HEALTH DENTAL VISION LIFE DISABILITY
IF you are a Group OVER 50, then the document below is very useful.
Group Health Employer Reporting Requirements (PDF)
Each of these products is available for Groups. We have a group census form above for most of the products.
Call us for assistance. 512.338.1191 and Ask for “Benefits.”
We offer the following group carriers:
You may qualify for a Special Enrollment Period if you or anyone in your household lost qualifying health coverage in the past 60 days OR expects to lose coverage in the next 60 days.
Coverage losses that may qualify you for a Special Enrollment Period:
You may qualify for a Special Enrollment Period if you or anyone in your household in the past 60 days:
Household moves that qualify you for a Special Enrollment Period:
Note: Moving only for medical treatment or staying somewhere for vacation doesn’t qualify you for an SEP.
Important: You must prove you had qualifying health coverage for one or more days during the 60 days before your move. You don’t need to provide proof if you’re moving from a foreign country or United States territory.
Other life circumstances that may qualify you for a Special Enrollment Period:
Get a no-obligation quote for Medicare Supplement coverage from Blue Cross and Blue Shield of Texas
If you are willing to share certain health care costs, this Medicare Supplement insurance plan can help you save on premiums while still receiving dependable coverage.
Medicare Supplement insurance costs include monthly premium payments and may include deductibles, out-of-pocket expenses, copayments and coinsurance. Here are some of the costs you can expect to pay with Plan N:
For more information on costs, get a quick quote or see the Medicare Supplement Outline of Coverage.
It’s important to know the critical features of the Medicare Supplement insurance plan you are considering. The Outline of Medicare Supplement Coverage provides brief descriptions of the basic provisions of the Medicare Supplement insurance plans, as well as details on policy renewability, benefit exclusions and coverage limitations.
* 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.
Blue Cross and Blue Shield of Texas (BCBSTX) will never terminate or refuse to renew your Medicare Supplement Insurance policy because of the condition of your health. However, to protect you and the rights of all policy holders, there are situations when a Medicare Supplement insurance plan may be terminated or a renewal refused:
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| HOSPITALIZATION*: Semi-private room and board, general nursing, and miscellaneous services and supplies | |||
| First 60 days | All but $1,316 | $1,316 (Part A deductible) | $0 |
| 61st through 90th day | All but $329 a day | $329 a day | $0 |
| 91st day and after: – While using 60 Lifetime Reserve Days – Once Lifetime Reserve Days are used: Additional 365 days |
All but $658 a day$0 | $658 a day
100% of Medicare eligible expenses |
$0$0** |
| Beyond the additional 365 days | $0 | $0 | All costs |
| SKILLED NURSING FACILITY CARE*: You must meet Medicare’s requirements, including having been in a hospital for at least three days and entered a Medicare-approved facility within 30 days after leaving the hospital | |||
| First 20 days | All approved amounts | $0 | $0 |
| 21st through 100th day | All but $164.50 a day | Up to $164.50 a day | $0 |
| 101st day and after | $0 | $0 | All costs |
| BLOOD | |||
| First three pints | $0 | Three pints | $0 |
| Additional amounts | 100% | $0 | $0 |
| HOSPICE CARE: You must meet Medicare’s requirements, including a doctor’s certification of terminal illness | |||
| All but very limited copayment/coinsurance for outpatient drugs and inpatient respite care |
Medicare copayment/ coinsurance |
$0 | |
* A benefit period begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.
** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| MEDICAL EXPENSES—IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as physicians’ services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment | |||
| First $183 of Medicare-approved amounts* | $0 | $0 | $183 (Part B deductible) |
| Remainder of Medicare-approved amounts | Generally 80% | Balance, other than up to $20 per office visit and up to $50 per emergency room visit.** | Up to $20 per office visit and up to $50 per emergency room visit.** |
| PART B EXCESS CHARGES (above Medicare-approved amounts) | |||
| $0 | $0 | All costs | |
| BLOOD | |||
| First three pints | $0 | All costs | $0 |
| Next $183 of Medicare-approved amounts* | $0 | $0 | $183 (Part B deductible) |
| Remainder of Medicare-approved amounts | 80% | 20% | $0 |
| CLINICAL LABORATORY SERVICES— TESTS FOR DIAGONOSTIC SERVICES | |||
| 100% | $0 | $0 | |
* Once you have been billed $183 of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.
