Medicare alone will not pay all of your clients' health care bills. BlueSecure insurance is designed to fill the "gaps" in standard Medicare coverage. This employer-sponsored insurance plan can give your clients more coverage and reduce their out-of-pocket costs. If a client is turning 65 and has not applied for Medicare benefits, he or she must do so before enrolling in BlueSecure.
BCBSNM offers outpatient prescription drug coverage through Blue MedicareRx, our separate Medicare prescription drug plans.
BlueSecure includes:
- Freedom to choose doctors and specialists who accept Medicare payment
- No referral required
- Coverage when traveling
- Plan renews year after year, regardless of health
- Dollar for dollar coverage to match increased Medicare costs
- Hassle-free claims filing — no paperwork in most cases
BlueSecure includes benefits not offered by Medicare, such as skilled nursing expenses, foreign travel emergencies, and charges from health care providers in excess of Medicare's approved amount.
Here's how BlueSecure reduces out-of-pocket expenses:
| Benefits Medicare DOES NOT PAY in 2007 | Expenses Covered by BlueSecure |
|
PART A (Hospital Services*) |
$992 (Part A Deductible) |
|
$248 per day copayment for covered expenses for days 61-90 in hospital (totaling $7,440) |
$248 a day for 61st through 90th day |
|
$496 per day copayment for covered expenses while you use your Lifetime Reserve (totaling $29,760)** |
$496 a day for 91st day and after |
|
100% of Medicare allowable expenses for additional 365 days after Medicare hospital benefits stop completely |
100% of Medicare allowable expenses for additional 365 days |
|
Calendar year blood deductible (charges for first three pints of blood) |
3 pints of blood |
|
$124 per day for days 21-100 in a Skilled Nursing Facility (totaling $9,920) |
Up to $124 a day for 21st through 100th day |
|
PART B (Physician's Care and Medical Services) |
$131 (Part B Deductible) |
|
Coinsurance for medical expenses (Generally 20% of Medicare approved amount) † |
Generally 20% of Medicare approved amount |
|
100% of Medicare Part B excess charges (above Medicare approved amounts) |
100% of Medicare Part B excess charges (above Medicare approved amounts) |
|
Coinsurance for durable medical equipment (20% of Medicare approved amount)† |
20% of Medicare approved amount |
|
ADDITIONAL EXPENSES not covered by Medicare |
After member pays first $250, BlueSecure pays 80% of remainder of charges, up to a lifetime maximum benefit of $50,000 |
*Hospital benefits must be provided by facilities participating with Medicare. Payments are limited to the reasonable charge as determined by Medicare.
**After 90 days of hospitalization, Medicare benefits are paid from a one-time lifetime reserve of 60 additional days (days 91-150) which are not renewable each benefit period. See your Benefit Booklet for details and limitations of these benefits.
†After $131 Part B deductible is met.
††Foreign Travel Emergency covered at 80%; up to $50,000 lifetime maximum.
Learn More About BlueSecure
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Contact Us
For more information about our plans for groups, please contact BCBSNM Customer Service toll-free at (800) 432-0750 or email us.
Prospective Producers: To apply to become a contracted producer, see our Instructions, Agreement, and Business Associate Addendum (BAA).
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