Blue Access for Employers

Blue Cross Group Medicare OptionsSM

Blue Cross and Blue Shield of New Mexico (BCBSNM) offers employer and union groups a choice when it comes to Medicare health coverage for their retirees. Blue Cross Group Medicare Options include Medicare Advantage, Supplemental Medical, and Prescription Drug plans.

Richer Benefits, Lower Costs

Blue Cross Group Medicare Options plans can be custom designed with rich benefits and lower retiree costs than individual Medicare plans. Employers can subsidize the retiree contribution making it affordable as well as cost-effective. Both retirees and their Medicare-eligible spouses can enroll in these plans. BCBSNM members can easily move from their employee plan to their group retiree Medicare plan with little disruption.

Employer-Sponsored Medicare Plan Options

Retirees may be offered the following plans:

Blue Cross Group Medicare Advantage Open Access (PPO)SM Plan
Members can seek care from any provider that accepts Medicare nationwide at the same coverage level, in and out of network. Members may visit any provider that:

  1. Accepts Medicare
  2. Agrees to see them
  3. Agrees to bill BCBSNM

Retirees must continue to pay their Part B premium.

Blue Cross Group Medicare Advantage (PPO)SM Plan
Members can seek care both in and out of network. Members who receive care outside the network still receive some level of benefit, likely less than with in-network providers. Members do not have to choose a Primary Care Provider and may get care from a specialist without a referral. Retirees must continue to pay their Part B premium.

Blue Cross Group Medicare Advantage (HMO)SM Plan
Members are only covered when they seek care in-network, except for emergencies. A PCP must refer them to a specialist. Retirees must continue to pay their Part B premium.

Blue Cross Group MedicareRx (PDP)SM Plan
Plans provide coverage for prescription drugs. They enhance Original Medicare and BlueAssureSM policies and provide members with access to over 64,000 pharmacies. The formulary has the most commonly prescribed medications and low copays for generics.

Extra Health and Wellness Benefits

Part of the 'advantage' to offering a Blue Cross Group Medicare Advantage plan is the benefits above and beyond standard health insurance. The availability, cost and level of coverage can vary from plan to plan and can be custom designed for each group. Supplemental plan options include dental, vision, hearing, over-the-counter allowance, discount programs, fitness program, transportation, member rewards program, post-discharge meals and more.

Helpful Tools

Formulary Drug List

Plan formulary is easily accessible online

www.prime.com

Pharmacy Mail Order

Easy refill-by-mail program.

www.alliancerxwp.com

Provider Finder

Search Provider Finder to find the most up-to-date network of doctors, specialists, hospitals and other health care providers.