** The copayment of up to $50 is waived if the insured is admitted to any hospital and the emergency visit is covered as a Medicare Part A expense.
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| HOME HEALTH CARE MEDICARE-APPROVED SERVICES | |||
| – Medically necessary skilled care services and medical supplies | 100% | $0 | $0 |
| – Durable medical equipment First $183 of Medicare-approved amounts* |
$0 | $0 | $183 (Part B deductible) |
| Remainder of Medicare-approved amounts | 80% | 20% | $0 |
* Once you have been billed $183 of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| FOREIGN TRAVEL —NOT COVERED BY MEDICARE: Medically necessary emergency care services beginning during the first 60 days of each trip outside the USA | |||
| First $250 each calendar year | $0 | $0 | $250 |
| Remainder of charges | $0 | maximum benefit of $50,000 | over the $50,000 lifetime maximum |
Get a no-obligation quote for Medicare Supplement coverage from Blue Cross and Blue Shield of Texas
If you are willing to share certain health care costs, this Medicare Supplement insurance plan can help you save on premiums while still receiving dependable coverage.
Medicare Supplement insurance costs include monthly premium payments and may include deductibles, out-of-pocket expenses, copayments and coinsurance. Here are some of the costs you can expect to pay with Plan L:
For more information on costs, get a quick quote or see the Medicare Supplement Outline of Coverage.
It’s important to know the critical features of the Medicare Supplement insurance plan you are considering. The Outline of Medicare Supplement Coverage provides brief descriptions of the basic provisions of the Medicare Supplement insurance plans, as well as details on policy renewability, benefit exclusions and coverage limitations.
Blue Cross and Blue Shield of Texas (BCBSTX) will never terminate or refuse to renew your Medicare Supplement Insurance policy because of the condition of your health. However, to protect you and the rights of all policy holders, there are situations when a Medicare Supplement insurance plan may be terminated or a renewal refused:
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| HOSPITALIZATION*: Semi-private room and board, general nursing, and miscellaneous services and supplies | |||
| First 60 days | All but $1,316 | 75% of Part A deductible | 25% of Part A deductible |
| 61st through 90th day | All but $329 a day | $329 a day | $0 |
| 91st day and after: – While using 60 Lifetime Reserve Days – Once Lifetime Reserve Days are used: Additional 365 days |
All but $658 a day
$0 |
$658 a day 100% of Medicare eligible expenses |
$0
$0** |
| Beyond the additional 365 days | $0 | $0 | All costs |
| SKILLED NURSING FACILITY CARE*: You must meet Medicare’s requirements, including having been in a hospital for at least three days and entered a Medicare-approved facility within 30 days after leaving the hospital | |||
| First 20 days | All approved amounts | $0 | $0 |
| 21st through 100th day | All but $164.50 a day | Up to $123.38 a day | Up to $41.12 a day |
| 101st day and after | $0 | $0 | All costs |
| BLOOD | |||
| First three pints | $0 | 75% | 25% |
| Additional amounts | 100% | $0 | $0 |
| HOSPICE CARE: You must meet Medicare’s requirements, including a doctor’s certification of terminal illness | |||
| All but very limited copayment/coinsurance for outpatient drugs and inpatient respite care |
75% of Medicare copayment/ coinsurance |
25% of Medicare copayment/ coinsurance |
|
* A benefit period begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.
** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| MEDICAL EXPENSES—IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as physicians’ services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment | |||
| First $183 of Medicare-approved amounts* | $0 | $0 | $183 (Part B deductible) |
| Preventive benefits for Medicare-covered services | Generally 75% or more of Medicare-approved amounts | Remainder of Medicare-approved amounts | All costs above Medicare-approved amounts |
| Remainder of Medicare-approved amounts | Generally 80% | Generally 15% | Generally 5% |
| PART B EXCESS CHARGES (above Medicare-approved amounts) | |||
| $0 | $0 | All costs (and they do not count toward annual out-of pocket limit of $2,560 )** | |
| BLOOD | |||
| First three pints | $0 | 75% | 25% |
| Next $183 of Medicare-approved amounts* | $0 | $0 | $183 (Part B deductible) |
| Remainder of Medicare-approved amounts | Generally 80% | Generally 15% | Generally 5% |
| CLINICAL LABORATORY SERVICES— TESTS FOR DIAGONOSTIC SERVICES | |||
| 100% | $0 | $0 | |
* Once you have been billed $183 of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.
** This plan limits your annual out-of-pocket payments for Medicare-approved amounts to $2,560 per year. However, this limit does NOT include charges from your provider that exceed Medicare-approved amounts (“excess charges”) and you will be responsible for paying this difference in the amount charged by your provider and the amount paid by Medicare for the item or services.
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| HOME HEALTH CARE MEDICARE-APPROVED SERVICES | |||
| – Medically necessary skilled care services and medical supplies | 100% | $0 | $0 |
| – Durable medical equipment First $183 of Medicare-approved amounts* |
$0 | $0 | $183 (Part B deductible) |
| Remainder of Medicare-approved amounts | 80% | 15% | 5% |
* Once you have been billed $183 of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.
Get a no-obligation quote for Medicare Supplement coverage from Blue Cross and Blue Shield of Texas
If you are willing to share certain health care costs, this Medicare Supplement insurance plan can help you save on premiums while still receiving dependable coverage.
High Deductible Plan F includes cost-sharing features that allow you to save on premiums while still receiving dependable coverage. For more detailed information about cost, coverage and renewability, click on the sections below.
Medicare Supplement insurance costs include monthly premium payments and may include deductibles, out-of-pocket expenses, copayments and coinsurance.
Other costs you can expect to pay with High Deductible Plan F:
For more information on costs, get a quick quote or see the Medicare Supplement Outline of Coverage.
Basic benefits:
It’s important to know the critical features of the Medicare Supplement insurance plan you are considering. The Outline of Medicare Supplement Coverage provides brief descriptions of the basic provisions of the Medicare Supplement insurance plans, as well as details on policy renewability, benefit exclusions and coverage limitations.
* 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.
Blue Cross and Blue Shield of Texas (BCBSTX) will never terminate or refuse to renew your Medicare Supplement Insurance policy because of the condition of your health. However, to protect you and the rights of all policy holders, there are situations when a Medicare Supplement insurance plan may be terminated or a renewal refused:
| Services | Medicare Pays | After you pay $2,180 Deductible**, Plan Pays | After you pay $2,180 Deductible, You Pay |
|---|---|---|---|
| HOSPITALIZATION*: Semi-private room and board, general nursing, and miscellaneous services and supplies | |||
| First 60 days | All but $1,316 | $1,316 (Part A Deductible) |
$0 |
| 61st through 90th day | All but $329 | $329 a day | $0 |
| 91st day and after: — While using 60 Lifetime Reserve days — Once Lifetime Reserve days are used: Additional 365 days |
All but $658$0 | $658 a day
100% of Medicare eligible expenses |
$0$0 ** |
| Beyond the additional 365 days | $0 | $0 | All costs |
| SKILLED NURSING FACILITY CARE*: You must meet Medicare’s requirements, including having been in a hospital for at least three days and entered a Medicare-approved facility within 30 days after leaving the hospital | |||
| First 20 days | All approved amounts | $0 | $0 |
| 21st through 100th day | All but $164.50 a day | Up to $164.50 a day | $0 |
| 101st day and after | $0 | $0 | All costs |
| BLOOD | |||
| First three pints | $0 | Three pints | $0 |
| Additional amounts | 100% | $0 | $0 |
| HOSPICE CARE: You must meet Medicare’s requirements, including a doctor’s certification of terminal illness | |||
| All but very limited copayment/coinsurance for outpatient drugs and inpatient respite care | Medicare copayment/coinsurance | $0 | |
* A benefit period begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.
** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| MEDICAL EXPENSES—IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as physicians’ services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment | |||
| First $183 of Medicare-approved amounts* | $0 | $183 (Part B deductible) |
$0 |
| Remainder of Medicare-approved amounts | Generally 80% | Generally 20% | $0 |
| PART B EXCESS CHARGES (above Medicare-approved amounts) | |||
| $0 | 100% | $0 | |
| BLOOD | |||
| First three pints | $0 | All costs | $0 |
| Next $183 of Medicare-approved amounts* | $0 | $183 (Part B deductible) |
$0 |
| Remainder of Medicare-approved amounts | 80% | 20% | $0 |
| CLINICAL LABORATORY SERVICES—TESTS FOR DIAGONOSTIC SERVICES | |||
| 100% | $0 | $0 | |
* Once you have been billed $183 of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| HOME HEALTH CARE MEDICARE-APPROVED SERVICES | |||
| — Medically necessary skilled care services and medical supplies | 100% | $0 | $0 |
| — Durable medical equipment First $183 of Medicare-approved amounts* |
$0 | $183 (Part B deductible) |
$0 |
| — Durable medical equipment Remainder of Medicare-approved amounts |
80% | 20% | $0 |
* Once you have been billed $183 of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| FOREIGN TRAVEL—NOT COVERED BY MEDICARE: Medically necessary emergency care services beginning during the first 60 days of each trip outside the USA | |||
| First $250 each calendar year | $0 | $0 | $250 |
| Remainder of charges | $0 | 80% to a lifetime maximum benefit of $50,000 | 20% and amounts over the $50,000 lifetime maximum |
Medicare Supplement insurance costs include monthly premium payments and may include deductibles, out-of-pocket expenses, copayments and coinsurance. Here are some of the costs you can expect to pay with Plan K:
For more information on costs, get a quick quote or see the Medicare Supplement Outline of Coverage.
It’s important to know the critical features of the Medicare Supplement insurance plan you are considering. The Outline of Medicare Supplement Coverage provides brief descriptions of the basic provisions of the Medicare Supplement insurance plans, as well as details on policy renewability, benefit exclusions and coverage limitations.
Blue Cross and Blue Shield of Texas (BCBSTX) will never terminate or refuse to renew your Medicare Supplement Insurance policy because of the condition of your health. However, to protect you and the rights of all policy holders, there are situations when a Medicare Supplement insurance plan may be terminated or a renewal refused:
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| HOSPITALIZATION*: Semi-private room and board, general nursing, and miscellaneous services and supplies | |||
| First 60 days | All but $1,316 | 50% of Part A deductible | 50% of Part A deductible |
| 61st through 90th day | All but $329 a day | $329 a day | $0 |
| 91st day and after: – While using 60 Lifetime Reserve Days – Once Lifetime Reserve Days are used: Additional 365 days |
All but $658 a day$0 | $658 a day
100% of Medicare eligible expenses |
$0$0** |
| Beyond the additional 365 days | $0 | $0 | All costs |
| SKILLED NURSING FACILITY CARE*: You must meet Medicare’s requirements, including having been in a hospital for at least three days and entered a Medicare-approved facility within 30 days after leaving the hospital | |||
| First 20 days | All approved amounts | $0 | $0 |
| 21st through 100th day | All but $164.50 a day | Up to $82.25 a day | Up to $82.25 a day |
| 101st day and after | $0 | $0 | All costs |
| BLOOD | |||
| First three pints | $0 | 50% | 50% |
| Additional amounts | 100% | $0 | $0 |
| HOSPICE CARE: You must meet Medicare’s requirements, including a doctor’s certification of terminal illness | |||
| All but very limited copayment/coinsurance for outpatient drugs and inpatient respite care |
50% of Medicare copayment/ coinsurance |
50% of Medicare copayment/ coinsurance |
|
* A benefit period begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.
** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| MEDICAL EXPENSES—IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as physicians’ services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment | |||
| First $183 of Medicare-approved amounts* | $0 | $0 | $183 (Part B deductible) |
| Preventive benefits for Medicare-covered services | Generally 75% or more of Medicare-approved amounts | Remainder of Medicare-approved amounts | All costs above Medicare-approved amounts |
| Remainder of Medicare-approved amounts | Generally 80% | Generally 10% | Generally 10% |
| PART B EXCESS CHARGES (above Medicare-approved amounts) | |||
| $0 | $0 | All costs (and they do not count toward annual out-of pocket limit of $5,120 )** | |
| BLOOD | |||
| First three pints | $0 | 50% | 50% |
| Next $183 of Medicare-approved amounts* | $0 | $0 | $183 (Part B deductible) |
| Remainder of Medicare-approved amounts | Generally 80% | Generally 10% | Generally 10% |
| CLINICAL LABORATORY SERVICES— TESTS FOR DIAGONOSTIC SERVICES | |||
| 100% | $0 | $0 | |
* Once you have been billed $183 of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.
** This plan limits your annual out-of-pocket payments for Medicare-approved amounts to $5,120 per year. However, this limit does NOT include charges from your provider that exceed Medicare-approved amounts (“excess charges”) and you will be responsible for paying this difference in the amount charged by your provider and the amount paid by Medicare for the item or services.
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| HOME HEALTH CARE MEDICARE-APPROVED SERVICES | |||
| – Medically necessary skilled care services and medical supplies | 100% | $0 | $0 |
| – Durable medical equipment First $183 of Medicare-approved amounts* |
$0 | $0 | $183 (Part B deductible) |
| Remainder of Medicare-approved amounts | 80% | 10% | 10% |
* Once you have been billed $183 of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.
Medicare Supplement insurance costs include monthly premium payments and may include deductibles, out-of-pocket expenses, copayments and coinsurance. Here are some of the costs you can expect to pay with Plan A:
For more information on costs, get a quick quote or see the Medicare Supplement Outline of Coverage.
Basic benefits:
It’s important to know the critical features of the Medicare Supplement insurance plan you are considering. The Outline of Medicare Supplement Coverage provides brief descriptions of the basic provisions of the Medicare Supplement insurance plans, as well as details on policy renewability, benefit exclusions and coverage limitations.
Blue Cross and Blue Shield of Texas (BCBSTX) will never terminate or refuse to renew your Medicare Supplement Insurance policy because of the condition of your health. However, to protect you and the rights of all policy holders, there are situations when a Medicare Supplement insurance plan may be terminated or a renewal refused:
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| HOSPITALIZATION*: Semi-private room and board, general nursing, and miscellaneous services and supplies | |||
| First 60 days | All but $1,316 | $0 | $1,316 (Part A Deductible) |
| 61st through 90th day | All but $329 a day | $329 a day | $0 |
| 91st day and after: – While using 60 Lifetime Reserve Days – Once Lifetime Reserve Days are used: Additional 365 days |
All but $658 a day
$0 |
$658 a day 100% of Medicare eligible expenses |
$0
$0** |
| Beyond the additional 365 days | $0 | $0 | All costs |
| SKILLED NURSING FACILITY CARE*: You must meet Medicare’s requirements, including having been in a hospital for at least three days and entered a Medicare-approved facility within 30 days after leaving the hospital | |||
| First 20 days | All approved amounts | $0 | $0 |
| 21st through 100th day | All but $164.50 a day | $0 | Up to $164.50 a day |
| 101st day and after | $0 | $0 | All costs |
| BLOOD | |||
| First three pints | $0 | Three pints | $0 |
| Additional amounts | 100% | $0 | $0 |
| HOSPICE CARE: You must meet Medicare’s requirements, including a doctor’s certification of terminal illness | |||
| All but very limited copayment/coinsurance for outpatient drugs and inpatient respite care |
Medicare copayment/ coinsurance |
$0 | |
* A benefit period begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.
** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| MEDICAL EXPENSES—IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as physicians’ services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment | |||
| First $183 of Medicare-approved amounts* | $0 | $0 | $183 (Part B deductible) |
| Remainder of Medicare-approved amounts | Generally 80% | Generally 20% | $0 |
| PART B EXCESS CHARGES (above Medicare-approved amounts) | |||
| $0 | $0 | All costs | |
| BLOOD | |||
| First three pints | $0 | All costs | $0 |
| Next $183 of Medicare-approved amounts* | $0 | $0 | $183 (Part B deductible) |
| Remainder of Medicare-approved amounts | 80% | 20% | $0 |
| CLINICAL LABORATORY SERVICES— TESTS FOR DIAGONOSTIC SERVICES | |||
| 100% | $0 | $0 | |
* Once you have been billed $183 of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| HOME HEALTH CARE MEDICARE-APPROVED SERVICES | |||
| – Medically necessary skilled care services and medical supplies | 100% | $0 | $0 |
| – Durable medical equipment First $183 of Medicare-approved amounts* |
$0 | $0 | $183 (Part B deductible) |
| Remainder of Medicare-approved amounts | 80% | 20% | $0 |
* Once you have been billed $183 of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.
Medicare Supplement insurance costs include monthly premium payments and may include deductibles, out-of-pocket expenses, copayments and coinsurance. Here is what you can expect to pay with Plan G:
For more information on costs, get a quick quote or see the Medicare Supplement Outline of Coverage.
It’s important to know the critical features of the Medicare Supplement insurance plan you are considering. The Outline of Medicare Supplement Coverage provides brief descriptions of the basic provisions of the Medicare Supplement insurance plans, as well as details on policy renewability, benefit exclusions and coverage limitations.
Blue Cross and Blue Shield of Texas (BCBSTX) will never terminate or refuse to renew your Medicare Supplement Insurance policy because of the condition of your health. However, to protect you and the rights of all policy holders, there are situations when a Medicare Supplement insurance plan may be terminated or a renewal refused:
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| HOSPITALIZATION*: Semi-private room and board, general nursing, and miscellaneous services and supplies | |||
| First 60 days | All but $1,316 | $1,316 (Part A Deductible) | $0 |
| 61st through 90th day | All but $329 a day | $329 a day | $0 |
| 91st day and after: – While using 60 Lifetime Reserve Days – Once Lifetime Reserve Days are used: Additional 365 days |
All but $658 a day$0 | $658 a day
100% of Medicare eligible expenses |
$0$0** |
| Beyond the additional 365 days | $0 | $0 | All costs |
| SKILLED NURSING FACILITY CARE*: You must meet Medicare’s requirements, including having been in a hospital for at least three days and entered a Medicare-approved facility within 30 days after leaving the hospital | |||
| First 20 days | All approved amounts | $0 | $0 |
| 21st through 100th day | All but $164.50 a day | Up to $164.50 a day | $0 |
| 101st day and after | $0 | $0 | All costs |
| BLOOD | |||
| First three pints | $0 | Three pints | $0 |
| Additional amounts | 100% | $0 | $0 |
| HOSPICE CARE: You must meet Medicare’s requirements, including a doctor’s certification of terminal illness | |||
| All but very limited copayment/coinsurance for outpatient drugs and inpatient respite care |
Medicare copayment/coinsurance | $0 | |
* A benefit period begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.
** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| MEDICAL EXPENSES—IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as physicians’ services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment | |||
| First $183 of Medicare-approved amounts* | $0 | $0 | $183 (Part B deductible) |
| Remainder of Medicare-approved amounts | 80% | 20% | $0 |
| PART B EXCESS CHARGES (above Medicare-approved amounts) | |||
| $0 | 100% | $0 | |
| BLOOD | |||
| First three pints | $0 | All costs | $0 |
| Next $183 of Medicare-approved amounts* | $0 | $0 | $183 (Part B deductible) |
| Remainder of Medicare-approved amounts | 80% | 20% | $0 |
| CLINICAL LABORATORY SERVICES— TESTS FOR DIAGONOSTIC SERVICES | |||
| 100% | $0 | $0 | |
* Once you have been billed $183 of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| HOME HEALTH CARE MEDICARE-APPROVED SERVICES | |||
| – Medically necessary skilled care services and medical supplies | 100% | $0 | $0 |
| – Durable medical equipment First $183 of Medicare-approved amounts* |
$0 | $0 | $183 (Part B deductible) |
| Remainder of Medicare-approved amounts | 80% | 20% | $0 |
* Once you have been billed $183 of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.
