How To Get A Blue Cross Plan For Seniors

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1 Medicare supplement plans Peace of mind from a name you trust

2 Flexible plans backed by over 70 years of experience We ll be there for you Medicare supplement plans are designed to fill in the gaps that Medicare leaves behind. Blue Cross and Blue Shield of Minnesota gives you plans with the coverage you need and the peace of mind you want. And since we ve been serving more Minnesotans than any other plan for over 70 years, you know we ll be there for you. Choose what s right for you Blue Cross plans are flexible to work with Medicare and your budget. You can personalize your plan with options like preventive care and prescription drug coverage. You can see almost any doctor in Minnesota and you never need a referral. And your plan travels with you, wherever you go. Important extras make the difference Even if you choose a plan without prescription drug coverage, you ll receive preferred drug pricing available only to Blue Cross members. You can also use a 24-hour nurse-advice phone line whenever you need it. You ll receive eyewear and hearing aid discounts, along with discounts on complementary care. The savings add up, and all are included at no additional cost. And when you have questions, our customer service representatives are ready to help, or you can visit mybluecross, your online member service center, any time.

3 Monthly rates for Blue Cross Medicare supplement plans Basic Medicare Blue Tobacco-free Standard (Basic Medicare Supplement) $85 $100 Plus optional coverage of preventive care services $ 5 $ 5 Plus optional coverage of Medicare s Part A deductible $44 $51 Plus optional coverage of Medicare s annual Part B deductible $ 8 $ 8 Plus optional coverage of amounts up to usual and customary charges $24 $36 Your monthly total for Basic Medicare Blue plus any or all options $ $ Senior Gold Tobacco-free Standard (Basic Medicare Select plan) $114 $151 Plus optional coverage of preventive care services $ 5 $ 5 Plus optional 50% coverage for generic prescription drugs (no maximum) $ 25 Lowest cost option $ 25 or optional 50% coverage of formulary brand and generic prescription drugs ($1,200 annual maximum) $ 55 $ 68 or optional 50% coverage of prescription drugs (no maximum) $125 $153 Your monthly total for Senior Gold plus optional preventive care and/or drug coverage $ $ Extended Basic Blue Tobacco-free Standard (Extended Basic Medicare Supplement) $728 $915 No options needed our most complete plan, with prescription drug coverage and preventive care services included Rates are subject to change annually. These rates are guaranteed through Dec. 31, 2004.

4 Medicare alone Medicare pays for some hospital and medical expenses, but it doesn t cover everything. Here are the charges you pay if you have Medicare alone. Under Part A hospital services, Medicare does not cover: $876 Part A deductible for each benefit period $219 daily coinsurance for days in a hospital $438 daily coinsurance for lifetime reserve days Any charges for days beyond your lifetime reserve days $ daily coinsurance for days in a skilled-nursing facility Any charges for days beyond 100 in a skilled-nursing facility Under Part B physician and medical services, Medicare does not cover: $100 Part B annual deductible 20% of eligible charges after the annual deductible 20% of charges for durable medical equipment 20% of charges for cancer screenings 20% of diabetic supplies In addition, Medicare does not cover: Prescription drugs (Limited coverage for inpatient drugs and certain cancer and organ transplant drugs) Charges for preventive care, like routine physical exams, an eye exam and a hearing screening Any charges above Medicare s approved amount (usual and customary) Care in a foreign country Rates are subject to change annually. These rates are guaranteed through Dec. 31, 2004.

5 Basic protection for the lowest cost Basic Medicare Blue Our plans fill in Medicare gaps (Look for the symbol.) Excellent protection for a mid-range price Senior Gold SM The most complete plan Extended Basic Blue Limits out-of-pocket expenses to $1,000 of eligible charges per year. (Basic Medicare Supplement) (Basic Medicare Select plan) (Extended Basic Medicare Supplement) Option Not covered Not covered 80% coverage for 20 extra days Option Not covered. Rx Advantage drug SM Rx Advantage or choose from savings program applies 3 coverage options (see next page) 80% coverage Option Option Up to $120 per year Option 80% coverage 80% for emergency care 80% for emergency care 80% for eligible charges

6 A range of prescription drug coverage options Choose the protection that works best for you We know you re concerned about the rising cost of prescription drugs. We also know that everyone s needs are different. That s why Blue Cross offers a range of prescription drug coverage options. The Basic Medicare Blue plan does not include drug coverage, but our drug discount program, Rx Advantage, can provide you with significant savings. The Senior Gold plan includes three drug coverage options: 50 percent coverage for generic prescription drugs no limit 50 percent coverage for the first $2,400 of formulary brand and generic prescription drugs (Blue Cross pays up to $1,200) 50 percent coverage for prescription drugs no limit Rx Advantage is included at no additional charge The Extended Basic Blue plan, our most complete plan, includes drug coverage at 80 percent. Mail-order savings With any of our plans, you can also save on maintenance drugs* through our mail-order program. * Maintenance drugs are prescription drugs used on an ongoing or long-term basis to treat chronic conditions.

7 Medicare basics Medicare covers some of your health care expenses Part A is for hospital services Part B is for physician and medical services Medicare doesn t cover all expenses, however There are gaps, for example, deductibles (where you pay a certain amount before coverage begins) and coinsurance (where you pay a percentage and Medicare pays a percentage). That s where Medicare supplement plans come in. Remember that no plan covers all charges.

8 Don t delay You have a six-month open enrollment period starting on the day your Medicare Part B coverage begins (usually the first day of the month you turn 65). If you join within that six-month period, you ll be accepted with no health questions asked. Answers are just a phone call away Call your agent for more information. You can find a local agent in the Yellow Pages under Insurance or by visiting Or talk with one of our representatives at (651) , toll free or TDD We re ready to help. F7656R02 (4/04)