2014 Plan 65 Select C

Plan 65 Select C pays the copayments, coinsurance, and deductibles for Original Medicare, Parts A and B. It also provides coverage for skilled nursing facilities (up to Medicare benefit limits) and pays for part of foreign travel emergency services.

This plan provides the same coverage as Plan 65 C – at a lower cost – when you use the Plan 65 Select C network of participating hospitals for inpatient services Find out more about the Hospital Network and see a list of participating hospitals: Plan 65 Select Hospital Network Listing.

*Your monthly premium may be different if you are transferring from another Plan 65 option. Please consult with Customer Service for more information.

Consider Blue MedicareRxSM (PDP) for drug coverage

Get an introduction to Blue MedicareRx on this site or see complete details on the Blue MedicareRx website.

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Reason to choose this plan
  • Select hospital network
    Skilled nursing facility coverage
    No up-front deductibles
Monthly Premium:
$159.63*
Age-in Monthly Premium (first year):
$111.74
Enroll now

To be eligible for Plan 65 Select C, you must be:

  • A Rhode Island resident
  • Enrolled in Medicare Part A and Medicare Part B

If you enroll in Plan 65 Select C within 6 months of when you become eligible for Medicare Part B* or when you leave your employer group coverage:

  • Automatically receive early enrollment discounts through our Age-in Credit plan
    • A 30% discount for the first year you are enrolled
    • 20% for the second year
    • 10% for the third year
  • Regular rates apply after the third year

*Individuals eligible for Medicare by disability are not eligible for the age-in credit program. Additional restrictions may apply. Please contact us for further information.

You also are able to enroll in Plan 65 Select C with the following qualifying events:

  • You have been enrolled for less than 12 months in a Medicare Advantage plan that you selected during your Initial Election Period (when you first became eligible for Medicare).
  • You suspended your Plan 65 benefits and obtained coverage under Medicaid less than 24 months ago, and now you are no longer eligible for Medicaid.
  • You are moving to Rhode Island from another state.
  • Your current coverage is being cancelled by your insurance company through no fault of your own.

If you do not meet the guidelines above, there is another option. Any member who enrolls in BlueCHiP for Medicare effective October 1, 2013 or later, and remains a BlueCHiP for Medicare member with no lapses in their BlueCHiP for Medicare coverage, has the one-time option to enroll in Plan 65 during a valid election period at any time in the future. Your monthly premium would be based on the regular rate.

Ready to enroll?

You may enroll in Plan 65 if you have a qualifying event. Otherwise you may enroll in Plan 65 A from October 15 to December 7 for coverage starting in January.

Need assistance shopping for insurance?

We’re available by phone, TTY, or for walk-in service during the day.
1-800-505-BLUE (2583)
TTY 711.
See the Contact Us page for hours.

If you already have Plan 65, please call Customer Service at
(401) 459-5000,
1-800-639-2227 or
TTY 711.

With Original Medicare, you pay With this plan, you pay
Inpatient Hospital Care*

Days 1-60: $1,216 Medicare Part A deductible**
Days 61-90: $304 per day
Days 91-150: $608 per day (lifetime reserve days) Days 151+: All costs

For in-network hospitals:
Days 1-60: $0 per day
Days 61-90: $0 per day
60 lifetime reserve days: $0 per day
365 additional lifetime reserve days: $0 per day

Skilled Nursing Facility Care*

Days 1-20: $0 per day
Day 21-100: $152 per day**
Days 101+: All costs

Days 1-100: $0 per day
Days 101+: All costs

Doctor Visits

20% of Medicare approved amount after Part B deductible.
$0 for “Welcome to Medicare” and annual wellness visits.

$0

Preventive Services

Generally $0. Consult “Medicare and You” handbook for details.

Generally $0. Consult “Medicare and You” handbook for details.

Home Healthcare $0

$0

Outpatient Surgery

20% of doctor charges and outpatient facility charges after Medicare Part B deductible

$0

End Stage Renal Dialysis

20% for renal dialysis and for nutrition therapy for end-stage renal disease after Medicare Part B deductible

$0

Diagnostic Tests, X-rays, and Lab Services

20% for diagnostic tests and X-rays after Medicare Part B deductible
$0 for Medicare-covered lab services

$0

Durable Medical Equipment

20% after Medicare Part B deductible

$0

Ambulance Services

20% after Medicare Part B deductible

$0

Foreign Travel

All costs

20% after $250 annual deductible for emergency healthcare during the first 60 days of each trip. There is a $50,000 lifetime maximum.

2014 Medicare Part A deductible = $1,216 per benefit period
2014 Medicare Part B deductible = $147 per calendar year.

* Per benefit period. A benefit period begins on the first day you receive services as an inpatient in a hospital, and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 consecutive days.

** The Original Medicare coinsurance, deductibles, out-of-pocket maximums, and premiums listed are current for 2014 and are subject to change on an annual basis. Monthly premium may be lower or higher based on income.

Key Documents

Related Documents

Plan 65 Application

Related Links

Additional information you may need about prescription drug coverage:

When you enroll in this plan, you are invited to sign in at BCBSRI.com to access the following online programs and resources to help you stay healthy and save money:

  • Health Center – Visit the Health Center to find answers to your health questions and resources that will help you lead a healthy life. You’ll find in-depth information about prescription and over-the-counter medications, Decision Points on dozens of medical tests, surgeries, and treatments, and useful interactive tools and quizzes.
  • Blue365SM – Blue365 is an exclusive national program that provides discounts on products and services from leading national companies like Nutrisystem®, Reebok®, H&R Block®, and others.

Health Center

Last updated: 01/07/2014