Medicare Supplement Plans: Medex Gold

Medex Gold is a Medicare supplement plan. It can be added to Medicare A and B coverage to fill "gaps" in your Medicare coverage. As a supplemental insurance plan, Medex Gold helps cover health care expenses left over after Medicare has covered its portion of costs. Medex Gold also has prescription coverage. For more information, click here. To learn more about our other Medex options, read our Freedom of Choice: Solutions for Seniors brochure. You can also view a high-level comparison of all our direct pay Medex plans.

Medex Gold might be right for you if:

You want to supplement your Medicare A & B coverage in order to cover out-of-pocket costs
You want the freedom to see any Medicare doctor or hospital without having to select a primary care physician (PCP) or get a referral
You want the peace of mind of carrying the most recognized ID card in health care today

Medex Gold will no longer be available to new applicants after December 31, 2005. However, if you are becoming eligible for Medicare benefits, and would like to enroll in Medex Gold, you may do so from September 15, 2005 until December 31, 2005 with an effective date of December 1, 2005.

If you're currently enrolled in Medex Gold, you know the value of your plan and we want to assure you that your coverage will continue as is. However, if you're considering changing your Medex coverage at some point, you cannot re-enroll in Medex Gold if you leave the plan.

You are eligible to apply for any of our Medex plans if you meet all of the following requirements:

You live in Massachusetts.
You are eligible for Medicare Part A enrolled in Medicare Part B
You are over age 65, or if you are under age 65, you qualify for Medicare coverage because of disability, except for end-stage renal disease.

Medex Gold covers your prescription medications with no annual dollar limit. When you purchase prescriptions at retail pharmacies, you pay a $35 quarterly calendar-year deductible. After that, generic medications are covered 100% and you pay 20% for brand-name medications. A mail service program can help you get the most for your health care dollars: you pay only $2 for generic prescriptions, and $15 for brand-name prescriptions for up to a 90-day supply when you use the mail service option.

It's also important to note that Medex Gold is creditable coverage, which simply means that the prescription coverage you receive under Medex Gold meets the standards set by the Centers for Medicare & Medicaid Services (CMS). Coverage is considered creditable if it pays out at least as much as the Medicare prescription benefit will pay out in 2006. This is an important consideration if, at some point, you consider changing your health coverage from Medex Gold to another plan.

These rates are effective March 15, 2005, and are subject to change effective March 15, 2006.

Premiums for Medex Gold are $523.13 monthly or $1,556.88 quarterly (every three months).
Individuals aged 65 who enroll in Medex when initially eligible for Medicare Part B could qualify for discounted rates. Please call 1-800-678-2265 to determine if you are eligible for the discount.

To apply for coverage, just download and read the application and outline of coverage. Then print, complete, and sign the application form and mail it to:

Blue Cross Blue Shield of Massachusetts
Consumer Sales
100 Hancock Street 09/8B
North Quincy, MA 02171

You may also fax your application form to 617-246-3633.

For additional information about other health plans for seniors available in Massachusetts, you can call the Massachusetts Executive Office of Elder Affairs at 1-800-243-4636. You can also visit the Massachusetts Division of Insurance on the web at:

http://www.state.ma.us/doi/Consumer/CSS_health.html.

You can also contact The SHINE Program, Massachusetts' state health insurance program that provides free, one-on-one health insurance information, counseling and assistance to Medicare beneficiaries of all ages. Call SHINE, toll-free, at 1-800-AGE-INFO (1-800-243-4636), and press "2". TTY: 1-800-872-1066. You can visit their website at www.medicareoutreach.org

The federal government has a Medicare information telephone line and website. Call 1-800-MEDICARE (1-800-633-4227), or TTY: 1-877-486-2048 24 hours a day, 7 days a week. You can visit the Medicare website at www.medicare.gov

You can also call the Social Security Administration for help with questions about eligibility and enrolling Medicare, and for questions about eligibility and help with the costs of a Medicare Part D prescription plan. 1-800-772-1213. TTY: 1-800-325-0778.