Blue Cross Senior Secure Plan 1 Review

The Blue Cross Senior Secure Plan 1 is a Medicare Advantage plan HMO offered through Anthem Blue Cross.  It is only available to residence in California, and the coverage is different depending on what county you live in.  One version is available in Orange and Los Angeles county, and the other version is available in Kern, Riverside, San Bernardino, Santa Barbara, and San Diego counties.  I will break down the two plans below, and the differences in the coverage they offer.  Keep in mind that you may only sign up for the plan offered where you reside.

Senior Secure Plan 1 (Orange + Los Angeles)

  • Premium – $0 monthly
  • Maximum Out of Pocket – $3,350 annually
  • Referrals are required for specialists
  • Hospital copay – $150/day Days 1-5
  • Doctor’s Visits – $5 = Primary; $30 = Specialists
  • Outpatient Surgery – $30 – $125 copay
  • Labs – $0 copay
  • Diagnostic Procedures and X-rays – $30 – $150
  • Part D Deductible – $0
  • Part D Drugs – Tier 1 = $7; Tier 2 = $43; Tier 3 = $85; Tier 4 + Tier 5 = 33%
  • Many generic drugs covered through the coverage gap
  • Preventative dental offers 1 cleaning at $0 copay
  • Hearing and eye exams available for a copay

Senior Secure Plan 1 (Other Counties)

  • Premium – $0 monthly
  • Maximum Out of Pocket – $3,350 annually
  • Referrals are required for specialists
  • Hospital copay – $175/day Days 1-7
  • Doctor’s Visits – $10 = Primary; $35 = Specialists
  • Outpatient Surgery – $35 – $150 copay
  • Labs – $10 copay
  • Diagnostic Procedures and X-rays – $35 – $150
  • Part D Deductible – $0
  • Part D Drugs – Tier 1 = $7; Tier 2 = $43; Tier 3 = $85; Tier 4 + Tier 5 = 33%
  • Many generic drugs covered through the coverage gap
  • Preventative dental offers 1 cleaning at $0 copay
  • Hearing and eye exams available for a copay

Since these plans are HMO’s you will want to make sure your providers are in the plan’s network.  You will also want to compare this plan with others at medicare.gov.  Finally, I always recommend that you talk with an independent insurance agent about what your options are.

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