Blue Medicare Supplement Insurance Plans

Medicare Supplement Insurance Plans are identified by the letters A, B, C, D, F, G, M and N 1 . Each plan covers a different set of costs.

The chart lists plans available in Oklahoma.

copay applies 6

Eligibility

Medicare Supplement Insurance Plans complement Original Medicare. If you’re eligible for Medicare, you’re also eligible for a Medicare Supplement Insurance Plan.

Eligibility is simple. If you’re at least 65, you must be:

• Enrolled in Medicare Parts A and B.
• A resident of the state where the plan is offered.

If you’re under 65 and disabled, you must be:

• Getting Social Security Disability Insurance for 24 consecutive months, or
• Be diagnosed with amyotrophic lateral sclerosis (ALS), in which case Medicare starts immediately

Enrollment Periods

You can enroll in a Medicare Supplement Insurance Plan during the six-month open enrollment period that starts once you’re 65 and have Medicare Part B. This six-month open enrollment period is the best time to enroll because it’s the only time when enrollment is guaranteed. If you want a Medicare Supplement Insurance Plan after the open enrollment period, you may have to meet certain requirements and could pay more for the plan.

Guaranteed Eligibility

If you are an Oklahoma resident, age 65 or older, have Medicare Part A and are within the six months following your enrollment for Medicare Part B, your acceptance is guaranteed. If you are an Oklahoma resident, under age 65, have Medicare Part A and are within the six months following your enrollment for Medicare Part B, your acceptance is guaranteed for Plan A. If you are an Oklahoma resident turning age 65, were previously enrolled in Medicare Parts A and B, and apply within six months of turning age 65, your acceptance is guaranteed.

Premium Discounts

A BCBSOK Medicare Supplement premium discount may be available. Read the eligibility criteria to see if you qualify. If you are eligible for a discount, the discount will be applied to your next bill and remain in effect as long as you are enrolled in your BCBSOK Medicare Supplement plan. Discounts cannot be combined; only one type of discount per member is permitted.

Eligibility Criteria

Household Discount

You may be eligible for a discount if you enrolled in a BCBSOK Medicare Supplement policy issued with an effective date on or after May 1, 2019, and you either:

• Reside with a spouse or civil union/domestic partner; or
• Have resided with as many as three adults age 60 or older for the last 12 months.

The discount is 10%.

Continue With Blue SM Discount

You may be eligible for a discount if you enrolled in a BCBSOK Medicare Supplement policy issued with an effective date on or after January 1, 2022 and you were enrolled in a Blue Cross and Blue Shield commercial group or individual health insurance coverage plan and that coverage was within one year of your BCBSOK Medicare Supplement policy becoming effective. The discount is 7%.

Blue Family Discount SM

You may be eligible for a discount if you enrolled in a BCBSOK Medicare Supplement policy issued with an effective date on or after January 1, 2024 and you meet the criteria for both the Household Discount AND the Continue with Blue Discount. The discount is 12%.

Reduced Premium Options – Blue Plan65 Select

Some Medicare Supplement Insurance Plans have a money saving option called Blue Plan65 Select. With this option, the Medicare Part A deductible is covered for non-emergency care at Blue Plan65 Select hospitals. If it’s an emergency, the Part A deductible is covered by any hospital.

Blue Plan65 Select is not an HMO. You can choose your own doctors and specialists. To avoid paying the Part A deductible, you must agree to use a Blue Plan65 Select hospital for non-emergency care.

You’re eligible if you live within 25 miles of any Blue Plan65 Select hospital. Find a list of Medicare Select hospitals. Plans F and N have Blue Plan65 Select options in Oklahoma.

Only certain hospitals are network providers under this policy. Check with your doctor to find out if they have admitting privileges at the network hospital. If they do not, you may be required to use another doctor at the time of hospitalization or, if you still use a non-network hospital, you must pay the Part A deductible and any non-covered charges.

Introducing a New Plan G Option: Plan G Plus

Beginning October 1, 2022 Plan G standard and Plan G Select will have plus options available. Plan G Plus plans have the same medical coverage as their regular versions. They also have additional benefits and programs included so members can get more out of their Blue Medicare Supplement Insurance Plan. Additional benefits and programs include dental, vision, hearing, and fitness.

Read this chart for more details.

