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Medicare Plans for Individuals

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.

Blue Cross Medicare Advantage Plans

Our HMO, HMO-POS 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.)

Blue Cross Medicare Advantage (HMO)SM

  • Typically have lower or $0 monthly premiums
  • Care is handled by one primary care provider (PCP) who knows the member's health history
  • Costs will be as low as possible when members see a provider in the network
  • Members may be required to get a referral from their PCP prior to visiting a specialist
  • These plans may or may not cover prescription drugs

Blue Cross Medicare Advantage (PPO)SM

  • Tend to have higher monthly premiums
  • Members are not required to select a PCP
  • Members may use doctors, hospitals and providers outside of the network, but they may pay higher copays and coinsurance
  • Members save money if they use doctors, hospitals and other health care providers within the plan’s network
  • These plans may or may not cover prescription drugs

Blue Cross MedicareRx Plans

Blue Cross MedicareRx plans go beyond Original Medicare to offer coverage for prescription drugs. Whether your clients have a few prescriptions or a lot, BCBSIL 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 plans.)

Blue Cross MedicareRx Basic (PDP)SM

  • Nationwide Pharmacy Network
  • Annual deductible applies to all Tiers
  • No Gap coverage
  • Narrow Formulary

Blue Cross MedicareRx Choice (PDP)SM

  • Nationwide Pharmacy Network
  • Annual deductible applies to Tiers 3, 4, and 5
  • No Gap coverage
  • Essential Formulary

Blue Cross MedicareRx Value (PDP)SM

  • Nationwide Pharmacy Network
  • Annual deductible applies to Tiers 3, 4, and 5
  • Gap coverage for Tier 1 Only
  • Broad Formulary

Medicare Supplement Insurance Plans

BCBSTX provides excellent supplemental plans for Texas residents over age 65 or who are eligible for Medicare. For Texans over age 65, they are guaranteed acceptance if they have Medicare Parts A and B.

BCBSTX offers four main Medicare Supplement coverage options. Each plan covers a different set of costs. We also offer a money-saving option called Medicare Select. With this option, the Medicare Part A deductible is covered for non-emergency care at Medicare Select hospitals. If it’s an emergency, the Part A deductible is covered at any hospital. An added advantage to the Medicare Select plans —  your client's premiums will be even lower than our already competitive Standard rates.

Learn more about all BCBSTX Medicare Supplement plans.

Last Updated: Nov. 27, 2023