Individual Medicare Plans
Medicare health coverage through Blue Cross and Blue Shield of New Mexico 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.
Medicare Advantage Plans
Our HMO and PPO plans bundle cost-saving and value-added options with Original Medicare benefits. Here are some plan highlights. (Producers must be certified to sell MAPD plans.)
| Plan Name | HMO | PPO |
| Monthly Premiums | Typically lower or $0 | Tend to be higher |
| Primary Care Provider (PCP) | Required | Not required |
| Network Flexibility | Must use in-network | Can use out-of-network |
| Referral for Specialists | May require refereral from PCP | Not required |
| Cost Savings | Lower costs in-network | Higher costs for out-of-network |
| Prescription Drug Coverage | May or may not include drug coverage | Includes drug coverage |
Prescription Drug Plans
Our prescription drug plans go beyond Original Medicare to offer coverage for prescription drugs. Whether your clients have a few prescriptions or a lot, BCBSNM 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.)
| Plan Name | Blue Cross MedicareRx Choice (PDP)℠ | Blue Cross MedicareRx Value (PDP)℠ | |
| Pharmacy Network | Nationwide | Nationwide | |
| Annual Deductible | $0 deductible for tiers 1 and 2 generic drugs Deductible applies to tiers 3, 4 and 5 |
$0 deductible for tiers 1 and 2 generic drugs Deductible applies to tiers 3, 4 and 5 |
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| Formulary Type | Essential formulary: geared for those who take no drugs or a few generic drugs | Broad formulary: geared for those who need greater coverage for brand name and generic drugs |
Medicare Supplement Plans
BCBSNM offers a wide variety of Medicare Supplement Insurance Plans. Even if your client is covered by Medicare, they may still be responsible for a large portion of their health care costs. We offer an array of basic, comprehensive and budget-conscious plans.
