What You Need to Know About Open Medicare Enrollment | California Blue Shield


From October 15 to December 7, millions of Medicare beneficiaries will have the option to choose a health or drug plan for 2021, or make changes to their current coverage during what’s called the annual election period (AEP).

We asked Krista Bowers, Managing Director and Vice President of Medicare at Blue Shield of California, for tips and things to consider for individuals and families looking for Medicare and Medicare Supplement plans for 2021.

What will be new in 2021 for Medicare beneficiaries considering Blue Shield of California plans, and what do they need to know?

Each fall, Medicare beneficiaries must think about making informed decisions about their health and drug needs for the following year and decide whether they want to change any of their Medicare coverage options. . This is especially important this year as we continue to navigate the COVID-19 pandemic and California wildfires.

As of January 1, 2021, we are excited to announce new benefits for Blue Shield of California Medicare Advantage plan members.[i], comprising:

  • Telehealth services by phone or video 24 hours a day, seven days a week.
  • Assessment and treatment of acupuncture not covered by Medicare.
  • Chiropractic services not covered by Medicare, including initial and subsequent examinations and treatments, x-rays and laboratory tests.
  • In addition to the annual wellness visit, a physical exam every 12 months that includes a comprehensive review of the member’s medical and family history, a detailed head-to-toe assessment, and other services.
  • Home meal delivery service for members discharging from an inpatient hospital or skilled nursing facility – up to 22 meals and 10 snacks.

We are also expanding our coverage across California, with service area extensions in Santa Clara, San Joaquin, Stanislaus, and Merced counties in Northern California, as well as San Luis Obispo and Santa Barbara counties. in the central coast region. Our goal is to serve more Californians through our innovative diet designs and benefits.

What sets Blue Shield apart from our Medicare and Medicare Supplement product lines?

This year, Blue Shield of California formed a collaboration with AAA Northern California to bring important products and services to our Medicare Supplement and Medicare Advantage plan members, which includes the launch of four new plans – Blue Shield Inspire (HMO), Blue Shield Inspire (HMO D-SNP), Blue Shield Inspire (PPO) and Blue Shield Medicare Supplement Plan G Inspire.

Blue Shield’s new Medicare Supplement Plan G Inspire will provide all the benefits of Medicare Supplement Plan G as well as additional health services such as:

  • Hearing aid including annual routine hearing test.
  • Vision benefits, including eye exam coverage and eyeglass frames and lenses or contact lenses.
  • Physician consultation benefit offering 24/7/365 access available by phone or video via computer or mobile app.
  • Over-the-counter items offer a quarterly allowance for items such as cold and allergy medications, first aid supplies, pain relievers and more.
  • SilverSneakers fitness benefits at no additional cost, including tools for general wellness over the phone, online or in person[ii].

All members of the Medicare G Inspire supplemental plan and eligible members of the Blue Shield Inspire Medicare Advantage plans[iii] will also have access to the benefits of independence and safe mobility which include[iv]:

  • Classic AAA membership[v] – a one-year subscription with AAA 24/7 roadside assistance.
  • AAA Roadwise Driver – a course designed to help older people hone their driving skills to become safer drivers.
  • Driving educational resources – with a dedicated website containing resources and tips for drivers, such as AAA Roadwise Rx[vi] – a tool designed to help members learn more about their medications and how they may affect their driving.

What are the most common mistakes people make when buying a health insurance plan?

Here are some common mistakes people can avoid when it comes time to shop for a health insurance plan.

  • Not signing up for Medicare at the right time. As you approach age 65, you’ll want to enroll during what the government calls your Initial Enrollment Period (IEP). This period begins three months before the month of your 65th birthday and lasts until three months after.
  • Not understanding your reimbursable expenses. Although Medicare covers most of the medical expenses of its registrants, they may also have to pay the reimbursable expenses.
  • Choose a Medicare Advantage plan whose network does not include your health care providers.
  • Choose drug insurance that does not fully and affordably cover your prescriptions that you need.

Choosing the right health plan is important at any stage of life, and we’re here to help. As a nonprofit health plan, our north star is to ensure that all Californians have health care worthy of our family and friends and affordable in a sustainable manner, and this is especially true of members of our Medicare plan.

[i] Benefits vary by plan and service area. See blueshieldca.com/medicare for full details.

[ii] Benefits vary by plan and service area. See blueshieldca.com/medicare for full details.

[iii] As of January 1, 2021, available in select northern California counties.

[iv] Blue Shield Inspire Chronic Illness Special Supplementary Benefit (SSBCI) requires determination of eligibility. You must have one or more eligible chronic illnesses to receive this benefit. To determine eligibility for SSBCI, Blue Shield Inspire members with a plan effective date of January 1, 2021 or later must complete an attestation form and submit it to the plan. For members whose effective Blue Shield Inspire registration date is prior to January 1, 2021, Blue Shield will review member data to determine their eligibility and notify members of their eligibility. Please see the EOC plan for more details.

[v] Classic AAA membership, new or renewed for one year in 2021, valued at up to $ 56 / year. AAA membership provided by AAA Northern California, Nevada and Utah.

[vi] This tool aims to provide users with general information to help them better understand the road safety implications of using certain drugs before driving. The information is not medical advice. Consult your doctor before changing medications or driving, or if you have specific medical questions or think you have a medical condition.

Blue Shield Inspire (HMO) is only available in the following counties: Alameda, Fresno, Madera, Merced, Sacramento, Santa Clara, San Joaquin, San Mateo, and Stanislaus.

Blue Shield Inspire (HMO D-SNP) is only available in the following countries: Fresno, San Joaquin, and Stanislaus.

Blue Shield Inspire (PPO) is only available in the following county: Alameda.

SilverSneakers is a registered trademark of Tivity Health, Inc. © 2020 Tivity Health, Inc. All rights reserved.


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