Blue Cross and Blue Shield of Texas Group Medicare Advantage PPO (MPO) plan
How it works:
Here are some highlights about this plan. Refer to the plan documents for additional details.
- This is a national plan covering all eligible beneficiaries regardless of where they reside in the U.S., D.C., and five U.S. territories.
- You can visit doctors, specialists, and hospitals in or out of the Blue Cross and Blue Shield of Texas network for the same cost share as long as the provider participates in Medicare and accepts the plan.
- Referrals are not required to see a specialist.
- Part D prescription drug coverage is included.
- Routine vision, hearing, podiatry, and many other benefits are included.
Are you eligible?
- Retirees and eligible spouses, ages 65 or older, and enrolled in Medicare Part A and Part B.
- Those under 65 who qualify for Medicare due to disability or other special circumstances.
- You must reside in the United States, District of Columbia, or U.S. territories.
- If you are enrolling for the first time, you must complete a Retiree Health Benefit Enrollment form no more than 60 days before your retiree health benefits become effective.
- If you are already enrolled in this group plan, you do not need to take any action.
Blue Cross and Blue Shield of Texas Group Medicare Advantage HMO (PMA) plan
How it works:
Here are some highlights about this plan.
- You must reside in one of the Texas eligible counties to be on this plan.
- You are required to select a primary care provider (PCP) to coordinate your care.
- You must utilize providers participating in the Blue Cross and Blue Shield of Texas Medicare Advantage HMO (PMA) network to receive covered services.
- Referrals are required to see a specialist.
- Part D prescription drug coverage is included.
- Routine vision, hearing, podiatry, and many other benefits are included.
Are you eligible?
- Retirees and eligible spouses, ages 65 or older, and enrolled in Medicare Part A and Part B.
- Those under 65 who qualify for Medicare due to disability or other special circumstances.
- You must reside in one of these Texas counties: Angelina, Aransas, Atascosa, Bandera, Bee, Bexar, Collin, Comal, Cooke, Dallas, Denton, Ellis, Erath, Fannin, Grayson, Gregg, Guadalupe, Henderson, Hood, Houston, Hunt, Jim Wells, Johnson, Kaufman, Kendall, Kerr, Kleberg, Medina, Nacogdoches, Navarro, Nueces, Panola, Parker, Polk, Rockwall, Rusk, San Augustine, San Jacinto, San Patricio, Shelby, Smith, Tarrant, Trinity, Tyler, Van Zandt, Victoria, Walker, Wilson and Wise.
- If you are enrolling for the first time, you must complete a Retiree Health Benefit Enrollment form. If you are already enrolled in this group plan, you do not need to complete another Group Medicare Advantage Enrollment Request form.
Retirees age 65 and older:
Blue Cross and Blue Shield of Texas Medicare Advantage PPO (MPO) and Medicare Advantage HMO (PMA) plans include prescription drug benefits. During annual enrollment, if you are changing from the PPO plan or HDP to one of the Blue Cross and Blue Shield of Texas Medicare Advantage plans and you use a mail order pharmacy, make sure you have a supply of medication on hand to carry you through the month of January. If you use home delivery, mail a new prescription to Express Scripts.
Group Medicare Advantage plans:
When you enroll in the Blue Cross and Blue Shield of Texas Medicare Advantage PPO (MPO) and Medicare Advantage HMO (PMA) plans, you are automatically enrolled in a Medicare-approved Part D prescription drug benefit offered through Blue Cross and Blue Shield of Texas .
No coverage gap or deductible:
The PEBC group Medicare Advantage PPO (MPO) and Medicare Advantage HMO (PMA) plans include Part D coverage, but it may not be the same Part D plan offered elsewhere. Your prescription drug benefits are not subject to the coverage gap or deductible.
Additional benefits included with the Group Medicare Advantage PPO (MPO) and HMO (PMA) plans, not covered by Medicare
Fitness program:
Silver Sneakers is the gold standard in Medicare fitness programs for body and mind. And it’s available with your Medicare Advantage PPO (MPO) and Medicare Advantage HMO (PMA) plan at no additional cost.
2025 PEBC Retiree Health Benefits Enrollment Guide
