Welcome to the Blue Shield Medicare [Webinar]/[Sales

Blue Shield of California 1

Welcome to the Blue Shield

Medicare [Webinar]/[Sales Presentation]

Hello and welcome!

I am your host, <name >, and I am excited to go over Medicare

options available in <County/region> and answer all your

questions.

<During this online meeting, you are encouraged to submit your

questions. Simply type them in the Q&A chat box. You can also

wait until the end when all lines will be unmuted for Q&A.>

<If you cannot hear us, make sure you are connected by phone

or computer. Move your mouse to the bottom of the screen then

click on the phone icon .>

<Sit back and relax. We will begin in a moment.>

Enroll today: : <(XXX) XXX-XXX [TTY: 711]>

Y0118_20_607A_M Approved 08242020

BSCWEBSEMPRES21


• Our Value Proposition

• What is Medicare?

• The different parts of Medicare and Medicare coverage choices at-a-glance

• When Can You Enroll in Medicare?

• Annual enrollment period

• Initial enrollment period

• Blue Shield Medicare Supplement plans (Medigap)

• What they are, buying plans, switching plans, and what’s not covered

• Blue Shield Medicare Prescription Drug Plans

• What Blue Shield offers

• Blue Shield Medicare Advantage HMO [<and PPO>] Part C Plans

• Blue Shield 65 Plus (HMO), Blue Shield Inspire (HMO), Blue Shield Vital (HMO) and many others

• Next Steps

• Questions

Agenda



The Blue Shield of California brand has over 80 years of experience in the

market. We have comprehensive product offerings (MAPD, Medicare

Supplement and PDP plans) designed to fit the needs and budgets for all

customers.

Value Proposition

2% Pledge (Giving Back)

Transforming Health Care

Blue Shield of California’s 2% Pledge reflects our commitment to our not-for-

profit mission. We pledge to limit our annual net income to 2 percent of

revenue, and we will return the difference to our customers and the

community, with approval by the Board of Directors.

At Blue Shield of California, we continually ask ourselves how we can innovate

and challenge the status quo to create a healthcare system worthy of our

family and friends. This goal guides our decisions and drives our every action.

Blue Shield of California Value Proposition



Medicare Part A

(hospital insurance) – automatic

• Helps cover inpatient care in hospitals

• Helps cover skilled nursing facility,

hospice, and home health care

Medicare Part B

(medical insurance) – requires a premium

• Helps cover physician services,

hospital outpatient care, and home health care

• Helps cover many preventive services to help maintain your health and to keep certain illnesses from getting worse

The Different Parts of Medicare

Medicare Part C

(also known as Medicare Advantage)

• Offers health plan options by Medicare-approved private insurance companies or health plans like Blue Shield of California

• Combines benefits and services covered

under Part A and Part B, and often Part D; some also include extra benefits

Medicare Part D

(Medicare prescription drug coverage)

• A prescription drug option run by Medicare-approved private insurance companies or health plans like Blue Shield of California

• Helps cover the cost of prescription drugs



Medicare doesn’t cover the cost of

all services. You’ll have to pay for the

costs of those services yourself,

unless:

• You have other insurance that coversthose costs

• You have a Medicare health plan that covers those costs

You generally have to pay other costs

with Original Medicare coverage, such as your deductible, coinsurance, andcopayments.

The costs of some of the items

and services that Original

Medicare doesn’t cover include:

• Long-term care (also called custodial care)

• Most dental care

• Eye exams related to prescribingglasses

• Dentures

• Cosmetic surgery

• Acupuncture

• Hearing aids and exams for fittingthem

• Routine foot care

For more information

To learn more about Medicare, the different parts of Medicare, and Medicare enrollment periods, visit https://www.medicare.gov/what-medicare-covers/whats-not-covered-by- part-a-part-b, and read the Medicare & You handbook. You can also call (800) MEDICARE [(800) 633-4227], 24 hours a day/seven days a week. TTY

users should call (877) 486-2048.

