Welcome | Medicare Members | Excellus BlueCross BlueShield (2024)

FAQs

Is Excellus an HMO or PPO? ›

Excellus BlueCross BlueShield is an HMO plan and PPO plan with a Medicare contract.

Anthem, which owns Blues plans in several states, and Excellus (whose parent is Lifetime Healthcare Co.) are separate entities but linked through the Blues network.

The New York State Conference of Blue Cross and Blue Shield Plans (NYSCOP) is a partnership of New York Blue Cross Blue Shield Plans, including Excellus Blue Cross Blue Shield, Empire Blue Cross Blue Shield, Empire Blue Cross Blue Shield HealthPlus and Highmark Blue Cross Blue Shield of Western New York.

A Flexible Spending Account (FSA) offers a smart, simple way to set aside money tax free to cover the everyday expenses you know you'll have in the coming year. You can use it to pay for eligible non-covered medical or dental expenses, child care, and even dependent adult care costs.

An HMO is a good choice if you want the cheapest health insurance and don't mind staying within the plan's provider network. A PPO would probably be the better option if flexibility is what you prefer, even if it means higher health insurance costs. Out-of-network care? Need to name a primary care physician (PCP)?

Excellus BlueCross BlueShield is a nonprofit plan based in upstate New York. It earns high-quality marks and offers a good selection of Medicare Advantage HMO and PPO plans.

Blue Cross Blue Shield mashup, we've found that BCBS performs better overall than Anthem, offering coverage in all 50 states compared to Anthem's 14 and outperforming Anthem in user reviews. Read our Blue Cross Blue Shield vs. Anthem comparison to see which company is best for your health insurance needs.

Lifetime Healthcare, Inc.

Excellus BlueCross BlueShield / Parent organization

Meet income eligibility requirements. (Examples: single adults earning up to $25,520; adults in family of four earning up to $52,400) Meet immigration status requirements. You can enroll in the Essential Plan any time of year. Apply online, over the phone, or in-person.

Excellus BlueCross BlueShield, headquartered in Rochester, NY, is part of a $6 billion family of companies that finances and delivers health care services across upstate New York and long term care insurance nationwide.

How many members does excellus BCBS have? ›

Excellus BlueCross BlueShield, a nonprofit independent licensee of the BlueCross BlueShield Association, is part of a family of companies that finances and delivers vital health care services to about 1.5 million people across upstate New York.

1996Excellus, Inc., a nonprofit holding company, is created by the mergers of the BlueCross BlueShield Plans in Central New York and Rochester. 1997BlueCross BlueShield of Utica-Watertown joins Excellus.

Flex cards allow Medicare Advantage beneficiaries to access their cash-like benefits, including over-the-counter, grocery, and meal benefits. Not all Medicare Advantage plans offer flex spending cards.

To get a Medicare flex card, you must be eligible to enroll in a Medicare Advantage Plan that offers a flex card as a benefit. To be eligible for a Medicare Advantage plan, you must qualify for Original Medicare Parts A and B. This means you must be 65+ years of age or have a qualifying disability.

Facts about Flexible Spending Accounts (FSA)

You can use funds in your FSA to pay for certain medical and dental expenses for you, your spouse if you're married, and your dependents.

However, if you've already got a health plan and don't know which plan type you have, you can check your insurance card or contact your insurance provider directly. If you have an online account through your provider that allows you to access plan details, you can also start there.

Preferred provider organization (PPO) A type of medical plan in which coverage is provided to participants through a network of selected health care providers, such as hospitals and physicians. Enrollees may seek care outside the network but pay a greater percentage of the cost of coverage than within the network.

EPO plans offer a larger network than an HMO plan but typically do not have the out-of-network benefits of PPO plans. EPO plans do not require you to select a primary care physician (PCP) giving you a broader network of providers.

HMOs will not cover out of network care. With a POS, or point-of-service plan, you also have one PCP who manages your access to other doctors. However, you can visit doctors out of network but it will cost more. With a PPO, or preferred provider organization plan, you don't need a referral to seek additional care.