
Blue Cross Blue Shield of Illinois - Medicare Select Supplement Plans
Medicare Select options offer you the same solid benefits as the standard Blue Cross Blue Shield of Illinois Medicare Standard Supplement Plans, but cost less. You save on premiums simply by agreeing to use any of the Medicare Select participating hospitals for non-emergency elective admissions as defined by the admitting hospital. If you do not use one of these hospitals for your non-emergency admissions, you pay the full Part A deductible. Medicare Select is not an HMO. With Medicare Select, you are fully covered for emergency care at any hospital, and you can choose your own doctors and specialists.
Medicare Select Plan options include Plan D, Plan F, Plan K and Plan L and are available in specific geographic areas only. You must live within a 30 mile radius of a Medicare Select participating hospital.
Blue Cross Blue Shield of Illinois Medicare Select Supplement Plans
| Plans |
D | F | K* | L* |
| Basic Benefits | X | X | X | X |
| Skilled Nursing Coinsurance | X | X | 50% | 75% |
| Part A Deductible | X | X | 50% | 75% |
| Part B Deductible | - | X | - | - |
| Part B Excess (100%) | - | X | - | - |
| Foreign Travel Emergency | X | X | - | - |
| At Home Recovery | X | - | - | - |
| Annual Out-of-Pocket Cost | - | - | $4,620 | $2,310 |
**Plans K and L provide for different cost-sharing than plans A-F. Once you reach the annual limit, the plan pays 100% of the Medicare copayments, coinsurance and deductibles for the rest of the calendar year. The out-of-pocket annual limit does NOT include charges from your provider that exceed Medicare-approved amounts, called "excess charges." You will be responsible for paying excess charges.
Plan D
| Plan D |
|---|
Plan D is the second most popular Blue Cross Blue Shield of Illinois Medicare Supplement plan. It covers:
- Your Part A deductible and coinsurance
- The cost of 365 extra days of hospital care during your lifetime after Medicare coverage ends
- Your Part B coinsurance and the cost of the first three pints of blood/li>
- Medicare Part A hospital deductible and copayments
- Skilled nursing facility copayment
- Foreign travel emergency care
- Important benefits for at-home care after a hospital stay in addition to the basic benefits
Plan F
| Plan F |
|---|
Plan D is the most popular Blue Cross Blue Shield of Illinois Medicare Supplement plan. No other standardized Medicare Supplement plan offered in Illinois offers more complete protection for your uncovered Part B medical expenses than Plan F. It covers:
- Your Part A deductible and coinsurance
- The cost of 365 extra days of hospital care during your lifetime after Medicare coverage ends
- Your Part B coinsurance and the cost of the first three pints of blood
- Medicare Part A hospital deductible and copayments
- Skilled nursing facility copayment
- Foreign travel emergency care
- $135 Part B Medicare deductible
- Part B doctor charges that are in excess of Medicare-approved amounts
Plan K
| Plan K |
|---|
Plan K covers:
- Fifty percent of your Part A deductible and coinsurance
- The cost of 365 extra days of hospital care during your lifetime after Medicare coverage ends
- Preventive benefits for Medicare-covered services usually leave you with 25% to pay -- plan K pays that 25%
- Ten percent of your 20% Part B coinsurance and the 50% of the cost of the first three pints of blood
- Fifty percent of the skilled nursing facility copayment
- Once you've reached your $4,620 annual out-of-pocket limit, the plan pays 100% of the Medicare copayments, coinsurance and deductibles for the rest of the calendar year.
Plan L
Plan L covers:
- Seventy-five percent of your Part A deductible and coinsurance
- The cost of 365 extra days of hospital care during your lifetime after Medicare coverage ends
- Preventive benefits for Medicare-covered services usually leave you with 25% to pay -- plan L pays that 25%
- Fifteen percent of your 20% Part B coinsurance and the 75% of the cost of the first three pints of blood
- Seventy-five percent of the skilled nursing facility copayment
- Once you've reached your $2,310 annual out-of-pocket limit, the plan pays 100% of the Medicare copayments, coinsurance and deductibles for the rest of the calendar year.



