California Health News

Blue Shield Medicare Supplement Prescription Drug Benefit Changes

Kevin Knauss

Blue Shield of California

Members in a closed plan that includes prescription drug benefits will receive 2017 notices!

We are notifying the members in the following closed plans that their prescription drug coverage will be considered non-creditable in 2017, which is a change from 2016, when their prescription drug coverage was considered creditable.  This means that the coverage offered by their plan is not expected to pay out as much as standard Medicare prescription drug coverage pays.

We are notifying the members in the following closed plans that their prescription drug coverage will continue to be considered non-creditable in 2017. No change from 2016.

Important Notice From Blue Shield of California About

Your Prescription Drug Coverage and Medicare

Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Blue Shield of California (Blue Shield) and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.

There are three important things you need to know about your current coverage and Medicare’s prescription drug coverage:

  1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare.You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
  1. Blue Shield has determined that the prescription drug coverage offered by your Blue Shield Medicare Supplement plan is, on average for all plan participants, NOT expected to pay out as much as standard Medicare prescription drug coverage pays. Therefore, your coverage is considered Non-Creditable Coverage. This is important because, most likely, you will get more help with your drug costs if you join a Medicare drug plan, than if you only have prescription drug coverage from your Blue Shield Medicare Supplement plan.This also is important because it may mean that you may pay a higher premium (a penalty) if you do not join a Medicare drug plan when you first become eligible.
  1. You can keep your current coverage from Blue Shield. However, because your coverage is non-creditable, you have decisions to make about Medicare prescription drug coverage that may affect how much you pay for that coverage, depending on if and when you join a drug plan. When you make your decision, you should compare your current coverage, including what drugs are covered, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area. Read this notice carefully – it explains your options.

When Can You Join A Medicare Drug Plan?

You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th to December 7th.

Since you are losing creditable prescription drug coverage under the Blue Shield Medicare Supplement plan, you are also eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.

When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan?

Since the coverage under your Blue Shield Medicare Supplement plan, is not creditable, depending on how long you go without creditable prescription drug coverage you may pay a penalty to join a Medicare drug plan. Starting with the end of the last month that you were first eligible to join a Medicare drug plan but didn’t join, if you go 63 continuous days or longer without prescription drug coverage that’s creditable, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join.

What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan?

If you decide to join a Medicare drug plan, your current Blue Shield Medicare Supplement coverage will be affected.

You cannot have prescription drug benefits through both a Medicare Supplement plan and a Medicare Prescription Drug Plan at the same time. If you enroll in a Medicare Prescription Drug Plan and also wish to keep your Medicare Supplement plan, please let us know, as federal law requires us to remove the prescription drug benefit from your Medicare Supplement. When we do, we will adjust your Medicare Supplement plan rates to reflect removal of the prescription drug benefit.

If you choose to get your Medicare prescription drug coverage through a Medicare Advantage plan (a managed care plan offered by a company such as Blue Shield that contracts with the federal government to provide your Medicare benefits), you must cancel your Blue Shield Medicare Supplement. When making your decision, please keep in mind that recent changes in law require us to make certain changes to our Medicare Supplement plans. These changes will have an effect on your future rates, especially for policies with drug benefits. Please contact your broker or Blue Shield representative if you have any questions, so we can discuss any differences in rates, as well as all of your different healthcare choices.

If you do decide to join a Medicare drug plan and drop your current Blue Shield Medicare Supplement prescription drug coverage, be aware that you and your dependents will not be able to get this coverage back.

For More Information About This Notice Or Your Current Prescription Drug Coverage…

Contact the person listed below for further information. NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan and if this coverage through Blue Shield changes. You also may request a copy of this notice at any time.

For More Information About Your Options Under Medicare Prescription Drug Coverage…

More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare.

You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage:

If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at

www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).

Date: 10/01/16

Name of Entity/Sender: Blue Shield of California

Contact–Position/Office: Customer Service

Address: P.O. Box 272540

Chico, CA 95927-2540

Phone Number: (800) 248-2341 [TTY: 711]