Original Medicare Part A & Part B: What’s Not Covered

(not a complete list)


https://www.medicare.gov/what-medicare-covers/whats-not-covered-by-part-a-part-b

https://www.medicare.gov/what-medicare-covers/whats-not-covered-by-part-a-part-b


There are two main ways to get your Medicare coverage: Original

Medicare, which can be supplemented by a Medicare Supplement

plan, or a Medicare Advantage Plan.

Original Medicare Medicare Advantage (also known as Part C)

• Original Medicare includes Medicare Part A (hospital

insurance) and Part B (medical insurance).

• If you want drug coverage, you can join a separate Part D

plan.

• To help pay your out-of-pocket costs in Original Medicare (like your

deductible and 20% coinsurance), you can also shop for and buy

supplemental coverage.

• Medicare Advantage is an “all in one” alternative to Original

Medicare. These “bundled” plans include Part A, Part B, and usually

Part D.

• Some plans may have lower out-of-pocket costs than Original

Medicare.

• Some plans offer extra benefits that Original Medicare doesn’t

cover – like vision, hearing, or dental.

Part A Part A

Part B Part B

You can add: Most plans include:

Part D Part D

You can also add: Some plans also include:

Lower out-of-pocket costs

Extra benefits

Supplemental coverage(Some examples include coverage from a Medicare

Supplement Insurance [Medigap] policy, or coverage from a

former employer orunion.)

Source: 2020 Medicare & You handbook, www.medicare.gov.

Your Medicare Coverage Choices at-a-Glance


http://www.medicare.gov/


Annual Enrollment Period: This is the time to add, drop or change a Medicare Advantage plan.

You can also make changes to your Medicare Advantage and Medicare prescription drug coverage when certain events happen in your life, like if you move or lose other insurance coverage. These chances to make changes are called Special Enrollment Periods (SEPs).

Annual Enrollment Period & Special Enrollment Periods

Those who qualify for both Medicare and Medi-Cal can join, switch or drop a Medicare plan during the Annual Enrollment Period and one time in each of the following Special Enrollment Periods: Jan-Mar; Apr-Jun; Jul-Sep.

]

[



Open Enrollment Period allows beneficiaries who are enrolled in a Medicare Advantage Plan to make a one-time change. This can be done January 1 through March 31 each year.

Open Enrollment Period

]

[


Beneficiaries get a one-time election to make any of the following

changes through the Medicare Advantage Open Enrollment Period:

• Switch from a Medicare Advantage Prescription Drug Plan (MAPD) to

a different MAPD.

• Switch from an MAPD to an MA-only plan.

• Switch from an MA-only to an MAPD.

• Switch from an MA-only plan to a different MA-only plan.


The best time to enroll in Medicare is during the seven-month window

called your Initial Enrollment Period (IEP).

For example, if your birthday is in June, you can enroll as early as March

and as late as September.

Note: If you are already receiving Social Security or Railroad Retirement

Board benefits, you are automatically enrolled in Original Medicare.

You can sign up for Medicare at your local Social Security office or by

applying online at SocialSecurity.gov.

Initial Enrollment Period


[

]

http://questions.medicare.gov/app/answers/detail/a_id/2191/kw/effective%20dates

http://www.socialsecurity.gov/retire2/applying1.htm

http://www.socialsecurity.gov/policy/docs/ssb/v68n2/v68n2p41.html

https://secure.ssa.gov/apps6z/FOLO/fo001.jsp

http://www.ssa.gov/medicareonly/

Blue Shield Medicare

Supplement plans


• You must have both Medicare Parts A and B.

• Standardized plans with varying benefits.

• Designed to cover the gaps of Original

Medicare, including some deductibles and

coinsurance of Medicare-allowed amounts

for covered healthcare expenses.

• Offered by private health plans like

Blue Shield of California.

• Freedom to choose any medical doctor or

hospital that accepts Medicare anywhere

you travel in the United States.

• You must pay monthly plan premiums in

addition to Medicare Part B premium.

