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Excellus Medicare Plans

Excellus BlueCross BlueShield, headquartered in Rochester, NY, is part of a $5 billion family of Blue Cross/Blue Shield companies that finances and delivers health care services. Excellus is New York State's largest nonprofit health plan. They offer Medicare Advantage Plans to New Yorkers, as well as long term care insurance nationwide.

Medicare Advantage Plans

Excellus BlueCross BlueShield contracts with the Federal government to offer Medicare Advantage and Medicare Prescription Drug plans. Medicare Blue Choice is a Medicare-approved HMO and Medicare Blue PPO is a Medicare-approved PPO.

Medicare Blue PPO (preferred provider organization) offers the following benefits and costs:

  • A $64 monthly premium in additional to the regular monthly Medicare Part B premium;
  • A $4,000 out of pocket maximum;
  • Inpatient hospital stays:No limit to the number of days covered by the plan each benefit period. / $500 co-pay for each Medicare-covered hospital stay / $0 co-pay for additional hospital days / $1,500 out-of-pocket limit every year
  • Skilled nursing facilities:Plan covers up to 100 days each benefit period / No prior hospital stay is required. / For Medicare-covered SNF stays: / Days 1 - 100: $50 co-pay per day

Medicare Value Plus

Medicare Blue Choice Value Plus HMO (Health Maintenance Organization) offers the following benefits and costs:

  • A $69 monthly premium in additional to the regular monthly Medicare Part B premium;
  • A $4,000 out of pocket maximum;
  • Inpatient hospital stays:No limit to the number of days covered by the plan each benefit period / $350 co-pay for each Medicare-covered hospital stay / $0 co-pay for additional hospital days / $1,050 out-of-pocket limit every year;
  • Skilled nursing facilities: The Plan covers up to 100 days each benefit period / No prior hospital stay is required. / For Medicare-covered SNF stays: / Days 1 - 100: $50 co-pay per day.
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