Blue Shield 65 Plus
Your Medicare-entitled, retiring employees can now get a health plan that focuses on their benefit needs at lower costs than those of most existing Blue Shield commercial HMO plans.
- Provides the same range of comprehensive benefits as those found in Blue Shield HMOs offered to active employees, including 24-hour access to health experts and programs to support better health and more effective care.
- Flexible, customized coverage to meet retired workers' benefit needs.
- Open to all Medicare-entitled retirees who reside in the plan service area and are entitled to Medicare Parts A and B.1
To offer the plan, you must be a large group with 51 or more eligible employees and have a minimum of 50 or more Medicare-entitled retirees who live in the plan service area and are entitled to Medicare Parts A and B. You must also currently offer coverage to your Medicare-eligible retirees.
Learn more about Blue Shield 65 Plus. (PDF, 211KB)
1 Blue Shield 65 Plus (HMO) is a Medicare-approved HMO with a Medicare Advantage-Prescription Drug (MA-PD) plan contract. Blue Shield 65 Plus (HMO) offers individual and employer group retiree plans to Medicare beneficiaries who are entitled to Part A and Part B. Individual plans are open to all Medicare beneficiaries who reside within a plan’s specific service area. Employer group retiree plans are open only to Medicare beneficiaries who are eligible group retirees and who reside within a plan’s specific service area. Blue Shield 65 Plus (HMO) individual and employer group retiree plans have different service areas, benefits and provider networks. Minimal copayments, restrictions, and limitations apply to some services. Members must continue to pay the Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. Members must receive all routine care from plan providers. If members receive routine care from out-of-plan providers, neither Medicare nor Blue Shield will be responsible for the costs. Blue Shield of California has a contract with the federal government that is renewed annually and the availability of coverage beyond the end of the current contract year is not guaranteed.