Frequently asked questions

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Q: What is Medicare? 

A: Medicare is a Federal health insurance program for people ages 65 years or older, certain people with disabilities, and people with permanent kidney failure treated with dialysis or a transplant. Medicare has three parts - Part A, which is hospital insurance; Part B, which is medical insurance; and Part D, which is prescription drug coverage.

Q: What is a Blue Medicare Supplement plan? 

A: Medicare Supplement insurance policies are sometimes called Medigap plans. Medigap plans are private health insurance policies that cover some of the costs original Medicare (Parts A and B) does not cover. Some Medigap policies will cover services not covered by Medicare, such as preventive care. Medigap has 10 standard plans called Plan A through J, and 2 high deductible plans called Plan H Prime and J Prime. BCBSNC offers Plans A through Plan F and Plan H through Plan J.¹

Q: Why do I need a Blue Medicare Supplement plan? 

A: Medicare does not pay for all of your health care bills. Supplemental plans are designed to pay many of those extra expenses not covered by Medicare alone, such as deductibles and copayments.¹

Q: Will I have a waiting period for any pre-existing conditions? 

A: Pre-existing conditions are conditions for which medical advice was given or treatment was recommended by or received from a doctor within six months of the effective date of coverage. The six month waiting period will be reduced by the amount of time you have spent under other health insurance coverage as long as the coverage is terminated no more than 63 days prior to your effective date. The six month waiting period is also waived if you apply within six months of your Medicare Part B enrollment date.

Q: Do I have to answer health questions to qualify for a Blue Medicare Supplement plan? 

A: No, if you apply six months before or six months after your 65th birthday, or if you apply within six months of your Medicare Part B effective date. Yes, if you apply six months past your Medicare Part B effective date.

Q: Will my rates increase because I get older? 

A: No. If you receive an increase in the future, it will be due to medical inflation or claims experience. You will never be singled out for a rate increase, provided that you stay in your current Blue Medicare Supplement plan.²

Q: What action should I take when I receive an explanation of benefits statement? 

A: The explanation of benefits statement is not a bill. It is a notification that your claim has been processed and indicates any amounts paid, denied or owed by you to providers of care.

Q: What does the "Your Balance" field mean on the explanation of benefits statement? 

A: This is the amount you are responsible to pay to the provider of care.

Q: Does the "Your Balance" field include prior payments (made by subscriber or Medicare)? 

A: No. The "Your Balance" field indicates our calculation of your liability. Any amounts paid by you or Medicare are not reflected in the calculation.

Q: Where can I get more information regarding Medicare? 

A: Please visit http://www.medicare.gov

Q: Is prescription drug coverage a benefit of any of the Blue Medicare Supplement Plans? 

A: Prescription drug coverage is not included as a benefit of any Blue Medicare Supplement plan. On January 1, 2006, Medicare’s prescription drug coverage became effective. Medicare Prescription Drug Coverage was designed by the U.S. Congress to help you pay for the prescription drugs you need. If you would like this prescription drug coverage, you must purchase it separately from your Medigap (Blue Medicare Supplement) health plan. Everyone with Medicare is eligible for this coverage. Beneficiaries are not automatically enrolled. You may choose to purchase this private insurance on an annual basis.

Q:  Does BCBSNC offer prescription drug coverage for Medicare beneficiaries? 

A: Yes. You may choose from two Medicare Prescription Drug Plans. These plans must be purchased separately from your Blue Medicare Supplement plan. Everyone with Medicare, or entitled to Medicare is eligible for this coverage. Medicare beneficiaries are not automatically enrolled, and joining is not mandatory. However, you may have a late enrollment penalty imposed by the federal government if you do not have creditable coverage at the time you enroll. You may choose to purchase this coverage on an annual basis. To learn more about plan benefit and review rates, go to Medicare Prescription Drug Plans.

Q: What if I have a drug discount card? 

A: If you were enrolled in a Medicare-approved drug discount card plan, Medicare prescription drug coverage replaced that program as of January 1, 2006, and the discount card is no longer available. That’s because the discount card program was intended to provide temporary assistance, until Medicare Prescription Drug Coverage was implemented.