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BlueCross BlueShield of North Carolina

Group Medicare Options

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Are you looking for quality coverage for your retirees? Blue Cross and Blue Shield of North Carolina (BCBSNC) offers Medicare Advantage and prescription drug plans that can be customized to meet the needs of your retirees - and your business.

BCBSNC can help you manage coverage for your growing number of retirees. We'll also help ease the transition for employees as they move from your active plan to retiree coverage. All while providing the same quality coverage you offer for your active employees.

BCBSNC offers three types of retiree coverage:

Blue Medicare HMOSM (Health Maintenance Organization) is a Medicare Advantage plan that provides health care and services from doctors and hospitals that are within the plan's network.

  • Provides Parts A and B coverage, while keeping out-of-pocket costs lower
  • Includes coverage for inpatient and outpatient services, skilled nursing facility care, home health care and more
  • No referral needed to see a specialist

Blue Medicare PPOSM (Preferred Provider Organization) is a Medicare Advantage plan that provides health care and services from doctors and hospitals in the plan's network, but also allows recipients to go to doctors and hospitals outside of the network, usually at a higher cost.

  • Provides Parts A and B coverage, while keeping out-of-pocket costs lower
  • Includes health care benefits and Medicare prescription drug coverage, combined in one plan1
  • PPO Network Sharing provides access to in-network providers across the U.S.
  • No referral needed to see a specialist

Blue Medicare RxSM (Prescription Drug Plan) is a prescription drug plan for Medicare customers, servicing all of North Carolina.1

  • Uses a pharmacy network that includes most national chains, and includes mail order pharmacy services
  • Provides additional savings with our Preferred Pharmacy Network
  • Makes prescription refills easy with mail order pharmacy services that deliver prescriptions directly to recipients


  1. A formulary applies for all plans that include Medicare prescription drug coverage.

Why Choose Blue?

Blue Cross and Blue Shield of North Carolina (BCBSNC), the most trusted health insurance company in North Carolina, is pleased to offer quality Medicare coverage for your business.1 We offer a Medicare Advantage plan with an extensive network to meet the needs of your retirees.

But BCBSNC is about more than just health insurance:

  • We're a proud supporter of the Senior Games, a year-round health promotion and education program for seniors with over 60,000 participants, as well as the Special Olympics here in North Carolina
  • We're a grateful recipient of AARP's Top Employer for Employees Over 50 Award and the 2013 World's Most Ethical Company Award from Ethisphere2
  • We're an active corporate citizen in North Carolina, providing support and volunteers for Habitat for Humanity, North Carolina food banks and many other local causes

We're committed to our state and our customers, whether we're providing quality Medicare Advantage or prescription drug plans, customizing retiree plans to best suit your business, or doing our part to make health care more accessible and more affordable in North Carolina.

Thank you for your interest in BCBSNC.



  1. Prophet Brand Tracking Study; October 2012. Total sample size: 2,900.
  2. Awarded to BCBSNC by the Ethisphere Institute. In 2013, companies in more than 100 countries and 36 industries were reviewed and of those 138 organizations were designated as World's Most Ethical.

Medicare is made up of different parts, each handling different types of health care services or supplies:

Medicare Comparison

Medicare Parts A and B (Original Medicare)

Parts A and B (also known as Original Medicare) are run by the Federal Government. With these parts, the government pays the doctors and hospitals you visit directly for your health care services.

Part A covers:

  • Hospital inpatient care services
  • Inpatient care for nursing homes or other skilled nursing facilities
  • Hospice care

Part A pays most hospital costs for stays that last up to 60 days annually. After 60 days, you pay a daily copayment for each additional day. If you're hospitalized for more than 90 days, you may have to pay for all of your care.

Part B covers:

  • Doctor visits
  • Outpatient care (including preventive services)
  • Physical or occupational therapy
  • Home health care services that are medically required

Part B doesn't limit how many covered medical services you can get, as long as the services are medically necessary to treat a medical illness or condition. Some services, such as preventive care and screenings, may be limited.

In addition, with Parts A and B:

  • You can enroll in Medicare Part D to receive prescription drug coverage
  • You can enroll in a Medicare Supplement plan, to help with the Part A and Part B costs that Medicare doesn't cover

Medicare Part C (Medicare Advantage)

With Part C plans, the government pays a set fee to your plan for your health care and then your plan pays the doctors and hospitals.

Part C plans include:

  • The same coverage and services as Medicare Parts A and B, plus additional benefits (such as vision and dental)
  • Part A benefits, including hospital visits, skilled nursing care and home health care
  • Part B benefits, including doctor visits, outpatient care, screenings, shots, lab tests, etc.
  • Prescription drug coverage, if Part D coverage is included in the Part C plan

Some Part C plans may also include coverage for other services, including fitness programs or hearing and vision care.

We provide two types of Medicare Advantage plans:

  1. Health Maintenance Organization (HMO): Known as Blue Medicare HMOSM. This plan features a network of doctors and hospitals where you can receive medical services.
  2. Preferred Provider Organization (PPO): Known as Blue Medicare PPOSM. Provides the flexibility to visit doctors and hospitals inside and outside of the plan's network, but services outside the network usually cost more than inside the network.

You must be entitled to Part A and enrolled in Medicare Part B to get a Medicare Advantage plan.

Medicare Part D (Prescription Drug Plans)

Part D plans help pay for prescription drugs, as well as brand name and generic medications.

Part D plans have:

  • Formularies, which are lists of the drugs covered under a plan
  • Different levels of cost-sharing, which means you pay different amounts for your prescription drugs, depending on the level
  • A network of available pharmacies for you to choose from, and can include local or nationwide access, or mail order pharmacy services

Important Legal Information and Disclaimers

The information on this page is current as of 10/1/2014.

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