• Standardized Medicare Supplement plan

designs do NOT include: Part D prescription

drug coverage, routine vision care, routine

dental care, and hearing aids.

PPO

Medicare Supplement

Plan

Part B Deductible

F

Y

Member

John Doe

ID#

XEAJ12345678

Group# X0001002

Effective 09/01/2016

Blue Shield Medicare Supplement plans

(also known as Medigap)



1 Sav ings due to increased efficiencies from administering Medicare Supplement plans under this program/serv ice are passed on to the subscriber. The Welcome to Medicare Rate Sav ings do not apply to Plan N.

• Many ways to save, including the

Welcome to Medicare Rate

Savings1

• A diverse range of Medicare

Supplement plans to choose from

• SilverSneakers® fitness and

wellness programs

• NurseHelp 24/7SM advice phone line

and online instant messaging

service available

• Outstanding customer service

• Convenience of adding

other types of coverage:

– Medicare Part D Prescription Drug Plans

– Two dental PPO plans to choose

from that are specifically designed for Blue Shield Medicare Supplement plan members

Why Choose a Blue Shield Medicare Supplement plan?


]

[


New! Blue Shield Medicare Supplement Plan G Inspire1

Blue Shield of California, together with AAA, is pleased to introduce Plan G

Inspire, our new Medicare Supplement plan that includes a benefit designed to

help promote continued independence and safer mobility. With Plan G Inspire,

all members, including existing AAA Members, receive all the benefits included

with our Plan G Extra, plus:

[<Enroll today: <(XXX) XXX-XXXX [TTY: 711]>]

[

]

• One-Year Classic AAA Membership2 – with 24/7 roadside assistance, annually upon enrollment.

• AAA Roadwise Driver – a course designed to help you refine your driving skills to become a safer driver.

• Educational Driving Resources – with a dedicated website containing resources and advice for drivers, such as AAA Roadwise Rx3 – a tool designed to help you learn more about your medications and how they may affect your driving.

1 Effect ive January 1, 2021, available in select counties in northern California. Please refer to the Summary of Benefits/Evidence of Coverage (EOC) for plan details and eligibility requirements.2 One-year new or renewal Classic AAA M embership, valued at up to $56/year in 2021. AAA M embership provided by AAA Nort hern Cali fornia, Nevada & Utah. 3 This t ool is intended to provide users with general information to help them better understand the traffic safety implicati ons of using certain medications before driving. The information is not medical advice.

Consult with your doctor before altering any medications or driving, or if you have specific medical questions or think you may be suffering from any medical condition.

© 2021 AAA Nort hern California, Nevada & Utah. All rights reserved. AAA Nort hern California, Nevada & Utah is independent of Blue Shield of California.


Blue Shield Medicare Supplement plans <Effective January 1, 2021>


[

]

Plan A Plan N Plan G Plan G Extra <New!> Plan G Inspire1 Plan F Extra2

Medicare Part A coinsurance and hospitalization √ √ √ √ √ √

Medicare Part B coinsurance or copayment √ √3 √ √ √ √

Blood (first 3 pints) √ √ √ √ √ √

Part A hospice care coinsurance or Copayment √ √ √ √ √ √

Medicare Part A deductible √ √ √ √ √

Skilled nursing facility care √ √ √ √ √

Medicare Part B excess charges3 √ √ √ √

Medicare Part B deductible √

SilverSneakers® fitness and wellness programs4√ √ √ √ √ √

NurseHelp 24/74 √ √ √ √ √ √

Enjoy Extra Benefits Included with Your Plan

Vision benefits5√ √ √

Hearing aid benefits √ √ √

Emergency alert device √

Physician consultation benefits√ √

Quarterly allowance for over-the-counter (OTC) items6 √ √

Independence and Safe Mobility with AAAo Classic AAA Membership7

o AAA Roadwise Drivero Educational Driving Resources, like AAA

Roadwise Rx8

√

1. Available in Alameda, Alpine, Amador, Butte, Calaveras, Colusa, Contra Costa, Del Norte, El Dorado, Fresno, Glenn, Humboldt, Kings, Lake, Lassen, Madera, Marin, Mariposa, Mendocino, Merced, Modoc, Mono, Monterey, Napa, Nevada, Placer, Plumas,

