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Submitted URL: http://www.bcbsmnmedicare.com/
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Submission: On November 30 via api from US — Scanned from US

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 1. Members
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 4. Medicare Materials




MEDICARE MATERIALS


ORDER MEDICARE MATERIALS TO BE DELIVERED TO YOUR HOME OR DOWNLOAD A DIGITAL
VERSION IF AVAILABLE 

 

You can also order materials by calling 1-877-662-2583/TTY 711, 8 a.m. to 8 p.m.
Central Time, daily.

 

If you prefer printed enrollment materials delivered to your mailbox, we’re
happy to send it them you. Simply select the materials below that best fit your
needs.

 


SELECT YOUR FREE, NO OBLIGATION 2023 MATERIALS BELOW.

Select your county to see plans and options available for that location.


MEDICARE DECISION GUIDE

Start here to get an overview of available Medicare plans, benefits and costs.
This guide will help you confidently choose a plan that’s right for you in three
easy steps. 

Download 2023 PDF - English

Download 2023 PDF - Spanish

 

Step-by-Step Guide to Medicare

Understand your Medicare benefits.

Download 2023 PDF-[COMING SOON]

 

County - Any -AllAitkinAnokaBeckerBeltramiBentonBig StoneBlue
EarthBrownCarltonCarverCassChippewaChisagoClayClearwaterCookCottonwoodCrow
WingDakotaDodgeDouglasFaribaultFillmoreFreebornGoodhueGrantHennepinHoustonHubbardIsantiItascaJacksonKanabecKandiyohiKittsonKoochichingLac
qui ParleLake of the WoodsLakeLe
SueurLincolnLyonMahnomenMarshallMartinMcLeodMeekerMille
LacsMorrisonMowerMurrayNicolletNoblesNormanOlmstedOtter
TailPenningtonPinePipestonePolkPopeRamseyRed
LakeRedwoodRenvilleRiceRockRoseauSaint
LouisScottSherburneSibleyStearnsSteeleStevensSwiftToddTraverseWabashaWadenaWasecaWashingtonWatonwanWilkinWinonaWrightYellow
Medicine



2023

2023 Medicare Decision Guide
Decision Guide

Confidently choose a plan that’s right for you in 3 easy steps. This guide
includes an overview of available Medicare plans, benefits and costs.

Add to order

2023 Medicare Advantage Metro Region Enrollment Kit
Enrollment Kit

Learn about Medicare Advantage (PPO) plans. Plans include medical and
prescription drug coverage, a select doctor network, SilverSneakers and dental
benefits. Also included is information on Medical-only plans for enrollees who
have credible prescription drug coverage.

Kit includes plan information, summary of benefits, star ratings sheet, plan
enrollment form and return envelope.

Anoka
Carver
Chisago
Dakota
Hennepin
Isanti
Ramsey
Scott
Sherburne
Washington
Wright

Add to order

2023 Medicare Advantage South Region Enrollment Kit
Enrollment Kit

Learn about Medicare Advantage (PPO) plans. Plans include medical and
prescription drug coverage, a select doctor network, SilverSneakers and dental
benefits. Also included is information on Medical-only plans for enrollees who
have credible prescription drug coverage.

Kit includes plan information, summary of benefits, star ratings sheet, plan
enrollment form and return envelope.

Blue Earth
Dodge
Faribault
Fillmore
Freeborn
Houston
Martin
Mower
Nicollet
Olmsted
Steele
Wabasha
Waseca
Watonwan
Winona

Add to order

2023 Medicare Advantage West Region Enrollment Kit
Enrollment Kit

Learn about Medicare Advantage (PPO) plans. Plans include medical and
prescription drug coverage, a select doctor network, SilverSneakers and dental
benefits. Also included is information on Medical-only plans for enrollees who
have credible prescription drug coverage.

Kit includes plan information, summary of benefits, star ratings sheet, plan
enrollment form and return envelope.

Becker
Beltrami
Benton
Big Stone
Brown
Cass
Chippewa
Clay
Clearwater
Cottonwood
Crow Wing
Douglas
Grant
Hubbard
Jackson
Kandiyohi
Kittson
Lac qui Parle
Lake of the Woods
Lincoln
Lyon
Mahnomen
Marshall
Morrison
Murray
Nobles
Norman
Otter Tail
Pennington
Polk
Pope
Red Lake
Redwood
Renville
Roseau
Stearns
Swift
Todd
Wadena
Wilkin

Add to order

2023 Platinum Blue Enrollment Kit
Enrollment Kit

Medicare-approved Cost plan with three medical plan options that you can pair
with built-in prescription drug coverage for greater convenience and simplicity.
Features our lowest priced option for health coverage only.

