Compare plans

We want to help you choose the
Blue Medicare Supplement plan that’s
right for you. First, take a look at the
benefits listed in the chart and determine which ones are most important to you.
Then, select the plan that includes those benefits. Premiums for each plan are
listed at the bottom of the chart.

A wide selection
of plans
Largest market share*
Local company
you’ve trusted for
over 75 years
Value-added
programs¥

Members have the freedom to choose their own doctor without a referral and can visit any
Medicare-participating hospital. And in most cases, we handle Part A and Part B Medicare
claims and supplemental claims automatically

Quality supplemental coverage

Wide selection of plans We offer eleven Blue Medicare Supplement plans to fit individual health care needs and budgets.
Blue Medicare Supplement may help take care of costs that Original Medicare doesn’t cover, so
members won’t have to worry about their health-related expenses.Locked in entry-age1 forever
For our entry-age plans, when members enroll in a Blue Medicare Supplement plan within
the first six months of enrolling in Medicare Part B, they lock in their entry-age forever.1
Rate adjustments will be made only due to medical inflation or overall claims experience.

No waiting periods for
pre-existing conditions18
Members who enroll early may be eligible for a Blue Medicare Supplement plan without
medical underwriting and waiting periods for pre-existing conditions

Choice of doctors with
virtually no claims to file
Members have the freedom to choose their own doctor without a referral and can visit any
Medicare-participating hospital. And in most cases, we handle Part A and Part B Medicare
claims and supplemental claims automatically.

Early enrollment means guaranteed acceptance
Enrollees cannot be turned down for Blue Medicare Supplement
coverage with BCBSNC if they meet all of the following
requirements:
+ They are age 65 or older and eligible for Medicare or under
age 65 and are eligible for Medicare by reason of disability
(Plans A, and C)

We want to help you choose the
Blue Medicare Supplement plan that’s
right for you. First, take a look at the
benefits listed in the chart and determine which ones are most important to you.
Then, select the plan that includes those benefits. Premiums for each plan are
listed at the bottom of the chart

+ They enroll within 6 months of enrolling in Medicare Part B
+ They are not covered by certain Medicaid programs
+ They are a resident of North Carolina

Benefits covered by
Blue Medicare Supplement
(Original Medicare does not cover the following benefits3)

Compare plans
Benefits covered by
Blue Medicare Supplement
(Original Medicare does not cover the following benefits3)
Part A (Hospitalization)
$1,100 Inpatient hospital deductible each benefit period
$275 a day copayment for days 61-90 in a hospital
$550 a day copayment for days 91-150 (lifetime reserve4)
100% of Medicare allowable expenses for additional
365 days after Medicare hospital benefits stop completely
First 3 pints of blood per calendar year5
$137.50 per day for days 21-100 in a skilled nursing facility6
Hospice care copayment/coinsurance
Part B (Physician and medical services)
$155 Part B deductible
Generally, 20% of Medicare-approved amount
(Part B coinsurance) after Part B deductible is met
100% of Medicare Part B excess charges7
Additional benefits not covered by Medicare
Benefits for medically necessary emergency care
received in a foreign country8
Blue Medicare Supplement monthly rates9
Age Under 65
Age 65
66–69
70–74
75 and over
1)With our entry-age plan, members enroll and lock in their entry-age forever, as long as they stay in the Medicare supplement plan that they initially chose. Any rate adjustments will only be due to medical inflation or overall claims experience. Any change in their rate will be preceded by a 30-day notice and is guaranteed for 12 months. Rates are subject to change June 1 of each year, but members alone will
not be singled out for premium increases based on their health or age. 2)When you enroll in an attained-age plan, your initial rate may be lower than the rate of an entry-age rated plan, and your rates will increase as you age, due to your age. Compare entry-age and attained-age plans to see which plans offer the best cost for you. 3)This is only a summary of benefits describing the policies’ most important features. The policy is the insurance contract. You must read the policy itself to understand all the rights and duties of both you and your insurance company. These policies may not fully cover all of your medical costs. Neither BCBSNC nor its agents are affiliated with Medicare. 4) After 90 days of hospitalization, Medicare benefits are paid from a one- time, lifetime reserve of 60 additional days, which are not renewable each benefit period. 5) If blood is donated to replace what you use, there is no charge. 6) You must have been in a hospital for at least three days and enter a Medicare-approved facility generally within 30 days after hospital discharge, no benefits after 100 days. 7) On all plans offered except PLANS F, High Ded F and G, members may be responsible for charges higher than the amount approved by Medicare unless the provider agrees to accept Medicare’s approved amount as full payment. These plans are covered at 100% for these charges. 80% of medically necessary emergency care services beginning during the first 60 days of trip outside of USA, after $250 annual deductible, up to $50,000
We want to help you choose the
Blue Medicare Supplement plan that’s
right for you. First, take a look at the
benefits listed in the chart and determine which ones are most important to you.
Then, select the plan that includes those benefits. Premiums for each plan are
listed at the bottom of the chart.
Entry-age and attained-age plans
We offer Blue Medicare Supplement plans with entry-age rates or attained-age rates. When you enroll in an entry-age plan, you lock in your entry-age. Your plan’s rates won’t increase due to age.1 So, if you purchase an entry-age plan at age 65,
you’ll always pay the rate of a 65-year old, even as you age, provided you remain in
the entry-age plan.
We also offer attained-age plans that feature lower initial rates than the initial rate of entry-age plans, but these rates increase due to age. You can compare entry-age and attained-age plans to see which one best meets your needs.

Benefits covered by
Blue Medicare Supplement
(Original Medicare does not cover the following benefits3)
Part A (Hospitalization)
$1,100 Inpatient hospital deductible each benefit period
$275 a day copayment for days 61-90 in a hospital
$550 a day copayment for days 91-150 (lifetime reserve4)
100% of Medicare allowable expenses for additional
365 days after Medicare hospital benefits stop completely
First 3 pints of blood per calendar year5
$137.50 per day for days 21-100 in a skilled nursing facility6
Hospice care copayment/coinsurance
Part B (Physician and medical services)
$155 Part B deductible
Generally, 20% of Medicare-approved amount
(Part B coinsurance) after Part B deductible is met
100% of Medicare Part B excess charges7
Additional benefits not covered by Medicare
Benefits for medically necessary emergency care
received in a foreign country8

Early enrollment means guaranteed acceptance
Enrollees cannot be turned down for Blue Medicare Supplement
coverage with BCBSNC if they meet all of the following
requirements:
+ They are age 65 or older and eligible for Medicare or under
age 65 and are eligible for Medicare by reason of disability
(Plans A, and C)
+ They enroll within 6 months of enrolling in Medicare Part B
+ They are not covered by certain Medicaid programs
+ They are a resident of North Carolina

* Based on “2008 Medicare Supplement Insurance Experience Exhibits”, published in 2009 by
the National Association of Insurance Commissioners (NAIC), as supplied by Mark Farrah.
¥ These value-added programs may change or be discontinued at any time. BCBSNC does not
profit from this program. BCBSNC provides these programs for member convenience and is
not liable in any way for the goods and services received. These programs are not part of a
member’s policy or benefits, but are value-added discounts available for their use.
18 Pre-existing conditions are conditions for which medical advice was given or treatment was
recommended by or received from a physician within six months before the effective date of
coverage. If enrollees wait until after the deadline to enroll, they may have a waiting period for preexisting
conditions and may have to complete a medical questionnaire