Sacramento, San Benito, San Francisco, San Joaquin, San Mateo, Santa Clara, Santa Cruz, Shasta, Sierra, Siskiyou, Solano, Son oma, Stanislaus, Sutter, Tehama, Trinity, Tuolumne, and Yuba. Please refer to the <Summary of Benefits/ Evidence of Coverage (EOC) for plan details and eligibility requirements.

2. Plan F Extra is only available to applicants who attained age 65 before January 1, 2020 or first became eligible for Medicare benefits due to disability before January 1, 2020.3. Plan N pays 100% of the Part B coinsurance, except for a co-payment of up to $20 for some office visits and up to a $50 co-payment for emergency room visits that do not result in an inpatient admission.

4. Available to all Blue Shield of California Medicare Supplement plan members at no additional cost.5. Vision benefits include coverage for costs that are not traditionally covered by Original Medicare, such as, eye exam, frames, eyeglass lenses or contact lenses.

6. One-time use per quarter allowance for eligible items. Unused allowance cannot be rolled over into the next quarter.7. One-year new or renewal Classic AAA Membership, valued at up to $56/year in 2021. AAA Membership provided by AAA Northern Califo rnia, Nevada & Utah.

8. This tool is intended to provide users with general information to help them better understand the traffic safety implication s of using certain medications before driving. The information is not medical advice. Consult with your doctor before altering any medications or driving, or if you have specific medical questions or think you may be suffering from any medical condition.

© 2021 AAA Northern California, Nevada & Utah. All rights reserved. AAA Northern California, Nevada & Utah is independent of Blue Shield of California.


Medicare Supplement plan Rates1 for Ages 65 to 66 <Effective July 1, 2021>

1 M onthly plan dues depend on your age and where you live. The dues shown are for non-tobacco users, single-party, ages 65-66 who live in Region 1 except ZIP codes 91711, 91759, 91765, 91766, 91767, 93535, 93544, 93563, and 93591; Region 2, Region 3 including LA ZIP Codes 91711, 91759, 91765, 91766, 91767, 93535, 93544, 93563, and 93591, and Regions 4, 5, 8 and 9. Other rates may apply. Rates listed do not include anyW elcome to Medicare Rate Savings or AutoPay and Household Savings. For the exact rate that applies to you, please refer to the rate charts in Blue Shield’s enrollment/presale kit. Monthly plan dues areeffective July 1, 2021. All dues are subject to change.

2 Available in Alameda, Alpine, Amador, Butte, Calaveras, Colusa, Contra Costa, Del Norte, El Dorado, Fresno, Glenn, Humboldt, Kings, Lake, Lassen, Madera, Marin, Mariposa, Mendocino, Merced, Modoc, M ono, Monterey, Napa, Nevada, Placer, Plumas, Sacramento, San Benito, San Francisco, San Joaquin, San Mateo, Santa Clara, Santa Cruz, Shasta, Sierra, Siskiyou, Solano, Sonoma, Stanislaus, Sutter, Tehama, Trinit y, Tuolumne, and Yuba. Please refer to the Summary of Benefits/ Evidence of Coverage (EOC) for plan details.

3 Plan F Ext ra is only available t o applicants who attained age 65 before January 1, 2020 or firs t became eligible for Medicare benefits due to disability before January 1, 2020.