Kit includes plan information, summary of benefits, star ratings sheet, plan
applications and forms and return envelope.

Aitkin
Carlton
Cook
Goodhue
Itasca
Kanabec
Koochiching
Lake
Le Sueur
McLeod
Meeker
Mille Lacs
Pine
Pipestone
Rice
Rock
Saint Louis
Sibley
Stevens
Traverse
Yellow Medicine

Add to order

2023 MedicareBlue Rx Enrollment Kit
RX (PDP) Enrollment Kit

A stand-alone prescription drug plan that offers three options for prescription
drug coverage. Pair it with medical-only health coverage.

Kit includes plan information, summary of benefits, star ratings sheet, plan
enrollment form and return envelope.


Add to order

2023 Medicare Advantage / Platinum Blue (Cost) Individual Standard (Choice and
Complete plans) Formulary
RX Formulary

Look up prescription drugs to find out what is covered, and which drug tier your
drug is under. You can also look up covered drugs at myprime.com


Add to order

2023 Medicare Advantage / Platinum Blue (Cost) Individual Value (Core, Comfort,
and Group MAPD Classic Rx1 plans) Formulary
RX Formulary

Look up prescription drugs to find out what is covered, and which drug tier your
drug is under. You can also look up covered drugs at myprime.com


Add to order

2023 Medicare Supplement Enrollment Kit
Supplement Enrollment Kit

Learn about Medicare Supplement plans that supplement your Original Medicare
benefits. These plans provide medical only coverage and include SilverSneakers. 

Kit includes plan information, Choosing a Medigap Policy, summary of coverage
and disclosure of information, plan application and return envelope.


Add to order

2023 Medicare Supplement Summary of Coverage and Disclosure
Summary of Benefits

Medicare Supplement plan overview and coverage information.


Add to order

2023 Summary of Benefits Med. Advantage Core, Choice, Complete - South
Summary of Benefits

Summary of the medical and prescription drug benefits covered by Blue Cross
Medicare Advantage plans

Blue Earth
Dodge
Faribault
Fillmore
Freeborn
Houston
Martin
Mower
Nicollet
Olmsted
Steele
Wabasha
Waseca
Watonwan
Winona

Add to order

2023 Summary of Benefits Med. Advantage Core, Comfort, Choice, Complete - Metro
Summary of Benefits

Summary of the medical and prescription drug benefits covered by Blue Cross
Medicare Advantage plans

Anoka
Carver
Chisago
Dakota
Hennepin
Isanti
Ramsey
Scott
Washington

Add to order

2023 Summary of Benefits Med. Advantage Core, Comfort, Choice, Complete - West
Summary of Benefits

Summary of the medical and prescription drug benefits covered by Blue Cross
Medicare Advantage plans

Becker
Beltrami
Benton
Big Stone
Brown
Cass
Chippewa
Clay
Clearwater
Cottonwood
Crow Wing
Douglas
Grant
Hubbard
Jackson
Kandiyohi
Kittson
Lac qui Parle
Lake of the Woods
Lincoln
Lyon
Mahnomen
Marshall
Morrison
Murray
Nobles
Norman
Otter Tail
Pennington
Polk
Pope
Red Lake
Redwood
Renville
Roseau
Sherburne
Stearns
Swift
Todd
Wadena
Wilkin
Wright

Add to order

2023 Summary of Benefits Medicare Advantage Freedom BlueSM - Metro
Summary of Benefits

Summary of the medical benefits covered by Blue Cross Medicare Advantage plans

Anoka
Carver
Chisago
Dakota
Hennepin
Isanti
Ramsey
Scott
Washington

Add to order

2023 Summary of Benefits Medicare Advantage Freedom BlueSM - South
Summary of Benefits

Summary of the medical benefits covered by Blue Cross Medicare Advantage plans

Blue Earth
Dodge
Faribault
Fillmore
Freeborn
Houston
Martin
Mower
Nicollet
Olmsted
Steele
Wabasha
Waseca
Watonwan
Winona

Add to order

2023 Summary of Benefits Medicare Advantage Freedom BlueSM - West
Summary of Benefits

Summary of the medical benefits covered by Blue Cross Medicare Advantage plans

Becker
Beltrami
Benton
Big Stone
Brown
Cass
Chippewa
Clay
Clearwater
Cottonwood
Crow Wing
Douglas
Grant
Hubbard
Jackson
Kandiyohi
Kittson
Lac qui Parle
Lake of the Woods
Lincoln
Lyon
Mahnomen
Marshall
Morrison
Murray
Nobles
Norman
Otter Tail
Pennington
Polk
Pope
Red Lake
Redwood
Renville
Roseau
Sherburne
Stearns
Swift
Todd
Wadena
Wilkin
Wright

