If You’re on Medicare

This is an overhaul of the health care system, and there are some immediate effects on Medicare beneficiaries:

  • Donut hole rebates: This year, if you’re receiving Medicare benefits (and are not already receiving ) and your prescription drug coverage reaches the coverage gap in 2010, you will automatically be mailed a one-time, $250 rebate check. There is nothing you need to do. Checks are being mailed monthly throughout the year as beneficiaries reach the “donut hole.”
  • Preventive care: There will be no cost-sharing, such as, copays for most preventive services required by the Centers for Medicare and Medicaid services, including breast, prostate, cervical, and colon cancer screening, bone mass measurement, and routine physical exams.
  • Medicare Advantage (MA) enrollment period change: People with Medicare may enroll in a plan or prescription drug plan during the six-week Annual Election Period (AEP), from November 15 through December 31 for 2010, and from October 15 through December 7 for every year after.

Independence Blue Cross has several Medicare Supplement Plans that include enhanced hospice benefits compliant with Medicare regulations. On the web, we offer IBXmedicare.com, where the complexities of Medicare are spelled out in simple language and you can compare plans, find a pharmacy, and much more.

See our timeline to learn about how IBC will implement all the provisions of the law into our plans, now through 2020.

New out-of-pocket maximums

A new maximum out-of-pocket (MOOP) limit, mandated by the Centers for Medicare & Medicaid Services, is now in effect for Medicare Advantage HMO and PPO members. Once members have reached this limit, they will not be liable for any additional claim costs (Part A and B) for the remainder of the calendar year.

For 2011, the following amounts apply:

  • HMO members: $6,700.
  • PPO members: $6,700 for in-network services, and $10,000 for in-network and out-of-network services combined.

The following deductible, copay, and coinsurance amounts will be included in the MOOP:

  • medical (Medicare Part A and B services);
  • mental health (Medicare Part A and B services);
  • pharmacy (Medicare Part B drugs only).
  • Part D drugs do not count toward the MOOP and will continue to be part of the existing true out-of-pocket costs limit.


If you need help in understanding IBC’s Medicare plan options, please visit our website at IBXmedicare.com.