When you turn 65, you have options for your health care. People often think that when they hit this milestone birthday, they are automatically enrolled in Medicare or that coverage is complete. That is not the case. 

Here are some important things to know about Medicare and your options. 

What kind of Medicare plans does BlueCross have? 

BlueCross has Medicare Advantage, Medicare Supplement and prescription drug plans. 

What is the benefit of a BlueCross Medicare plan? 

Not all health plans are alike. BlueCross is the only South Carolina based Medicare plan. South Carolinians answer the phones when you call. Your neighbors are here to service you when you choose a BlueCross plan. 

BlueCross is not publicly traded on Wall Street. We are member-focused, not shareholder-focused. And with more than 75 years in the state, we’ve proven a commitment to our state. 

But that’s not all. There’s more benefits to choosing a BlueCross Medicare plan: 

• Five-star customer service, according to the Centers for Medicare & Medicaid Services (CMS)
• Stable network coverage across the state 
• Flexibility with a 36-month trial 

What is the 36-month exclusive trial rights? 

BlueCross gives members more flexibility than any other carrier in South Carolina. We offer a 36-month trial if BlueCross Medicare Advantage is selected when you are new to Medicare. 

We did this to give members the most peace of mind and flexibility. When you elect a BlueCross Medicare Advantage plan during your initial election period or initial coverage election period, you can switch to a BlueCross Medicare Supplement plan without underwriting, regardless of health status. 

It is important to know: 

• The 36-month period begins when Medicare becomes your primary health insurance. 
• You must maintain continuous BlueCross Medicare Advantage coverage during the 36-month period. 
• You must enroll in a BlueCross Medigap plan during a CMS-approved period that allows switching. 
• Members receive the standard BlueCross Medigap rate with any discounts that apply at that time of enrollment. 

We are the only plan in South Carolina to offer this flexibility to its members. CMS allows for a 12-month trial right on Medicare Advantage plans. After this period, members will usually have to undergo underwriting to determine health status and eligibility. 

Where can I get help understanding my Medicare options? 

You can reach us any time on the phone if you have questions about your Medicare coverage. Call us at 800-760-3690. 

You can also visit us in-person at one of our South Carolina BLUE^SM retail centers. 

Find more information about the basics of Medicare below. 

What is Medicare? 

Medicare* is a federal health insurance program for people over 65 and certain younger individuals with disabilities. There are some gaps in coverage for Original Medicare. 

Medicare has four parts*: Medicare Part A, Part B, Part C and Part D. Original Medicare includes Part A (hospital insurance) and Part B (medical insurance). Medicare Advantage, an alternative to Original Medicare, is Part C. Part D is a Medicare drug plan for prescription medicines. Bundled plans typically include Part A, Part B and Part D. 

One misunderstanding about Original Medicare is that it is free and covers all of an individual’s medical expenses. This is not true. 

Do I have to switch to Medicare when I turn 65? 

You can keep your health plan when you turn 65. But if you have a health plan through the Affordable Care Act (ACA), you will likely lose government subsidy support* when you turn 65. This will increase the cost of monthly premiums. 

Do I have to switch to Medicare if I continue to work past 65? 

About 20 percent of Americans continue to work after their 65th birthday. If you get your health insurance through your employer and continue to work, you can stay on your employer-sponsored health plan. 

Your employer cannot encourage you to leave your plan for a Medicare plan. However, many employees might find that a Medicare plan is cheaper than employer coverage. 

Everyone has different circumstances. It is important to do your research and find the correct coverage and plan for your needs. 

When should I start planning for Medicare? 

Most people start considering their options when they turn 64. You should understand the basics of Medicare so you are prepared to pick the right plan for you. When you are first eligible for Medicare*, you have a seven-month initial enrollment period to sign up. This period begins three months before you turn 65, includes the month you turn 65 and ends three months after you turn 65. 

How do I apply for Medicare? 

Some people get Medicare automatically. Others have to sign up. You may have to sign up if you are 65 or almost 65 and not getting Social Security. You can find more information about getting started with Medicare online. You can also call a BlueCross BlueShield of South Carolina agent who can walk you through your options at 800-760-3690. 

Do I have to keep the same Medicare plan? 

No. You can make changes to your Medicare plan. But you are limited as to when you can make changes.  

When can I make changes to my Medicare plan? 

During the annual election period* (AEP) between Oct. 15 and Dec. 7, you can make changes that will go into effect Jan. 1. You can sign up for a Medicare Advantage plan or a Medicare prescription drug plan during this time. 

There are other opportunities to make changes outside of that cycle during special enrollment periods* (SEP). There is an open enrollment period* (OEP) every Jan. 1 to March 31 for members to make changes to Medicare Advantage plans.  

You can add a Medicare Supplement plan, also known as Medigap, at any time. 

What is Medicare Advantage? 

Medicare Advantage*, also known as Part C, offers coverage not included with Original Medicare, such as prescription drug coverage.  

Medicare plans from private insurance companies provide more coverage than Original Medicare. BlueCross has two types of Medicare Advantage plans, and both offer prescription drug coverage as a benefit. 

These plans also have annual limits on out-of-pocket costs. After you reach the limit, the plans pay 100 percent for covered services for the rest of the year.

Anyone on Original Medicare should know they have zero financial protection. Medicare pays 80 percent for Part A (hospital insurance) and Part B (medical insurance). Members pay the remaining 20 percent. 

There is no limit to the amount a member may have to pay out of pocket. The member would still be required to purchase a Part D (prescription drug*) plan to have drug coverage and avoid a penalty. 

Medicare enrollees may owe a late enrollment penalty if they do not have a Medicare prescription drug plan, a Medicare Advantage plan or credible prescription drug coverage.

With Medicare Advantage, members pay a low monthly premium or no premium — depending on the plan — for more complete coverage and other benefits. Our plans may include additional benefits such as dental, vision, hearing and other services. 

What is Medicare Supplement? 

Medicare Supplement* plans help bridge the gap in coverage for Original Medicare. These plans can help pay some of the remaining costs, such as copays, deductibles or coinsurance. 

Even though you can sign up for these plans at any time, the best time to sign up is during your initial Medicare enrollment.

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