Welcome | Medicare Members | Excellus BlueCross BlueShield (2024)

At Excellus BlueCross BlueShield, our plans go beyond the basics to make sure members get the care they need, when and where they need it. Let's get started!

Benefits included in all Medicare Advantage plans:

Welcome | Medicare Members | Excellus BlueCross BlueShield (1)

Dental

What's Covered

  • Preventive dental with no copay for routine care such as cleanings, X-rays, and oral exams
  • Comprehensive dental with a $1,000 annual allowance for care like select crowns, root canals, fillings, and extractions

See the Dental HighlightsOpen a PDF for details.

To use your dental benefits, schedule an appointment with an in-network dentist or Find a Dentist near you.

Welcome | Medicare Members | Excellus BlueCross BlueShield (2)

Vision

What's Covered

  • Annual eyewear allowance of at least $120 towards contact lenses and eyeglasses (frames & lenses)

To use your vision benefits, schedule an appointment with any licensed provider or Find a Provider near you.

Welcome | Medicare Members | Excellus BlueCross BlueShield (3)

Hearing

What's Covered

  • Free annual routine hearingexam and reduced hearing aid costs with TruHearing®
  • Advanced hearing aid: $499, premium hearing aid: $799

To use your hearing benefits, schedule an appointment by calling 1-855-205-5519 (TTY 711) Monday – Friday, 8 a.m. to 9 p.m. ET.

Welcome | Medicare Members | Excellus BlueCross BlueShield (4)

Over-the-Counter (OTC) benefit of at least $120/year

What's Covered

  • At least $30/quarter ($120/year) for common items such as aspirin, vitamins, cold and cough medications, bandages, and more

See the OTC HighlightsOpen a PDF for details. You’ll receive a catalog of covered items by mail.

To use your OTC benefits, choose one of the following ordering methods:

  • Online: Visit the OTC Benefits website (powered by Convey Health) – registration required
  • Phone: Call 1-855-657-7543 (TTY 711), Monday – Friday, 8 a.m. to 11 p.m. ET
  • Mail: Use the mail order form in the product catalog that was mailed to you
  • App: Download and use the OTC Anywhere mobile app
Welcome | Medicare Members | Excellus BlueCross BlueShield (5)

Silver&Fit®

What's Covered

  • No membership fee when you join a participating fitness center
  • Receive a $150 reimbursem*nt annually to join a qualified, out-of-network fitness center

To use your fitness benefit, learn more about the program and then visit the (login required) for a list of participating facilities.

Welcome | Medicare Members | Excellus BlueCross BlueShield (6)

$0 preventive care

What's Covered

  • Health screenings, including mammograms, colorectal cancer screening, bone density tests, and more
  • $0 preventive vaccines (on most plans)

To use your preventive care benefits, visit an in-network provider for recommended care. You can also download a preventive care checklist to make sure you’re getting the care you need.

Welcome | Medicare Members | Excellus BlueCross BlueShield (7)

$0 and low-cost Tier 1 generic drugs

What's Covered

  • $0 and low-cost Tier 1 generic drugs on all Medicare Advantage prescription drug plans

To learn more about your prescription drug benefits, choose from the following options:

  • Check drug prices for your plan
  • Learn how to lower your out-of-pocket prescription costs
  • Ask our pharmacist a question or see if you qualify for a full medication review

Some plans also have:

Welcome | Medicare Members | Excellus BlueCross BlueShield (8)

Transportation for health-related trips

What's Covered

  • 12 one-way non-emergency trips per calendar year with SafeRide® (50-mile limit per ride)

See the SafeRide Transportation Highlights for details.

To schedule a ride, call SafeRide at 1-888-617-0270 (TTY 711), Monday - Saturday, 8 a.m. to 8 p.m. ET.

Welcome | Medicare Members | Excellus BlueCross BlueShield (9)

Mom’s Meals® delivery service

What's Covered

  • 2 home-delivered meals per day for 7 days after an observation, inpatient, or skilled nursing stay

See the Mom’s Meals Highlights for details.

To use your Mom’s Meals benefit, call 1-877-222-1240 (TTY 711), Monday – Friday, 8:30 a.m. to 4:30 p.m. ET. Keep in mind that this benefit must be used within 30 days of discharge.

Welcome | Medicare Members | Excellus BlueCross BlueShield (10)

$500 Flex Card (for eligible PPO plans)

What's Covered

  • $500 for use on dental, hearing and vision expenses not already covered
  • Earn up to $100 in additional funds when you complete certain activities

See the PPO Highlights for details.

To use your flex card benefit, simply pay for expenses with the card that was mailed to you. The full $500 balance will be loaded on the card and ready to use on your plan start date. To check your balance, log in to your member account or call 1-833-655-1780 (TTY 711).

Tip: Use your plan benefits first and then use your flex card to pick up any remaining balance. If you forget your card, you can submit a claim and get reimbursed with your flex card balance. Your card is good for a few years so once you use it, don’t throw it away – it will be reloaded next plan year.

We’re here to help:

Welcome | Medicare Members | Excellus BlueCross BlueShield (11)

Find the care you need

Check to see if your doctor participates with your plan:

  • Find a Doctor
  • Find a Dentist

Additional ways to get help:

  • Try telehealth for care by telephone, email, or chat
  • Call our 24/7 Nurse Line for quick answers to medical questions

Remember to complete the Authorization Release Form on the Caregiver Support page so we can share protected health information (PHI) with a spouse, child, or caregiver. You can also submit this form online.

Welcome | Medicare Members | Excellus BlueCross BlueShield (12)

Not sure what your plan covers?

