Group Medicare

Stay well ahead with Blue Shield Group Medicare plan options that fit your needs.

Group Medicare plans centered around you

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Blue Shield of California Group Retiree plan types

Contact your employer’s benefits administrator or labor and trust union for more information on which plan types they offer.

Group Medicare Advantage Prescription Drug Plan HMO (GMAPD-HMO)

Group Medicare Advantage HMO Plans are an all-in-one alternative to Original Medicare. These bundled options include the full benefits of Medicare Parts A and B in a single plan. They also include prescription drug coverage. With a Medicare Advantage HMO plan, In-Network providers include Blue Shield of California Medicare HMO contracted providers and Blue Card providers. For Blue Shield of California Out-of-Network providers, members can utilize any Medicare Participating provider as long as they are willing to either bill Blue Shield directly, or the local Blues plan if the member is out of state.

Group Medicare Advantage Prescription Drug Plan PPO (GMAPD- PPO)

Group Medicare Advantage PPO Plans are an all-in-one alternative to Original Medicare. These bundled options include the full benefits of Medicare Parts A and B in a single plan. They also include prescription drug coverage. With a Group Medicare Advantage PPO plan, we have 18 counties in our GMAPD-HMO service area, and In-Network providers include Blue Shield of California Medicare HMO contracted providers.

Questions to ask yourself when transitioning to Medicare

When am I eligible for Medicare?

You become eligible for Medicare when you turn 65. You have a window to sign up for Medicare. It begins 3 months before you turn 65 and ends 3 months after you turn 65. Younger individuals who have a disability or End-Stage Renal Disease may also be eligible.

How do I know if I am covered by my employer after 65?

The first step in deciding whether you should explore Medicare enrollment while working beyond the age of 65 is to make sure that you are covered by work after 65. It’s important to make sure you have a conversation with your employer's benefits administrator or labor and trust union before your 65th birthday to make sure you know what you need to do in terms of health insurance coverage.

Will I get Part A if I don't retire at 65?

If you have been working for at least 10 years, and paying your Medicare taxes, Medicare Part A is available for free. If you qualify for premium-free Part A, you can always just opt for Part A of Medicare, even before retirement regardless of whether you have health coverage from your employer or labor and trust union. It’s important to make sure that you decline Part B coverage and ensure that your current employment status is recorded as the reason why you are opting out of Part B coverage.

What will happen to my Health Savings Account (HSA)?

If your employer or labor and trust union offers an HSA or Health Savings Account and you are enrolled, you should not opt for Medicare Part A, even if you are eligible. According to the IRS rules, those enrolled in Medicare are no longer allowed to contribute to an HSA. So, if you work for a company with more than 20 employees, and you have HSA coverage, you can choose to postpone your enrollment until you stop receiving this coverage.

What do I do when I am ready to retire after 65?

When you are ready to now leave work life behind, there is important information to keep in mind about Medicare and retirement. First, if you have an HSA, and you are at least six months beyond retirement age, Social Security offers six months’ worth of benefits as back pay. While this is a positive move, it also means that you have a six-month roll back on Part A coverage. Implying that the last six months of your HSA plan will be taxed. There is also a special enrollment period to keep in mind when retiring, regardless of the kind of coverage you have. This special enrollment period allows you to apply for Medicare for eight months—starting a month from the day you retire or a month after the day you lose your employer or labor and trust union sponsored health insurance.

Which Blue Shield of California Retiree plan(s) does my employer offer?

Speak with your plan’s benefits administrator or labor and union trust to learn more about your Group Retiree plan options and how to enroll.

What are the Blue Shield of California Retiree eligibility requirements?

To enroll in a Blue Shield of California Retiree plan you must meet the eligibility requirements. You must have both Medicare Parts A & B, live in a Blue Shield assigned service area, be a U.S. citizen or lawfully present in the U.S., and meet your former employer's or labor and trust union eligibility requirements.

Are your doctors, specialists, or hospitals part of a network?

Popular Medicare Advantage Plans such as Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO) plans restrict your usage of medical facilities to a fixed network. Ask your doctor if they are part of the network of the plans you are considering, or if they can refer you to someone within that network. To find out if your providers are in the Blue Shield network for the plans being offered to you, visit our Find a Doctor tool.

_{Blue Shield of California is an HMO and PPO plan with a Medicare contract. Enrollment in Blue Shield of California depends on contract renewal. Blue Shield of California offers individual and employer group retiree plans to Medicare beneficiaries who have 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. Individual and employer group retiree plans have different service areas, benefits and provider networks.}

_{Blue Shield of California is a PDP plan with a Medicare contract. Enrollment in Blue Shield of California depends on contract renewal. Blue Shield of California offers individual and employer group retiree plans to Medicare beneficiaries who have Part A and/or 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. Individual and employer group retiree plans have different service areas and benefits.}

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