Medicare Supplement insurance costs include monthly premium payments and may include deductibles, out-of-pocket expenses, copayments and coinsurance. Here is what you can expect to pay with Plan F:
For more information on costs, get a quick quote or refer to the Outline of Medicare Supplement Coverage.
It’s important to know the critical features of the Medicare Supplement insurance plan you are considering. The Outline of Medicare Supplement Coverage provides brief descriptions of the basic provisions of the Medicare Supplement insurance plans, as well as details on policy renewability, benefit exclusions and coverage limitations.
Blue Cross and Blue Shield of Texas (BCBSTX) will never terminate or refuse to renew your Medicare Supplement Insurance policy because of the condition of your health. However, to protect you and the rights of all policy holders, there are situations when a Medicare Supplement insurance plan may be terminated or a renewal refused:
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| HOSPITALIZATION*: Semi-private room and board, general nursing, and miscellaneous services and supplies | |||
| First 60 days | All but $1,316 | $1,316 (Part A Deductible) |
$0 |
| 61st through 90th day | All but $329 | $329 a day | $0 |
| 91st day and after: — While using 60 Lifetime Reserve days — Once Lifetime Reserve days are used: Additional 365 days |
All but $658
$0 |
$658 a day
100% of Medicare eligible expenses |
$0
$0** |
| Beyond the additional 365 days | $0 | $0 | All costs |
| SKILLED NURSING FACILITY CARE*: You must meet Medicare’s requirements, including having been in a hospital for at least three days and entered a Medicare-approved facility within 30 days after leaving the hospital | |||
| First 20 days | All approved amounts | $0 | $0 |
| 21st through 100th day | All but $164.50 a day | Up to $164.50 a day | $0 |
| 101st day and after | $0 | $0 | All costs |
| BLOOD | |||
| First three pints | $0 | Three pints | $0 |
| Additional amounts | 100% | $0 | $0 |
| HOSPICE CARE: You must meet Medicare’s requirements, including a doctor’s certification of terminal illness | |||
| All but very limited copayment/coinsurance for outpatient drugs and inpatient respite care | Medicare copayment/coinsurance | $0 | |
*A benefit period begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.
** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| MEDICAL EXPENSES—IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as physicians’ services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment | |||
| First $183 of Medicare-approved amounts* | $0 | $183 (Part B deductible) |
$0 |
| Remainder of Medicare-approved amounts | Generally 80% | Generally 20% | $0 |
| PART B EXCESS CHARGES (above Medicare-approved amounts) | |||
| $0 | 100% | $0 | |
| BLOOD | |||
| First three pints | $0 | All costs | $0 |
| Next $183 of Medicare-approved amounts* | $0 | $183 (Part B deductible) |
$0 |
| Remainder of Medicare-approved amounts | 80% | 20% | $0 |
| CLINICAL LABORATORY SERVICES—TESTS FOR DIAGONOSTIC SERVICES | |||
| 100% | $0 | $0 | |
* Once you have been billed $183 of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| HOME HEALTH CARE MEDICARE-APPROVED SERVICES | |||
| — Medically necessary skilled care services and medical supplies | 100% | $0 | $0 |
| — Durable medical equipment First $183 of Medicare-approved amounts* |
$0 | $183 (Part B deductible) |
$0 |
| — Durable medical equipment Remainder of Medicare-approved amounts |
80% | 20% | $0 |
* Once you have been billed $183 of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| FOREIGN TRAVEL—NOT COVERED BY MEDICARE: Medically necessary emergency care services beginning during the first 60 days of each trip outside the USA | |||
| First $250 each calendar year | $0 | $0 | $250 |
| Remainder of charges | $0 | 80% to a lifetime maximum benefit of $50,000 | 20% and amounts over the $50,000 lifetime maximum |
Medicare Supplement insurance costs include monthly premium payments and may include deductibles, out-of-pocket expenses, copayments and coinsurance. Here is what you can expect to pay with Plan F:
For more information on costs, get a quick quote or refer to the Outline of Medicare Supplement Coverage.
