare.
Group Retiree Medicare Plans
| Plan Name | Blue Cross Group Medicare Advantage Open Access (PPO)℠ Plan | Blue Cross Group Medicare Advantage (PPO)℠ Plan | Blue Cross Group Medicare Advantage (HMO)℠ Plan |
| Network Flexibility | Nationwide, no in-network or out-of-network restrictions | Nationwide, but in-network and out-of-network costs are different | Must use in-network providers. In and out-of-network is covered for emergencies |
| PCP Selection | Not required | Not required | Required |
| Specialist Referral | Not required | Not required | Required |
| Part D Prescription Benefits | Usually included. MA only plans are available | Included | Included |
| Benefits | Offers the most benefits bundled together | Traditional PPO that bundles benefits | Provider selection is limited but retiree costs may be lower |
Part D Prescription Drug and Supplemental Plans for Groups
| Plan Name | Blue Cross Group MedicareRx (PDP)℠ Plan | BlueStages℠ Medicare Supplement Insurance Plan |
| Drug Coverage | Coverage for outpatient medications not covered by Original Medicare | Not covered. Often paired with a PDP Plan |
| Network Type | Broad pharmacy network with multiple configuration options available | Can visit any provider that accepts Medicare |
| Deductible | Zero-deductible buy-up options available | N/A |
| Supplemental Drug Options | Buy-up options available | N/A |
| Billing Options | Account, direct, or split-billing available | Member cannot be billed directly. The employer collects member premium payments. If paired with a PDP plan, an employer is billed for each product separately. |
Medicare Advantage Benefits
Medical Wellness Benefits
Dental Coverage
Preventive and comprehensive plan options are available.
Vision Coverage
Options include annual routine exam, glaucoma screening and eyewear allowances.
Hearing Coverage
Plans can provide coverage for routine hearing exams and may include an allowance on hearing aids.
Virtual Visits
Doctors are available 24/7 via phone, mobile app or online for non-emergency medical and mental health care.
Lifestyle Wellness & Prevention Benefits
SilverSneakers® Fitness Program
Benefits include instructor-certified classes in thousands of locations nationwide. Virtual classes available.
Post-Discharge Meals
After hospital stays, members receive nutritious meals to aid in recovery.
Member Rewards Program
Members earn up to $100 gift cards from national and local retailers for going to annual check-ups or getting a flu shot.
Blue365® Discount Program
Discounts include contacts, dental care, fitness devices, glasses, healthy meals, hearing aids and more.
Over-the-Counter Medications Allowance
Drugstore medications and product allowances include antacids, first aid supplies, pain relievers, and more.
Non-Emergency Transportation
One-way transportation to covered medical service visits are available.
Delivering White Glove Service
The expert support retirees receive allows them to feel confident about transitioning to their new group retiree Medicare plan.
Convenient Digital Tools
Retirees can maximize their benefits with their member account online or via our mobile app to get plan documents, check coverages and costs, view claims, order an ID card and more.
Call Center Support
Our dedicated Medicare customer service advocates are available before, during and after enrollment to help retirees understand their plan and answer questions.
Generous Supplemental Benefits
Members have access to free wellness and fitness programs, virtual visits, nurse advice hotline, worldwide emergency travel, plus member rewards and discounts.
SilverSneakers® is a wellness program owned and operated by Tivity Health, Inc., an independent company. Tivity Health and SilverSneakers are registered trademarks or trademarks of Tivity Health, Inc., and/or its subsidiaries and/or affiliates in the USA and/or other countries.
Blue365 is only available to BCBSTX members with active health plan coverage. Members who do not have active health plan with BCBSTX will not be able to register on the Blue365 website. The relationship between Blue365, its vendors and BCBSTX is that of independent contractors. Blue365 is a discount program available to BCBSTX members who have medical coverage with BCBSTX. This is NOT insurance. Some of the services offered through Blue365 may be covered under your health plan. Refer to your benefit booklet or call the customer service number on your ID card for specific benefit information under your health plan. Use of Blue365 does not affect your premium nor do costs of Blue365 services or products count toward your plan deductible, calendar year or lifetime maximums. Discounts are only available through participating vendors. BCBSTX does not guarantee or make any claims or recommendations regarding the services of products offered by Blue365 and its vendors. You may want to consult with your physician prior to use of these services and products. Services and products are subject to availability by location. BCBSTX reserves the right to discontinue or change this discount program at any time without notice.
https://www.bcbsil.com/medicare/group-retiree-medicare/extra-health-and-wellness-benefits