Overview | Medicare Basics | Medicare FAQs

1. What is not covered by Original Medicare?
2. What is Medicare Prescription Drug coverage?
3. When can I switch Medicare plans?

What is not covered by Original Medicare?

Original Medicare coverage consists of Part A (which covers hospital and skilled nursing facility care), and Part B (which covers doctor bills and other medical expenses). It does not cover all of your health care costs.

Even with Medicare Part A and Part B coverage, you’re responsible for some out-of-pocket expenses including:

• Part A Hospital deductible ($992)
• Copayments for hospital stays over 60 days
• Care in a skilled nursing facility after 20 days
• Part B deductible ($131)
• Twenty percent coinsurance for doctor bills and other Part B medical expenses

For more information about what Original Medicare does and does not cover, visit www.medicare.gov*.

View a comparison chart that shows how BCBSNM Medicare Supplement plans can help reduce your out-of-pocket expenses.

Blue MedicareRx, the Medicare Part D Plan offered by BCBSNM.

Blue Medicare PPO, the Medicare Advantage Plan offered by BCBSNM.

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What is Medicare Prescription Drug coverage?

Medicare prescription drug coverage helps cover your prescription drug costs. You must choose a plan to get this coverage. You pay a monthly premium. You can join a Medicare Prescription Drug Plan that covers prescription drugs only (also referred to as "Medicare Part D"), or you can join a Medicare Advantage Plan that covers your doctor and hospital care as well as prescriptions.** If you enroll in a Medicare Part D plan and you currently have a Medicare Supplement (Medigap) plan that includes prescription drug coverage, you must contact your Medigap issuer and tell them you have enrolled in a Medicare Part D Plan***. If you decide to keep your current Medicare Supplement policy, your Medigap issuer will remove the prescription drug coverage portion of your policy and adjust your premium. This will occur as of the effective date of your coverage in the Medicare Part D plan. Call your Medigap issuer for details.

More about Blue MedicareRx, the Medicare Part D Prescription Drug Plan offered by BCBSNM.

More about Blue Medicare PPO, BCBSNM’s Medicare Advantage Plan that includes Medicare Prescription Drug coverage.

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When can I switch Medicare plans?

Generally if you join a Medicare Advantage Plan, other Medicare Health Plan, or a Medicare Prescription Drug Plan, you can only change plans under certain circumstances. You can choose to switch from your current plan from November 15 through December 31 of every year. Enrollment is generally for the calendar year. In certain cases, such as if you move or enter a nursing home, you can switch your plan at other times. After you request to switch, your plan will let you know the date your coverage ends.**

If you want to switch plans, contact your current plan and call 1-800-MEDICARE (1-800-633-4227) for more information.

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** Source: Medicare & You 2006 from Centers for Medicare & Medicaid Services.

*** Please Note: You can only have one Medicare-approved prescription drug plan at a time.