2017 Medicare Plans

Understanding Medicare and choosing a health plan are not always easy.  That’s why we’re here; to be your partner and help you along the way. Blue Shield of Northeastern New York offers different types of Medicare Advantage plans, giving you options to find the plan that’s right for you. 

Not sure where to start or which option to choose?  Call or chat online with us and we will help you find the right plan.

Senior Blue HMO

Nurse and Patient

With our Senior Blue health maintenance organization (HMO) coverage, you can choose from plans with low monthly premiums and have access to care out-of-network. All of our HMO plans feature worldwide emergency care coverage, nationwide urgent care coverage, no deductibles, and no referrals.

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Forever Blue Medicare PPO

Medicare Couple

Our Forever Blue Medicare preferred provider organization (PPO) plans offer the freedom to see any doctor or hospital that accepts Medicare nationwide. This plan also features worldwide emergency care coverage, no deductibles, no referrals, and prescription drug coverage. Choose a plan with a lower premium or a plan that allows you to pay in-network copays with participating doctors and hospitals when you travel.

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Optional Supplemental Dental Benefit

Medicare Couple

We have two optional supplemental dental benefits to choose from – Basic or Enhanced. With the Basic plan you pay $19 per month. With the Enhanced plan, you pay $34 per month. The optional supplemental dental benefit can be added to your Senior Blue HMO or Forever Blue Medicare PPO plan. This optional benefit is not covered by Original Medicare or included in your plan. You also need to continue paying your Medicare Part B and Medicare Advantage premiums.

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Medigap

Medigap

Original Medicare pays for many, but not all health care services and supplies. Medigap can help pay some of the health care costs (“gaps”) that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles.

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Medicare Advantage Out-of-Network Coverage Rules

Medigap

Information about what services are covered out-of-network on our Medicare Advantage Plans.

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1-877-258-7453 (TTY 711)

Oct. 1 - Feb. 14, 8 a.m. to 8 p.m., 7 days a week
Feb. 15 - Sept. 30, 8 a.m. - 8 p.m., Mon. - Fri.

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Find a Medicare Advantage meeting near you.

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You must live in one of the following Northeastern counties to be eligible for enrollment in one of our Medicare Advantage plans:

  • Albany
  • Columbia
  • Fulton
  • Greene
  • Montgomery
  • Rensselaer
  • Saratoga
  • Schenectady
  • Warren
  • Washington


You may enroll in a Medicare Advantage plan only during specific times of the year:

  • When you first become eligible for Medicare, the seven month period  beginning three months before you turn 65,
    the month you turn 65 and three months after you turn 65
  • If you get Medicare due to a disability
  • During the Annual Enrollment Period from October 15, 2016 and December 7, 2016

    In most cases, you must stay enrolled for the calendar year that starts the date your coverage begins.
    In certain situations, however, you may be able to join, drop or switch a Medicare Advantage Plan, at other times.

    Some of these situations include the following:
  • During the Medicare Advantage Disenrollment Period, between January 1 and February 14, you may drop your Medicare Advantage Plan and return to Original Medicare 
  • If you move out of the plan’s service area
  • If you have both Medicare and Medicaid
  • If you qualify for extra help to pay for your prescription drugs
  • If you live in an institution


If you have any questions, please call Customer Service at:
1-800-329-2792, TTY: 711

We are open:

October 1 - February 14

8 a.m. to 8 p.m., 7 days a week

February 15 - September 30

8 a.m. to 8 p.m., Monday-Friday

During non-business hours, your call will be answered by our automated phone system. A customer service representative will return your call on the next business day.

Call Customer Service for help if you have questions or concerns. We also welcome any suggestions you may have for improving our plan or to make recommendations regarding the Member Rights and Responsibilities Policy (Please see the Member Rights and Responsibilities section of your Evidence of Coverage for more information).

 

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change January 1 of each year. The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. 

Out-of-network/non-contracted providers are under no obligation to treat BlueShield of Northeastern New York members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. 

Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next.

BlueShield of Northeastern New York is a Medicare Advantage plan with a Medicare contract and enrollment depends on contract renewal.

Y0086_MRK1718 Approved
Content Last Updated December 15, 2016

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