Our Plans: Plan A Plan N Plan G Plan GExtra New! Plan G Inspire2 Plan F Extra3

Region 1 – Los Angeles County except ZIP Codes 91711, 91759, 91765, 91766, 91767, 93535, 93544, 93563, and 93591

$125 $143 $138 $152 N/A $184

Region 2 – Orange County $125 $143 $141 $155 N/A $189

Region 3 – San Diego, Sonoma, San Bernardino,Kern counties, and LA ZIP Codes 91711, 91759, 91765, 91766, 91767, 93535, 93544, 93563, and 93591

$119 $132 $128 $142 $142 $172

Region 4 – Riverside and Ventura counties $130 $147 $145 $159 N/A $195

Region 5 – San Joaquin, Santa Barbara, and

Stanislaus counties $111 $123 $118 $132 $132 $159

Region 8 – Includes San Francisco,San Mateo, Fresno, and Santa Clara counties

$110 $123 $118 $132 $132 $159

Region 9 – Sacramento, Amador, Calaveras, Colusa, El Dorado, Tehama, and Marin counties $108 $128 $123 $137 $137 $165

[<Enroll today: <(XXX) XXX-XXXX [TTY: 711]>]

[

]


Prescription Drug Plans


1 Does not apply to Blue Shield Rx Plus (PDP) Tier 1 Preferred Generic Drugs.

Complement your Blue Shield Medicare Supplement coverage with a

Medicare Part D Prescription Drug Plan by adding one of our PDP plans.

Blue Shield Rx Plus (PDP)

• $59.00 monthly plan premium

• $445 annual deductible1

• Lower cost-sharing than our Blue Shield Rx Enhanced (PDP)plan2

Blue Shield Rx Enhanced (PDP)

• $130.40 monthly plan premium

• $0 annual deductible

• Blue Shield Rx Enhanced (PDP) includes some drugs not on the Blue Shield Rx Plus (PDP)formulary

• You may want to consider this option ifyou take drugs on the Blue Shield RxEnhanced (PDP) formulary and don’twant an annual deductible

Blue Shield Medicare Part D Prescription Drug Plans

Effective January 1, 2021 – December 31, 2021



1 As of August 2018. Other Pharmacies are available in our netw ork.

All Blue Shield Medicare Prescription Drug Plans

• You can choose to get your prescriptions

filled at more than 6,000 network

pharmacies contracted with Blue Shield.1

• You pay less at network pharmacies that

offer preferred cost sharing than you do at

network pharmacies that offer standard

cost sharing.

• Receive a 90-day supply of covered drugs

for the cost of two 30-day supplies for Tiers

1 to 3 when filled at a network

pharmacy that offers preferred cost sharing

or through our mail serv ice pharmacy.

(Note: For Tiers 4 and 5, members are

responsible for the applicable coinsurance.

Tier 5 Drugs are available only at a 30-day

supply.)

Pharmacies that offer preferred

cost sharing include:

Costco

CVS Pharmacy

(including CVS

Pharmacy at Target)

Safeway and Vons

Albertsons/Sav-on/

Osco

Ralphs, Walmart

And many more

Blue Shield Medicare Part D Prescription Drug Plans

(continued)



Medicare Part D Coverage Gap: Donut Hole 2021



Advantage (HMO) [and

(HMO D-SNP)] [and (PPO)]

Part C Plans


1 Basic gym access is not included as part of the Blue Shield Vital (HMO) in Los Angeles, Orange, Riverside, and San Bernardino counties.

We offer a wide variety of Medicare Advantage coverage options to

meet your health care needs including HMO, HMO D-SNP and PPO plans.

• Plans include Part A (hospital insurance), Part B (medical insurance), and Part D prescription drug coverage

(a separate Medicare Prescription Drug Plan is not necessary).

• You must use plan doctors, hospitals, and other providers except in certain situations. We have a large network of

primary care physicians and specialists, so chances are you can keep seeing your doctor.

• Plan premiums vary by county (you must continue to pay Medicare Part Bpremium).

• There is a yearly cap on how much you will spend on Part A and Part B services (amount varies by plan and service area).

• Includes extra benefits like vision

coverage and basic gym access1 at no additional cost.

Let’s go through the Benefit Highlights to learn about the benefits for the plan(s)

available in this area.