Add to order

2023 Summary of Benefits Platinum Blue
Summary of Benefits

Summary of the medical and prescription drug benefits covered by Platinum Blue
(Cost) and Platinum Blue with Rx (Cost) plans

Aitkin
Carlton
Cook
Goodhue
Itasca
Kanabec
Koochiching
Lake
Le Sueur
McLeod
Meeker
Mille Lacs
Pine
Pipestone
Rice
Rock
Saint Louis
Sibley
Stevens
Traverse
Yellow Medicine

Add to order



2022

2022 Medicare Decision Guide
Decision Guide

Confidently choose a plan that’s right for you in 3 easy steps. This guide
includes an overview of available Medicare plans, benefits and costs.

Add to order

2022 Medicare Advantage Metro Region Enrollment Kit
Enrollment Kit

Learn about Medicare Advantage (PPO) plans. Plans include medical and
prescription drug coverage, a select doctor network, SilverSneakers and dental
benefits. Also included is information on Medical-only plans for enrollees who
have credible prescription drug coverage.

Kit includes plan information, summary of benefits, star ratings sheet, plan
enrollment form and return envelope.

Anoka
Carver
Chisago
Dakota
Hennepin
Isanti
Ramsey
Scott
Washington

Add to order

2022 Medicare Advantage South Region Enrollment Kit
Enrollment Kit

Learn about Medicare Advantage (PPO) plans. Plans include medical and
prescription drug coverage, a select doctor network, SilverSneakers and dental
benefits. Also included is information on Medical-only plans for enrollees who
have credible prescription drug coverage.

Kit includes plan information, summary of benefits, star ratings sheet, plan
enrollment form and return envelope.

Blue Earth
Dodge
Faribault
Fillmore
Freeborn
Houston
Martin
Mower
Nicollet
Olmsted
Steele
Wabasha
Waseca
Watonwan
Winona

Add to order

2022 Medicare Advantage West Region Enrollment Kit
Enrollment Kit

Learn about Medicare Advantage (PPO) plans. Plans include medical and
prescription drug coverage, a select doctor network, SilverSneakers and dental
benefits. Also included is information on Medical-only plans for enrollees who
have credible prescription drug coverage.

Kit includes plan information, summary of benefits, star ratings sheet, plan
enrollment form and return envelope.

Becker
Beltrami
Benton
Big Stone
Brown
Cass
Chippewa
Clay
Clearwater
Cottonwood
Crow Wing
Douglas
Grant
Hubbard
Jackson
Kandiyohi
Kittson
Lac qui Parle
Lake of the Woods
Lincoln
Lyon
Mahnomen
Marshall
Morrison
Murray
Nobles
Norman
Otter Tail
Pennington
Polk
Pope
Red Lake
Redwood
Renville
Roseau
Sherburne
Stearns
Swift
Todd
Wadena
Wilkin
Wright

Add to order

2022 Platinum Blue Enrollment Kit
RX (Cost) Enrollment Kit

Medicare-approved Cost plan with three medical plan options that you can pair
with built-in prescription drug coverage for greater convenience and simplicity.
Features our lowest priced option for health coverage only.

Kit includes plan information, summary of benefits, star ratings sheet, plan
applications and forms and return envelope.

Aitkin
Carlton
Cook
Goodhue
Itasca
Kanabec
Koochiching
Lake
Le Sueur
McLeod
Meeker
Mille Lacs
Pine
Pipestone
Rice
Rock
Saint Louis
Sibley
Stevens
Traverse
Yellow Medicine

Add to order

2022 MedicareBlue Rx Enrollment Kit
RX (PDP) Enrollment Kit

A stand-alone prescription drug plan that offers two options for prescription
drug coverage. Pair it with medical-only health coverage.

Kit includes plan information, summary of benefits, star ratings sheet, plan
enrollment form and return envelope


Add to order

2022 Medicare Advantage (PPO) / Platinum BlueSM (Cost) Formulary
RX Formulary

Look up prescription drugs to find out what is covered, and which drug tier your
drug is under. You can also look up covered drugs at myprime.com

Add to order

2022 Medicare Step-by-Step Guide
Step-by-Step Guide

New to Medicare guide to navigate Medicare choices

All

Add to order

2022 Medicare Supplement Enrollment Kit with Health History
Supplement Enrollment Kit

Learn about Medicare Supplement plans that supplement your Original Medicare
benefits. These plans provide medical only coverage and include SilverSneakers.
Request this kit if you have been enrolled in Medicare Part B for more than six
months and do not have guaranteed issue rights for another reason.

Kit includes plan information, Choosing a Medigap Policy, summary of coverage
and disclosure of information, plan applications and forms and return envelope.


