Blue Shield Medicare Advantage Plan

65 Plus (HMO)  & Choice 

(Choice has More Benefits, but Fewer Providers)

Enroll ONLINE

Blue Shield 65 Plus Choice Plan (HMO)
Summary of Benefits

2018   Email us [email protected] for 2019 Blue Shield 65 Plus Choice Plan (HMO) Summary of Benefits

Resources & Links

Member Services 800.766.4466   [TTY 711]. Available 7 a.m. to 8 p.m., seven days a week, from October 1 through February 14. However, after February 14, calls are handled by an automated phone system on weekends and holidays.

Blue Shield Financial Strength

More on financials & Mission Statement on our Individual Site

Silver Sneakers.com

Wellness Tools

Blue Shield Fraud Hotline

 

Blue Shield of California is an HMO and PDP plan with a Medicare contract.   Enrollment in Blue Shield of California depends on contract renewal.

 

Blue Shield 65 PlusSM (HMO),

Blue Shield 65 PlusSM Choice Plan (HMO) and

Blue Shield Trio Medicare (HMO) 

are Medicare HMOs with a Medicare Advantage-Prescription Drug Plan contract. These  plans cover the same basic benefits as Original Medicare plus Part D prescription drug coverage.

Our plans include*:

1. $0 monthly plan premium, depending on the plan and geographic area.
2. $0 copay for annual wellness visits
3. $0 copay for primary care physician and specialist office visits, depending on the plan
4. $0 copay for preferred generic drugs when purchased at Albertsons/Osco/Savon, Costco, CVS Pharmacy including CVS Pharmacy at Target), and Safeway, Vons, Walmart, Ralphs and many more pharmacies, and by mail service
5. $0 copay for SilverSneakers® fitness depending on the plan
6. Additional vision and hearing coverage
7. Optional supplement dental coverage with one of the state’s largest dentist networks
8. Personal Emergency Response System (PERS) and Hearing Aid benefits are available in Blue Shield 65 Plus Choice Plan offered in San Bernardino and Riverside counties and Blue Shield 65 Plus in Los Angeles, Orange and San Diego counties.

Blue Shield Authorized Agent - No extra charge to you - Click to learn more and enroll online
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Summary of Benefits
for Blue Shield Medicare Advantage Plans

For more information – Email us

Scope of Appointment – English

  • 20182019 Blue Shield 65 Plus (HMO) Los Angeles & Orange County
  • 20182019 Blue Shield 65 Plus (HMO) San Bernardino County
  • 20182019 Blue Shield 65 Plus (HMO) Riverside County
  • 20182019 Blue Shield 65 Plus (HMO) San Diego County
  • 20182019 Blue Shield 65 Plus (HMO) Ventura County
  • 2019 Blue Shield 65 Plus (HMO) San Luis Obispo and Santa Barbara counties
  • 20182019 Blue Shield 65 Plus (HMO) Fresno County
  • 2019 Blue Shield 65 Plus (HMO) Kern County  (PDF, 127.6KB)
  • 20182019 Blue Shield Trio Medicare (HMO)
  • 20182019 Blue Shield 65 Plus Choice Plan (HMO)Los Angeles & Orange County  
  • 2019 Blue Shield 65 Plus Choice Plan (HMO) San Bernardino & Riverside  

 

Formularies & Rx Prescription Drug Resources

View formularies

Blue Shield has a program that helps members with certain chronic conditions better manage their drug therapy.  Learn more about the program

Learn more about appeals and grievances

Find prior authorization request forms

Read FAQs

Learn about exceptions if you find our plan does not cover your medication and how you can ask us to make an exception to our coverage rules.  Learn more about coverage determinations

Medicare can help people with limited incomes pay for their prescription drug costs.  Find out how to get additional help

2019  Paper pdf Enrollment form

Medicare and You 2019 - Everything you want to knowMedicare and You 2019 #10050 - Everything you want to know * See their section on closing the donut hole

Learn More – Blue Shield Medicare Advantage Plans – ONLINE Enrollment

Applications:

Blue Shield Medicare Advantage
HMO ONLINE Enrollment Form 

20182019  Paper pdf Enrollment form

Online is better.  If you use paper, be sure to email back to us for processing and appointment as your broker, no extra charge.

20182019 Blue Shield Medicare Advantage HMO Change of Plan Form

2018 Medicare Plan Ratings Information for MAPD-English and Spanish  (PDF, 136KB)

2019 Medicare Plan Ratings Information for MAPD-English and Spanish

2019 Optional Supplemental Dental form English and Spanish  (PDF, 1MB)

 

18 comments on “Blue Shield 65 Plus HMO 2019

  1. I live in Orange County and have Blue Shield 65 Plus.

    I got an outpatient X-ray done at my doctor’s, St Jude Heritage.

    On my summary of benefits
    https://www.blueshieldca.com/bsca/bsc/public/broker/PortalComponents/StreamDocumentServlet?fileName=2019_MAPD-LAOR-SOB.pdf

    it clearly states that I pay nothing.

    However, Blue Shield is telling me that because my doctor ordered 2 views it now becomes a “complex X-ray” to quote them and therefore I have to pay a $40 co-pay as if it was a ct scan etc,

    What is going on?

    • Here’s some thoughts & suggestions:

      Medicare Advantage offers Part D Rx at no additional charge

      You might just pay cash for the entire MD visit, Medicare wouldn’t pay, as when you have Medicare Advantage, the Insurance Company takes care of everything.

      See our webpage on the pros & cons of Medi Gap vs Medicare Advantage and what’s best for each person.

      Just get a Part D plan and leave what Medicare doesn’t pay as something you pay out of pocket, like you’re doing now. Note, if you didn’t buy Part D when first eligible, there might be a late enrollment penalty.

      Get a Medi Gap plan. Look at High F from Blue Shield, sure it has a deductible, but that doesn’t stop Medicare from paying first. The price is right. Here’s where we explained to another web visitor how to figure out the rate chart. Or, just send an email, with zip code and date of birth and we can send you your specific rate.

      If you want to discuss this on the phone, face to face, video conference, etc. see above for our appointment scheduler.

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