Blue Shield Medicare Advantage HMO [and HMO D-

SNP] [and PPO] Part C Plans <Effective January 1, 2021>



[<

>]Enroll today: : <(XXX) XXX-XXX [TTY: 711]>


Next Steps: Annual Enrollment Period (AEP)

• ASK WHICH CHANGES APPLY TO YOU

❑ Review your existing benefits and costs - determine if the coverage you have meets

your healthcare needs for next year.

❑ Review your list of medications - will your prescription drugs be covered next year?

❑ Can you keep using the same pharmacies, hospitals, doctors and other providers?

❑ How much will you spend out-of-pocket for the services and prescriptions drugs you use regularly?

❑ How much will you spend on premiums and deductibles?

• COMPARE AND CHOOSE

❑ Learn about other plan choices, coverage and costs.

❑ Are you happy with your current plan?

• ENROLL

❑ You have between Oct. 15 and Dec. 7, 2020 to switch plans.

• CALL US, WE CAN HELP

❑ Still have questions? Call us and we will help you compare your coverage options and determine if you have the plan that best meets your health and financial needs.


]

[


Next Steps: Enrolling in Medicare

• SIX MONTHS BEFORE YOU TURN 65

❑ Research the Medicare plans and options available in your area.

❑ Decide which coverage options are most important to you based on your needs and budget.

• THREE MONTHS BEFORE YOU TURN 65

❑ Enroll in Original Medicare (Parts A and B).

❑ Consider which additional plans do the best job of completing your Medicare coverage.

• YOUR 65TH BIRTHDAY MONTH

❑ Sign up for the additional Medicare coverage you’ve chosen. You must already be

enrolled in Original Medicare (Parts A and B) before you can enroll in additional coverage.

• THREE MONTHS AFTER YOU TURN 65

❑ Your deadline for enrolling in Original Medicare (Parts A and B) is at the end of this

month. If you miss it, you may be charged a late enrollment penalty.

❑ Enroll in additional Medicare coverage to pay for costs that Original Medicare doesn’t cover.

NOTE: I f you’re already receiv ing retirement benefits from Social Security or the Railroad Retirement Board,

you’re automatically enrolled in Original Medicare (Parts A and B). No need to re-enroll.


]

[


Q & A



Thank you for attending today.

[<Talk directly with one of our dedicated, authorized Blue Shield

Medicare agents.>]

<Call me for a personalized phone consultation or to enroll today.>

[<Contact:>] <(XXX) XXX-XXXX [TTY: 711]>

<Call 8 a.m. to 8 p.m., seven days a week from October 1 through March 31,

and 8 a.m. to 8 p.m., weekdays from April 1 through September 30.>

<<Call 8 a.m. to <5:30 p.m.><8 p.m.>, <Monday through Friday><seven

days a week.>>


<Blue Shield of California is an HMO, HMO D-SNP, PPO and PDP plan with a Medicare contract and a contract with the California State Medicaid

Program. Enrollment in Blue Shield of California depends on contract renewal.

You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call:• 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/seven days a week;

• The Social Security office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call 1-800-325-0778; or• Your Medicaid office.

Silv erSneakers is a registered trademark of Tiv ity Health, Inc. © 2021 Tiv ity Health, Inc. All rights reserv ed.

NurseHelp 24/7 is a serv ice mark of Blue Shield of California.Blue Shield of California complies with applicable state laws and federal civ il rights laws, and does not discriminate on the basis of race, color,

national origin, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, or disability.

Blue Shield of California cumple con las leyes estatales y las leyes federales de derechos civ iles v igentes, y no discrimina por motiv os de raza, color, país de origen, ascendencia, religión, sexo, estado civ il, género, identidad de género, orientación sexual, edad ni discapacidad.

Blue Shield of California 遵循適用的州法律和聯邦公民權利法律，並且不以種族、膚色、原國籍、血統、宗教、性別、婚姻狀況、性別認同、性取向、年齡或殘障為由而

進行歧視。

Blue Shield of California is an independent member of the Blue Shield Association.>

Documents

Welcome to the Blue Shield Medicare [Webinar]/[Sales