Common Medicare Questions

Timing of enrollment or ability to change plans depends on your current situation. There are several enrollment periods to be aware of when planning your Medicare coverage including:

• Turning 65? Find Medicare enrollment information and tips for buying your Medicare Supplement at the right time.
• Extending retirement? Get all of the facts before you delay your Medicare enrollment.
• Receiving Disability? Learn when you’re eligible for Medicare.
• Changing Medicare plans? Learn about your opportunities to make changes to your coverage.

Learn more about Medicare enrollment. At BCBSND, one of our agents will help you through your Medicare supplement options and complete the enrollment for you.

There are four main parts of Medicare. The federal government offers Medicare Part A, which provides hospital coverage, and Part B, which provides physician coverage. Parts A and B are often referred to as Original Medicare.

Medicare Part C is Medicare Advantage, which bundles all of your coverage together into one plan, which is then administered by a private company. Medicare Part D provides prescription drug coverage.

If one person is not of Medicare age and wants to keep an existing health insurance plan, you can each have your own plan. One person can be on Medicare and the other can keep their individual or group plan.

You cannot keep your BCBSND Medicare Supplement plan, but you can transfer to a Medicare Supplement administered by a Blue Cross Blue Shield licensee in your state or with another carrier.

Your benefits follow Medicare guidelines, though out-of-pocket expenses may apply. In most situations, Medicare Parts A and B will not pay for health care outside the United States and its territories. Medicare may pay for inpatient hospital, doctor or ambulance services you receive in Canada or Mexico.

Some Medicare Supplement plans include foreign travel coverage while others do not. To find out which plans include foreign travel, compare Medicare Supplement plans or contact BCBSND.

Authorization for all medical services follows Medicare guidelines. In a situation where your Medicare Supplement plan covers additional expenses, services are authorized according to your plan’s benefits.

Once your number of inpatient hospital extends past 365, the supplement begins to pay as the primary coverage. Preauthorization of services is not required, and these services would be based on the Medicare fee schedule set by Centers for Medicare & Medicaid Services.

We follow Medicare guidelines—so if Medicare allows the expense, BCBSND will allow it. Similarly, if Medicare denies coverage, BCBSND would deny it as well. Some Medicare Supplement plans will cover the excess charge, which is the additional cost charged by providers above what Medicare allows.

NextBlue PPO Medicare Advantage plans provide the same benefits as Medicare Parts A and B, plus they include Part D/prescription drug coverage within the plan. In addition, plans offer additional benefits such as routine vision and dental services, hearing aid, fitness center memberships, or over-the-counter medication and supplies that are not covered by Original Medicare.

Prescription coverage is not included in Medicare Supplement plans. Part D coverage must be purchased to receive prescription benefits. NextBlue Medicare Advantage plans may include prescription coverage. Please reach out to NextBlue of North Dakota for additional details.

You can submit one payment for both Medicare Supplement plans; however, to ensure we apply appropriate payment to each plan, please include each invoice or clearly indicate that the payment is for two different Supplement plans.

We will handle all your claims for you.

You can keep your employer coverage and take Medicare when you are eligible. Both plans will work together to determine which coverage will function as primary and secondary.

Be sure to know all details and possible penalties in delaying your retirement.

You will not need to medically qualify if you meet any of the following criteria.

• If you are enrolling from a BCBSND individual or employer health plan without a lapse in coverage.
• If you are turning age 65 and you are enrolling within your seven-month initial enrollment period.
• If you are 65 years of age or older and you complete an application within 63 days of termination of coverage from an employer-provided health plan. Coverage termination must be through no fault of your own, such as termination of employment or if your employer no longer has an employer-sponsored health plan. A certificate of coverage—a written copy explaining the health benefits of the plan—must be attached to the application. The certificate of coverage can be provided by your employer or you can request it directly by contacting Member Services of your current health insurance provider.
• If coverage is not continuous or if the employer group doesn’t have the conversion guarantee, you would have to medically qualify.

When you notify BCBSND that you have another Medicare Supplement policy, your previous Medicare Supplement will be canceled on the paid-through date of your plan or at the end of the current month, whichever is earlier. Your request must be in writing.

If you are canceling your Medicare Supplement plan because you now have a Medicare Advantage plan in place, you must request the cancellation in writing. If your coverage period overlaps, your request will be denied and the BCBSND Medicare Supplement coverage will be canceled effective on the 15th of the month or the end of the month following the cancellation request. If you want to specify a specific time of the month to cancel (mid-month vs. end of month), then your request must be received or postmarked by that time.

For individual Medicare Supplement plans, premium refunds are prorated back to the date of death. These refunds for deceased members will be sent automatically "To the Estate of" the subscriber’s name. Refunds will not be reissued in a family member’s name, even if there is a Power of Attorney.

Contact your bank for help with cashing checks sent to the estate of deceased family members.