BCBSGa Emphasizes Better Health through New Medicare Advantage Plans in Georgia, Provider Collaboration, Extra Benefits

Staff Report From Georgia CEO

Tuesday, October 6th, 2015

As Medicare’s primary sales season gets under way, Blue Cross Blue Shield of Georgia is emphasizing better health in Georgia through provider collaboration and new Medicare Advantage plans with extra benefits.

“Even with the Medicare reimbursement environment changing, we think it’s critical to structure our plans to provide our members with real value over Original Medicare, including extra benefits and strong local alliances”

This includes expanding Dual-Eligible Special Needs Plans for people eligible for both Medicare and Medicaid, and traditional HMOs for the general population. BCBSGa Medicare Advantage Prescription Drug plans continue to offer significant benefits not available in Original Medicare, including dental and vision coverage.

“Even with the Medicare reimbursement environment changing, we think it’s critical to structure our plans to provide our members with real value over Original Medicare, including extra benefits and strong local alliances,” said David McNichols, president of the company’s Medicare central region.

Following are some specifics on BCBSGa MAPD plans that will be available for the Annual Election Period, or AEP, which begins Oct. 15 and continues through Dec. 7. BCBSGa offers MAPD plans primarily in the Atlanta, Columbus, Macon, Augusta and Savannah areas. Plans are effective Jan. 1, 2016.

New and expansion plans. BCBSGa is expanding its $0 premium MAPD Medicare Dual-Eligible Special Needs Plan, also known as a DSNP, called BCBSHP MediBlue Dual Advantage, to the following Georgia counties: Bryan, Burke, Columbia, Glascock, Jefferson, McDuffie, Richmond and Warren. A traditional HMO plan called BCBSHP MediBlue Plus is being expanded into those same counties. Like existing BCBSGa special needs plans in the state, the new DSNP plan includes dental and vision coverage, some transportation to doctor’s appointments and some over-the-counter drug costs, all at no extra cost. Unlike most plans, people who qualify for a DSNP have a continuous Special Election Period, which means they can elect a new plan at any time throughout the year.

Provider collaboration. BCBSGa is launching a new $0 premium HMO Select product in Clayton, DeKalb and Fulton counties called BCBSHP MediBlue Prime Select featuring a close collaboration with Emory Healthcare to coordinate care. Emory is Georgia’s largest health care system.

Online doctor’s visits. LiveHealth Online telehealth will continue to be available in BCBSGa’s plans. LHO allows members to access board-certified doctors through their computer or mobile device, and will include a behavioral health benefit effective Jan. 1, 2016. With this additional benefit, members can generally choose a qualified mental health expert and schedule a counseling session in advance to be held during available hours. (Those in crisis should call 911). Both seeing a doctor and counseling visits are available at $0 copay to eligible members.

More $0 generics. BCBSGa is enhancing its Medicare pharmacy benefits in 2016. Both Prescription Drug Plans and MAPD plans will feature a “Select Tier” with selected generic drugs for a $0 copay at preferred pharmacies, including some drugs that treat high blood pressure, high cholesterol and diabetes. BCBSGa also has several PDP plans that offer certain generics in the coverage gap for a $0 copay. BCBSGa has more than 200 preferred pharmacies in Georgia, including CVS, Food Lion, Kroger, Target and Wal-Mart (Sam’s Club).

In addition to MAPD plans, BCBSGa offers Medicare Supplement plans and standalone PDP plans across all Georgia counties. Medicare Supplement plans help cover costs Original Medicare doesn’t, such as copayments, coinsurance and deductibles. These plans offer access to any doctor or medical facility that accepts Medicare, generally for a higher premium than an MAPD. They are generally paired with a PDP.

“We pride ourselves in being one of the nation’s only insurers that can offer a full continuum of Medicare products, including something for every budget and lifestyle,” McNichols said.