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Medicare Plans for Individuals

Medicare health coverage through Blue Cross and Blue Shield of Oklahoma 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 and PPO plans bundle cost saving and value-added options with Original Medicare benefits. Here are some plan highlights.

Blue Cross Medicare Advantage (HMO)SM

  • Typically have lower or $0 monthly premiums
  • Members have flexibility to see their care is handled by one primary care provider (PCP) who knows their health history
  • Members pay a predetermined copay rate and no coinsurance to see doctors or provider in the network
  • Members may be required to get a referral from their primary care physician 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 have freedom to use doctors, hospitals and providers outside the network, but they might pay higher copays and coinsurance
  • Members will 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, BCBSOK 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

BCBSOK provides several excellent supplemental plans for Oklahoma residents over age 65 or who are eligible for Medicare. For Oklahomans over age 65, they are guaranteed acceptance if they have Medicare Parts A and B.

BCBSOK offers a variety of 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 BCBSOK Medicare Supplement plans.

 

Last Updated: Dec. 04, 2023