Add to order

2022 Medicare Supplement Enrollment Kit without Health History
Supplement Enrollment Kit

Learn about Medicare Supplement plans that supplement your Original Medicare
benefits. These plans provide medical only coverage and include SilverSneakers.
Request this kit if you are just becoming eligible
for Medicare or have other guaranteed issue rights.

Kit includes plan information, Choosing a Medigap Policy, summary of coverage
and disclosure of information, plan applications and forms and return envelope.


Add to order

2022 Medicare Supplement Summary of Coverage and Disclosure
Summary of Benefits

Medicare Supplement plan overview and coverage information.


Add to order

2022 Summary of Benefits Platinum Blue
Summary of Benefits

Summary of the medical and prescription drug benefits covered by Platinum Blue
(Cost) and Platinum Blue with Rx (Cost) plans

Aitkin
Carlton
Cook
Goodhue
Itasca
Kanabec
Koochiching
Lake
Le Sueur
McLeod
Meeker
Mille Lacs
Pine
Pipestone
Rice
Rock
Saint Louis
Sibley
Stevens
Traverse
Yellow Medicine

Add to order

2022 Summary of Benefits PPO Metro region - MA only
Summary of Benefits

Summary of the medical benefits covered by Blue Cross Medicare Advantage plans

Anoka
Carver
Chisago
Dakota
Hennepin
Isanti
Ramsey
Scott
Washington

Add to order

2022 Summary of Benefits PPO Metro region - MAPD
Summary of Benefits

Summary of the medical and prescription drug benefits covered by Blue Cross
Medicare Advantage plans

Anoka
Carver
Chisago
Dakota
Hennepin
Isanti
Ramsey
Scott
Washington

Add to order

2022 Summary of Benefits PPO South region - MA only
Summary of Benefits

Summary of the medical benefits covered by Blue Cross Medicare Advantage plans

Blue Earth
Dodge
Faribault
Fillmore
Freeborn
Houston
Martin
Mower
Nicollet
Olmsted
Steele
Wabasha
Waseca
Watonwan
Winona

Add to order

2022 Summary of Benefits PPO South region - MAPD
Summary of Benefits

Summary of the medical and prescription drug benefits covered by Blue Cross
Medicare Advantage plans

Blue Earth
Dodge
Faribault
Fillmore
Freeborn
Houston
Martin
Mower
Nicollet
Olmsted
Steele
Wabasha
Waseca
Watonwan
Winona

Add to order

2022 Summary of Benefits PPO West region - MA only
Summary of Benefits

Summary of the medical benefits covered by Blue Cross Medicare Advantage plans

Becker
Beltrami
Benton
Big Stone
Brown
Cass
Chippewa
Clay
Clearwater
Cottonwood
Crow Wing
Douglas
Grant
Hubbard
Jackson
Kandiyohi
Kittson
Lac qui Parle
Lake of the Woods
Lincoln
Lyon
Mahnomen
Marshall
Morrison
Murray
Nobles
Norman
Otter Tail
Pennington
Polk
Pope
Red Lake
Redwood
Renville
Roseau
Sherburne
Stearns
Swift
Todd
Wadena
Wilkin
Wright

Add to order

2022 Summary of Benefits PPO West region - MAPD
Summary of Benefits

Summary of the medical and prescription drug benefits covered by Blue Cross
Medicare Advantage plans

Becker
Beltrami
Benton
Big Stone
Brown
Cass
Chippewa
Clay
Clearwater
Cottonwood
Crow Wing
Douglas
Grant
Hubbard
Jackson
Kandiyohi
Kittson
Lac qui Parle
Lake of the Woods
Lincoln
Lyon
Mahnomen
Marshall
Morrison
Murray
Nobles
Norman
Otter Tail
Pennington
Pope
Red Lake
Redwood
Renville
Roseau
Sherburne
Stearns
Swift
Todd
Wadena
Wilkin
Wright

Add to order


Last updated October 1, 2022

S5743_091322P01_M
Y0138_091322P02_M

Blue Cross offers Cost, PPO, and PDP plans with Medicare contracts. Enrollment
in these Blue Cross plans depends on contract renewal. This information is not a
complete description of benefits. Call (651) 662-2583 or 1-877-662-2583 (TTY
call 711) for more information about Cost plans. Call 1-877-662-2583 (TTY call
711) for more information about supplement plans.

Prime Therapeutics LLC is an independent company providing pharmacy benefit
management services.

SilverSneakers® is a registered trademark of Tivity Health, Inc., an independent
company that provides health and fitness programs. Blue Cross Medicare
Advantage, Platinum Blue, Senior Gold and other Medicare Supplement and
SecureBlue plans are eligible.

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