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Medicare Advantage Plan Options

There are two Blue Cross and Blue Shield of Texas Group Retiree Medicare Advantage plans available:

Blue Cross Group Medicare Advantage Open Access (PPO)^SM (MPO)
Blue Cross Group Medicare Advantage (HMO)^SM (PMA)

These plans bundle Medicare Part A, Part B and Part D, plus extra health and wellness benefits not offered by Original Medicare. Both cover most common services such as provider visits, inpatient hospital and outpatient services, emergency care, as well as prescription drugs. They coordinate your care and offer disease prevention and management resources. The plans also take care of claims, and coordinate with Medicare.

Plan Documents

Find plan information and documents below. Detailed documents for each plan type are listed after the plan descriptions.

Blue Cross Group Medicare Advantage Open Access (PPO)(MPO)

This is a national plan covering all eligible beneficiaries regardless of where they reside in the U.S., and 5 U.S. territories. Because this is an open access plan, you can visit doctors, specialists and hospitals in or out of the Blue Cross and Blue Shield of Texas network for the same cost share as long as the provider is willing to see you as a patient, participates in Medicare and agrees to submit claims to the plan. Referrals are not required to see a specialist.

2025 Open Access (PPO)(MPO) Plan Documents

Plan documents will be posted as they are available.

Blue Cross Group Medicare Advantage (HMO)(PMA)

Your care is handled by a primary care provider who knows your health history. If you choose to enroll in the HMO plan, you must reside in the state of Texas. You are required to select a primary care provider (PCP) to coordinate your care. The HMO has a network of doctors, hospitals, pharmacies and other providers. If you use providers that are not in the network, the plan may not pay for those services. Visit Provider Finder^® to find a participating provider. Referrals are required to see a specialist.

2025 HMO (PMA) Plan Documents

Plan documents will be posted as they are available.

Prescription Drug Benefits

Both plans include prescription drug benefits, so you will not need a separate Medicare Part D plan. Prescription drug benefits cover common outpatient medications, like those used to treat blood pressure, cholesterol, depression and arthritis. You will have a copay for each Part D prescription. There is no Part D deductible to meet before your drugs are covered. Both plans have the 5 Tier Premier Formulary.

Enrolling in Medicare

If you are enrolling for the first time, you must submit a completed Retiree Health Benefit Enrollment form to your Human Resources department before your Medicare Advantage plan would become effective. You may submit the form up to 60 days in advance.

Enrollment in Medicare Part A and Part B through the federal government is required for retirees to be eligible for any retiree Medicare plans, including these PEBC Medicare Advantage plans. To have full coverage, you must sign up for Medicare Parts A & B and continue to pay your Part B premium. Please call the Social Security Administration at 1-800-772-1213 (TTY 1-800-325-0778) or go to www.ssa.gov to enroll in Medicare.

IMPORTANT: NEW MEMBER NUMBER
As a Blue Cross Group Medicare Advantage^SM member, you have a new member number and ID card. Be sure to show your new card to your providers or their office staff. Remind them that your old ID is no longer valid. If the provider does not use your new member number, your benefits cannot be confirmed and there may be delays in receiving care and processing your claims.

Welcome Call

We want to welcome you to your plan and answer any questions you may have. You will receive a call within the first 3 months of your plan on behalf of Blue Cross and Blue Shield of Texas to review your contact information, language preference, Rewards Program registration, and supplemental benefits.

If we are unable to reach you by phone, you may receive a Health Questionnaire Postcard in the mail. We appreciate your feedback.

Please note, you may opt out of communication at any time.

Need Help?

If you need personalized help, call 1-877-842-7564 (TTY 711). We are open:

October 1 – March 31 : Daily, 8:00 a.m. to 8:00 p.m., Local Time.
April 1 – September 30: Monday through Friday, 8:00 a.m. to 8:00 p.m., Local Time.

Alternate technologies (for example, voicemail) will be used on weekends and holidays.