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Blue Shield 65 Plus: an employer-sponsored Medicare Advantage HMO for retirees
Your clients can now get a health plan that focuses on the benefit needs of Medicare-entitled, retired workers – at lower costs than those of similar Blue Shield HMO plans.
  • Provides the same broad range of benefits as those found in our plans offered to active employees including 24-hour access to health experts and value added services to support better health and more effective care. 
  • Flexible, customized coverage to build the retiree plan to meet your clients' retired workers' benefit needs. Your clients can even build a plan that's identical to their active employees' Blue Shield HMO, for less.
  • 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, groups 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. Groups must also currently offer coverage to their Medicare-eligible retirees.
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.
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