Individual Medicare Plans
Medicare health coverage through Blue Cross and Blue Shield of Texas includes Medicare Advantage with Prescription Drug plans (MAPD), stand-alone Medicare Prescription Drug Plans (PDP), and Medicare Supplement Insurance Plans.
Producers selling our Medicare products have a large variety of options to share with their clients and a host of marketing and sales tools at the ready when they work with us.
Medicare Advantage Plans
Our HMO and PPO plans bundle cost-saving and value-added options with Original Medicare benefits. Here are some plan highlights. (Producers must be certified to sell MAPD plans.)
| Plan Name | HMO | PPO |
| Monthly Premiums | Typically lower or $0 | Tend to be higher |
| Primary Care Provider (PCP) | Required | Not required |
| Network Flexibility | Must use in-network | Can use out-of-network |
| Referral for Specialists | May require referral from PCP | Not required |
| Cost Savings | Lower costs in-network | Higher costs for out-of-network |
| Prescription Drug Coverage | May or may not be covered | Includes drug coverage |
Prescription Drug Plans
Our prescription drug plans go beyond Original Medicare to offer coverage for prescription drugs. Whether your clients have a few prescriptions or a lot, BCBSTX offers plans that can work for their health care needs and budget. Here are highlights of each plan. (Producers must be certified to sell PDP.)
| Plan Name | Blue Cross MedicareRx Choice (PDP)℠ | Blue Cross MedicareRx Value (PDP)℠ | |
| Pharmacy Network | Nationwide | Nationwide | |
| Annual Deductible | $0 deductible for tier 1 and tier 2 generic drugs Deductible applies to tiers 3, 4 and 5 | $0 deductible for tier 1 and tier 2 generic drugs Deductible applies to tiers 3, 4 and 5 | |
| Gap Coverage | No gap coverage | Gap coverage for Tier 1 only | |
| Formulary Type | Essential Formulary for those who take no drugs or few generic drugs | Broad Formulary for those who need greater coverage for brand name and generic drugs |
Medicare Supplement Plans
BCBSTX offers several Medicare Supplement coverage options. Each plan covers a different set of costs. We also offer money-saving high deductible options.
