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.
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 foreign travel emergency care.
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
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.
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.
A: Yes. Attained-age plans have low initial rates that increase due to age and overall claim experience. Our rates will only increase due to age when you move from one age band to the next.2
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.
A: This is the amount you are responsible to pay to the provider of care.
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.
A: Please visit http://www.medicare.gov
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.
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.
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.
1 The policy is the insurance contract. You must read the policy itself to understand all the rights and duties of both you and your insurance company. These policies may not cover all of your medical costs. Neither Blue Cross and Blue Shield of North Carolina nor its agents are endorsed by or affiliated with the United States government or the federal Medicare program.
2 When you enroll in an attained-age plan, your rates will increase as you age, due to your age. Our rates will only increase due to age when you move from one age band to the next. In addition, rate adjustments will also be due to medical inflation or overall claims experience. Rates are subject to change June 1 of each year and are guaranteed for 12 months. Any change in rate will be preceded by a 30-day notice. Members will not be singled out for premium increases based on their individual health. Medicare policies that are attained-age should be compared to issue-age rated policies. Premiums for issue-age policies do not increase due to age as the insured ages.
BCBSNC is a prescription drug plan sponsor with a Medicare contract. Prescription drug coverage is not sold as a benefit of any Medicare supplement plan.
If your coverage with BCBSNC has ended and you need proof of coverage or a Certification of Health Insurance Coverage, please call Customer Service at 1-800-672-6584, Monday - Friday, 8 a.m. to 6 p.m.
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