
Blue Cross Blue Shield of Illinois - Medicare Supplement Standard Plans
Blue Cross Blue Shield of Illinois Member Benefits
All Blue Cross and Blue Shield of Illinois Medicare Supplement plans give you:
- Guaranteed Acceptance with no health questions asked
- Freedom to choose any doctors or specialists
- Coverage with domestic travel (Plans D and F cover foreign travel)
- Guaranteed renewability regardless of changes in your health
- Coverage guaranteed to match Medicare's cost increases year after year
- Blue Extras Member Discount Program that include discounts on wellness products and services including vision, fitness clubs, weight management, complementary alternative medicine, hearing and more
- No claim forms, in most cases
Medicare Supplement Basic Benefits
Basic benefits included in all plans include:
- Hospitalization - Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.
- Medical Expenses - Part B coinsurance (generally 20% of Medicare-approved expenses), or in the case of hospital outpatient department services under a prospective payment system, applicable copayments.
- Blood - First three pints of blood each year.
*Plans K and L include benefits at different levels of cost sharing (see outline of coverage).
Blue Cross Blue Shield of Illinois Medicare Supplement Plans
| Plans |
A | D | F | K* | L* |
| Basic Benefits | X | X | X | X | X |
| Skilled Nursing Coinsurance | - | X | X | 50% | 75% |
| Part A Deductible | X | 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
High Deductible Plan F
| High Deductible Plan F |
|---|
High Deductible Plan F has the same benefits as Plan F after the annual deductible has been paid. The deductible amount represents the annual out-of-pocket expenses (excluding premiums) that you must pay before the policy begins paying benefits. High Deductible Plan F covers:
- High Deductible Plan F pays the same benefits as Plan F after you pay a calendar year deductible ($2,000 in 2009).
- Your Part A deductible and coinsurance
- Your Part B coinsurance and the cost of the first three pints of blood
- Benefits from High Deductible Plan F will not begin until your out-of-pocket expenses total $2,000.
- Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy.
- These expenses include the Medicare deductibles for Part A and B.
- These expenses do not include Plan F’s separate foreign travel emergency deductible.
- Medicare Part A hospital deductible and copayments
- Skilled nursing facility copayment
- $135 Part B Medicare deductible
- Part B doctor charges that are in excess of Medicare-approved amounts
- The cost of 365 extra days of hospital care during your lifetime after Medicare coverage
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 |
|---|
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.
Basic Plan A
| Plan A |
|---|
Basic Plan A covers:
- Your Part A 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