Log in to your member account to view your benefits and coverage, member card, claims, and more.

Please note: some actions associated with your account, such as paying a bill online, may not be available until after your plan starts. if you need help before your effective date, please call our Customer Care Advocates.

Welcome | Medicare Members | Excellus BlueCross BlueShield (13)

Still have questions? We’ve got answers.

View your Medicare plan information online or call our Customer Care Advocates. You can also visit us in person at our Resource Center.

Excellus BlueCross BlueShield is an HMO plan and PPO plan with a Medicare contract. Enrollment in Excellus BlueCross BlueShield depends on contract renewal. Submit a complaint about your Medicare plan at www.Medicare.gov or learn about filing a complaint by contacting the Medicare Ombudsman. Y0028_9775_C.

This page last updated 12-15-2023.

Welcome | Medicare Members | Excellus BlueCross BlueShield (2024)

FAQs

Is Excellus part of Medicare? ›

IMPORTANT NOTICE - A CONSUMER'S GUIDE TO HEALTH INSURANCE FOR PEOPLE ELIGIBLE FOR MEDICARE MAY BE OBTAINED FROM YOUR LOCAL SOCIAL SECURITY OFFICE OR FROM THIS INSURER. Excellus BlueCross BlueShield is not connected with or endorsed by the State of New York, the federal government or the federal Medicare program.

Are Excellus and Anthem the same? ›

Anthem, which owns Blues plans in several states, and Excellus (whose parent is Lifetime Healthcare Co.) are separate entities but linked through the Blues network.

How do I appeal an Excellus denial? ›

Call Customer Service at the phone number listed on your Member Card, or view our Contact Us page for a listing of phone numbers. You may also submit your grievance or request for appeal in writing. See our Contact Us page for the address of your local office.

What state is BCBS Excellus in? ›

Excellus BlueCross BlueShield, headquartered in Rochester, NY, is part of a $6 billion family of companies that finances and delivers health care services across upstate New York and long term care insurance nationwide.

Is Blueshield the same as Medicare? ›

Blue Shield of California is an HMO, HMO D-SNP, PPO, and PDP plan with a Medicare contract and a contract with the California State Medicaid Program. Enrollment in Blue Shield of California depends on contract renewal.

Who owns Excellus insurance? ›

What is better, Blue Shield or Anthem Blue Cross? ›

What we're seeing is that when comparing apples and apples, the Blue Shield of California formulary is broader than Anthem Blue Cross for Individual/Family and maybe even Small Business. Anthem made the move to a more limited drug list for their group business which was unprecedented.

What is the difference between Blue Cross and Blue Shield? ›

Blue Cross and Blue Shield developed separately, with Blue Cross providing coverage for hospital services and Blue Shield covering physicians' services. Blue Cross is a name used by an association of health insurance plans throughout the United States.

What is Anthem Blue Cross called in New York? ›

Empire is now Anthem. New name. Same commitment to you. As of January 1, 2024, the Empire BlueCross BlueShield and Empire BlueCross names are Anthem Blue Cross and Blue Shield and Anthem Blue Cross.

Which health insurance company denies the most claims? ›

Claim denial rates by insurance company
CompanyClaim denials
UnitedHealthcare32%
Anthem23%
Aetna20%
CareSource20%
1 more row
May 15, 2024

Do you have to pay if Medicare denies a claim? ›

If Medicare denies payment: You're responsible for paying. However, since a claim was submitted, you can appeal to Medicare. If Medicare does pay: Your provider or supplier will refund any payments you made (not including your copayments or deductibles).

How to successfully appeal an insurance denial? ›

Steps to Appeal a Health Insurance Claim Denial
  1. Step 1: Find Out Why Your Claim Was Denied. ...
  2. Step 2: Call Your Insurance Provider. ...
  3. Step 3: Call Your Doctor's Office. ...
  4. Step 4: Collect the Right Paperwork. ...
  5. Step 5: Submit an Internal Appeal. ...
  6. Step 6: Wait For An Answer. ...
  7. Step 7: Submit an External Review. ...
  8. Review Your Plan Coverage.

What is the credit rating of excellus? ›

'BBB+' Rating Affirmed Following Revised Capital Model Criteria; Outlook Remains Stable. On Nov. 15, 2023, we published our revised criteria for analyzing insurers' risk-based capital (see "Insurer Risk-Based Capital Adequacy--Methodology And Assumptions").

How many members does Excellus BCBS have? ›

Excellus BlueCross BlueShield, a nonprofit independent licensee of the BlueCross BlueShield Association, is part of a family of companies that finances and delivers vital health care services to about 1.5 million people across upstate New York.

Is Highmark part of Medicare? ›

Highmark offers a variety of Medicare Advantage plans throughout Pennsylvania, West Virginia, Delaware, and some counties in New York. Not all plans are offered in every coverage area. Prices vary based on your location, level of care, and services chosen.

Is Unitedhealthcare considered Medicare? ›

UHC Medicare Advantage plans cover features and benefits in addition to those included in Original Medicare. Members in some areas may have different plans from which to choose. The plans often include an integrated Medicare Part D prescription drug benefit.

Is Health New England part of Medicare? ›

Health New England Medicare Advantage is an HMO, HMO-POS, and PPO Plan with a Medicare contract. Enrollment in Health New England Medicare Advantage depends on contract renewal.

What is the difference between Medicare C and D? ›

Medicare Advantage Plan (Part C)

A type of Medicare-approved health plan from a private company that you can choose to cover most of your Part A and Part B benefits instead of Original Medicare. It usually also includes drug coverage (Part D). with drug coverage.

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