The Medicare Supplemental Plan works like a Medigap policy. It pays the part of Medicare-approved charges that Medicare does not, including deductibles and coinsurance. The Plan coordinates only with Medicare Parts A and B. It does not coordinate with Part C. BlueCross BlueShield of South Carolina (BlueCross) is the third-party administrator for the State Health Plan.
The Medicare Supplemental Plan does not pay for services for which Medicare does not pay. Sometimes, providers who do not accept Medicare charge you more than what Medicare allows. If so, you will pay the difference under the Supplemental Plan.
Prescription drug coverage
If you are enrolled in the State Health Plan as an active employee and you or your covered dependents become eligible for Medicare, PEBA automatically enrolls the Medicare-eligible member in Express Scripts Medicare®, the State Health Plan’s Medicare Part D program.
You can learn more about the Medicare Supplemental Plan and Express Scripts Medicare in the Insurance Coverage for the Medicare-eligible Member handbook.
If you are a retiree, and you are covered by the State Health Plan Standard Plan or Savings Plan before you become eligible for Medicare, PEBA will mail you a letter when you become Medicare-eligible because of age, which indicates that you will be automatically enrolled in the Medicare Supplemental Plan.
If you prefer another PEBA-sponsored health plan, you will need to inform PEBA within 31 days of Medicare Part A eligibility. If you are covered by a health plan offered through PEBA and you become Medicare-eligible for any reason, not just age, you will be able to change to the Medicare Supplemental Plan within 31 days of eligibility. After this 31-day period, you can change from the Standard Plan to the Medicare Supplemental Plan during the annual October open enrollment period. Plan changes made during open enrollment become effective on the following January 1. If you move out of the United States permanently, you may be eligible to change from the Medicare Supplemental Plan to the Standard Plan.
When you become eligible for Medicare, you will receive new identification cards from BlueCross, but your Benefits Identification Number (BIN) will not change. You can also access your digital identification card from the My Health Toolkit mobile app. If you need to order a replacement card, visit StateSC.SouthCarolinaBlues.com or call BlueCross at 888.214.6230. You will need your BIN. If you don’t know your BIN, log in to MyBenefits and select Get My BIN.