It’s important to know the critical features of the Medicare Supplement insurance plan you are considering. The Outline of Medicare Supplement Coverage provides brief descriptions of the basic provisions of the Medicare Supplement insurance plans, as well as details on policy renewability, benefit exclusions and coverage limitations.
Blue Cross and Blue Shield of Texas (BCBSTX) will never terminate or refuse to renew your Medicare Supplement Insurance policy because of the condition of your health. However, to protect you and the rights of all policy holders, there are situations when a Medicare Supplement insurance plan may be terminated or a renewal refused:
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| HOSPITALIZATION*: Semi-private room and board, general nursing, and miscellaneous services and supplies | |||
| First 60 days | All but $1,316 | $1,316 (Part A Deductible) |
$0 |
| 61st through 90th day | All but $329 | $329 a day | $0 |
| 91st day and after: — While using 60 Lifetime Reserve days — Once Lifetime Reserve days are used: Additional 365 days |
All but $658
$0 |
$658 a day
100% of Medicare eligible expenses |
$0
$0** |
| Beyond the additional 365 days | $0 | $0 | All costs |
| SKILLED NURSING FACILITY CARE*: You must meet Medicare’s requirements, including having been in a hospital for at least three days and entered a Medicare-approved facility within 30 days after leaving the hospital | |||
| First 20 days | All approved amounts | $0 | $0 |
| 21st through 100th day | All but $164.50 a day | Up to $164.50 a day | $0 |
| 101st day and after | $0 | $0 | All costs |
| BLOOD | |||
| First three pints | $0 | Three pints | $0 |
| Additional amounts | 100% | $0 | $0 |
| HOSPICE CARE: You must meet Medicare’s requirements, including a doctor’s certification of terminal illness | |||
| All but very limited copayment/coinsurance for outpatient drugs and inpatient respite care | Medicare copayment/coinsurance | $0 | |
*A benefit period begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.
** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| MEDICAL EXPENSES—IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as physicians’ services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment | |||
| First $183 of Medicare-approved amounts* | $0 | $183 (Part B deductible) |
$0 |
| Remainder of Medicare-approved amounts | Generally 80% | Generally 20% | $0 |
| PART B EXCESS CHARGES (above Medicare-approved amounts) | |||
| $0 | 100% | $0 | |
| BLOOD | |||
| First three pints | $0 | All costs | $0 |
| Next $183 of Medicare-approved amounts* | $0 | $183 (Part B deductible) |
$0 |
| Remainder of Medicare-approved amounts | 80% | 20% | $0 |
| CLINICAL LABORATORY SERVICES—TESTS FOR DIAGONOSTIC SERVICES | |||
| 100% | $0 | $0 | |
* Once you have been billed $183 of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| HOME HEALTH CARE MEDICARE-APPROVED SERVICES | |||
| — Medically necessary skilled care services and medical supplies | 100% | $0 | $0 |
| — Durable medical equipment First $183 of Medicare-approved amounts* |
$0 | $183 (Part B deductible) |
$0 |
| — Durable medical equipment Remainder of Medicare-approved amounts |
80% | 20% | $0 |
* Once you have been billed $183 of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.
| Services | Medicare Pays | Plan Pays | You Pay |
|---|---|---|---|
| FOREIGN TRAVEL—NOT COVERED BY MEDICARE: Medically necessary emergency care services beginning during the first 60 days of each trip outside the USA | |||
| First $250 each calendar year | $0 | $0 | $250 |
| Remainder of charges | $0 | 80% to a lifetime maximum benefit of $50,000 | 20% and amounts over the $50,000 lifetime maximum |