Diagnostic Services

• Periodic oral evaluations, 2 times per year
• Problem focused oral evaluations, 2 times per year
• Comprehensive oral evaluations, 2 times per year
• Oral cancer screenings, 1 time per year

50% of Maximum Allowance

Preventive Services

• Prophylaxis (cleanings), 2 times per year
• Topical fluoride applications, 2 times per year

50% of Maximum Allowance

Diagnostic Radiographs

• Full-mouth and panoramic films, 1 per year
• Bitewing films, 1 per year
• Periapical films, 1 per year

50% of Maximum Allowance

Basic Restorative Dental Services

• Amalgams, 1 per tooth per year
• Resin-based composite restorations, 1 per tooth per year

20% of Maximum Allowance

50% of Maximum Allowance

Non-Surgical Extractions

• Removal of retained coronal remnants, 1 per tooth per lifetime
• Removal of erupted tooth or exposed root, 1 per tooth per lifetime

50% of Maximum Allowance

Non-Surgical Periodontal Services

• Periodontal scaling and root planning, 1 per quadrant every 2 years
• Full-mouth debridement, 1 time per year
• Periodontal maintenance procedures, 2 times per year

50% of Maximum Allowance

Adjunctive Services

• Palliative treatment (emergency)
• Deep sedation / general anesthesia

50% of Maximum Allowance

70% of Maximum Allowance

Routine exam with dilation, 1x every 12 months

Eyeglasses or contact lenses
(conventional & disposable)

Remaining balance after $130 allowance

Remaining balance after $65 reimbursement

Routine exam, 1x every 12 months

Advanced hearing aid member fee with recharge

Premium hearing aid member fee with recharge

You can apply for a Blue Medicare Supplement Insurance Plan online, over the phone, or through the mail. You can access your Outline of Coverage on our Forms & Documents page.

Web

CALL 1-866-288-3539 (TTY 711 )

For personal help applying for a plan: We are open 8:00 a.m. – 8:00 p.m., local time, 7 days a week. If you are calling from April 1 through September 30, alternate technologies (for example, voicemail) will be used on weekends and holidays.

MAIL

Complete an application: You can download your Outline of Coverage and Application from our Forms & Documents page and mail it to: Blue Medicare Supplement
c/o Member Services
P.O. Box 3388
Scranton, PA 18505

Outline of Coverage

Application

Medicare Supplement Insurance Application English | español Find out about your Open Enrollment Period and other information: Choosing a Medigap Policy: A Guide to Health Insurance for People With Medicare

Medicare Supplement Insurance Plans are not allowed to offer coverage for prescription drugs. Many people with Medicare Supplement Insurance Plans get a prescription drug plan. Learn more about prescription drug plans.

Help Me Choose a Plan

Useful Tools

Rates as of 01/01/2024. Rates are illustrative only. Actual rates are based on your age, where you live, and your choice of coverage. Please do not send money, you cannot obtain coverage under the above plans until an application is completed and approved. Benefit exclusions and limitations might apply.

Important Information About Quotes for Medicare Supplement Insurance Plans

Quoted prices are based on the criteria specified during your search. This illustration is subject to Blue Cross and Blue Shield of Oklahoma's rating or underwriting and approval, as appropriate, and does not guarantee rates, coverage or effective date. Furthermore, rates are subject to change if any of the information you have provided changes when and if a policy is approved. In addition, Blue Cross and Blue Shield of Oklahoma reserves the right to change rates from time to time.

1. ‭Not all of these plans are offered by Blue Cross and Blue Shield of Oklahoma.
2. Blue Plan65 Select Plans require that you use a Blue Plan65 Select network hospital for non-emergency admissions to receive ‭coverage for the Medicare Part A deductible. In an emergency, the deductible is covered at any hospital from which you ‭receive care. Only certain hospitals are network providers under this policy. Check with your physician to determine if he or she ‭has admitting privileges at the network hospital. If he or she does not, you may be required to use another physician at the time ‭of hospitalization or you will be required to pay for all expenses. If an insured moves out of the service area, there will be a ‭reduction of benefit coverage and they will have the opportunity to purchase any Medicare Supplement Insurance policy with comparable ‭or lesser benefits offered by the insurer, or Medicare Supplement Insurance/Select plans A, B, C, or F, K, or L from any insurer within 63 days ‭of termination.‬‬‬‬‬‬‬
3. You must live within 25 miles of a participating Blue Plan65 Select hospital to be eligible.
4. Not to exceed any charge limitation established by the Medicare program or state law.
5. Plans cover medically necessary emergency care services needed immediately because of an injury or illness of sudden and unexpected onset, beginning during the first 60 days of each trip outside the USA. There is a deductible of $250 and a lifetime maximum benefit of $50,000.
6. Plan N requires a copayment of up to $20 for office visits and a copayment of up to $50 for ER.
7. These high deductible plans pay the same benefits as Plans F and G after one has paid a calendar-year $2,800 deductible. Benefits from High Deductible Plans F and G will not begin until out-of-pocket expenses are $2,800. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. This includes the Medicare deductibles for Part A and Part B, but does not include the plan’s separate foreign travel emergency deductible.

Last Updated: April 10, 2024

This Information is a solicitation for insurance.

Medicare Supplement Insurance Plan Notice:
Not connected with or endorsed by the U.S. Government or Federal Medicare Program.

Medicare Supplement Insurance Plans are offered by Blue Cross and Blue Shield of Oklahoma, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.

© Copyright 2024 Health Care Service Corporation. All Rights Reserved.

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