Blue Cross Medicare Advantage Plan eligibility

This is a Medicare plan offered by private insurance companies and other private establishments such as religious organizations, union, and others. Advantage plan works similar to a private insurance and provides more benefits compared to other plans. It was started in 1995, to give U.S citizens more health care options than they were already have.

You can never tell when your health will fail. Nonetheless, you need an assurance that your health expenses are well covered for when such happens.

Medicare Advantage plans can be found at   Advantage has specific conditions under which it works. It also has a network of health care providers with which it works with.


Eligibility for this plan exists if you follow the conditions attached to it, and if you fall under any of these categories:

  • Being young and disabled.
  • Having an End-Stage renal disease or kidney failure.
  • Being 65 and having worked, and in the process paid into the system.

Here are some of conditions attached to being under this plan:

  • Your health benefits will be provided by a Medicare Advantage rather than the traditional Medicare.
  • You must be ready to continue paying for your Medicare Part B premium.
  • Residence in the service area.
  • Being a member of Part A or Part B.
  • Having to receive health care only under a specific network of health care providers. There is an exception for emergencies.
  • Using your Medicare Advantage plan card, instead of the Medicare card.
  • There are no more Medicare Supplement insurance benefits.
  • There can be no stand-alone drug coverage except you choose a drug coverage from the Advantage options.

What are options in this plan?

Below are options available in the Advantage. You can choose from any of these:

  • Health Maintenance Organization (HMO): where health coverage is for a specific network of health care providers.
  • Preferred Providers Organization (PPO): is similar to HMO above, but consulting health providers outside the network is allowed.
  • Private fee-for-service (PFF): offers a choice of health provider and freedom to go outside the network.
  • Special Needs Plan (SNP): has four other options;
  1. Dual-Eligible Special Needs Plans (DSNPs) for those who get both Medicare and Medicaid.
  2. Chronic Special Needs Plans (CSNPs) for those who have a chronic or severe disability.
  3. Institutional Special Needs Plans (iSNPs) for those living in a skilled nursing facility.
  4. Institutional-Equivalent Special Needs Plans (ieSNPs) for the people living in an assisted living facility