Historical Newspapers of South Carolina

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Blue Cross-Blue Shield:, with Medicare Closes the Gaps Opened by Changes in Medicare Coverage -SPECIAL- The South Carolina Insurance Department recently approved new membership contracts that Blue Cross-Blue Shield of South Carolina now offers only to persons of age 65 and over. Why? Because the Federal Government this year raised the amounts of “deductible” and “co-insurance” that Medicare patients must pay on their hospital and nursing home bills. This means that Medicare leaves wider (more costly) gaps in its coverage for the age group 65-plus. What’s more, Medicare still leaves an annual $50.00 “deductible,” and 20 percent “co-insurance,” on all charges above that amount, for its beneficaries to pay whenever they get doctor bills. The new Blue Cross-65 membership and new Blue Shield-65 membership is the best way to cover the gaps in Medicare coverage. Regard less of the present state of their health, South Carolinians in the 65-plus age group can enroll, individually, under these new member ship contracts by using the coupon applica tion on this page. BLUE CROSS-65 DEDUCTIBLE - MEDICARE does not pay the first $52.00 of your hospital bills. BLUE CROSS - 65 will pay this $52.00 for you. CO-INSURANCE - MEDICARE does not pay $13.00 per day for the 61st day through the 90th day of hospitalization. BLUE CROSS - 65 will pay this $13.00 per day for you. New and Paying You Morel ADDITIONAL DAYS - MEDICARE gives you 60 additional days of hospital coverage during your lifetime. This Lifetime Reserve may be used by you wholly, or in part, at any tirru; you may need and wish to use it. Except for this 60-day Lifetime Reserve, Medicare benefits in the hospital cease after the 90tliday of hospitalization during any spell of illness. When you use your lifetime reserve days Medicare re quires that you pay $26.00 per day of your hospital bill. Look Ahead! If you enroll in Blue Cross - 65, Blue Shield - 65, or both, your coverage will be effective immediately upon acceptance of your application. Treatment of illness or injury that already exists on your effective date of enrollment cannot be covered until your membership has been in effect at least six months. However, you will be covering your new health care needs immediately upon the effective date of your membership. BLUE CROSS - 65 will pay $26.00 per day during the 91sj through the 150th day of hospitalization during any spell of illness. EMERGENCY OUTPATIENT CARE - MEDICARE will not pay any benefits for outpatient care unless you are covered by Part B. After a $50.00 calendar-year deductible, Part B of Medicare will pay 80% of your outpatient care bills. Dues — For each person enrolled, three months' dues for Blue Cross-65 is $10.95. Three months' dues for Blue Shield-65 is $13.95. The combined dues are $24.90 quarterly. To Enroll — Fill in the coupon and send it, with your first quarterly dues, to Blue Cross-Blue Shield of South Carolina, Forest Acres Branch, Columbia, S. C. 29206 BLUE CROSS - 65 will pay 20% of your outpatient hospital bill within 72 hours following an accidental injury and for emergency care for sudden and serious medical conditions rendered within 72 hours after the onset of such conditions. Also, Blue Cross - 65 will pay 20% of your outpatient hospital bills for use of the hospital’s facilities for minor surgical operations, radiation therapy, inhalation therapy and physical therapy. EXTENDED CARE FACILITY - MEDICARE will pay your bill in full, in a semi-private room, for the first 20 days while being treated in a skilled Extended Care Facility. MEDICARE does not pay $6.50 per day from the 21 si day through the 100th day. BLUE CROSS - 65 will pay $6.50 per day from the 21 si through the 100th day for you. The Extended Care Facility benefits from MEDICARE and Blue Cross are provided if you are discharged from a general hospital after a stay of 3 or more days and are admitted to an Extended Care Facility within 14 days. BLUE SHIELD - 65 The Blue Shield - 65 contract provides payment for Physician’s* ser vices without regard to Medicare. Enrollment is open to only those persons covered by Part B of Medicare, but Blue Shield-65 benefits are paid in addition to any Medicare payment for the same services. The following benefits are provided by Blue Shield - 65: SURGERY - Up to $325.00 according to a fee schedule. ANESTHESIA - Up to $65.00 based on time. MEDICAL CARE - For daily physician’s visits in a hospital for a non-surgical condition, $5.00 per visit beginning on the first day of confinement. Benefits are provided for as long as 90 days of care, if needed, and may be carried over to cover care in an Extended Care Facility. Each contract year, however, only 15 days’ benefits are pay able for inpatient medical care of mental or nervous illness. EMERGENCY MEDICAL CARE - $10.00 for a physician’s care when received within 72 hours of an accident. EMERGENCY X-RAY, DIAGNOSTIC X-RAY, and LABORATORY SERVICE - Paid according to a fee schedule. Upon acceptance, you will receive your new contracts, your Blue Cross-Blue Shield Identification Card, and a new Medicare Handbook. You will also have a 10-day right to examine your contract and, if dissatisfied, to return it and get your money back. Enroll Now! RENEWAL — Blue Cross and Blue Shield will not cancel these contracts because of any change in the physical or mental condition or health of any subscriber enrolled under them. Further, renewal of the contracts will not be refused by Blue Cross or Blue Shield because of the amount of claims paid for the subscriber. ff”LAST NAME FIRST NAME INITIAL ADDRESS (BOX OR STREET) 1. \Z\male 2. □ FEMALE YOUR DATE OF BIRTH MO. DAY YR. FOR BL UE CROSS USE ONL Y SOCIA L SECURITY NUMBER CITY STATE THIS APPLICA TION IS FOR: NEW MEMBERSHIP NOTICE: PERSONS ENTITLED TO BENEFITS UNDER INSURANCE POLICIES NOT RELATED TO MEDICARE SOMETIMES GET PRIORITIES NOT EXTENDED TO MEDICARE PATIENTS FOR BED SPACE. BEFORE YOU CANCEL YOUR PRESENT POLICY AND OBTAIN A POLICY TO SUPPLEMENT MEDICARE BENEFITS, THE LAWS OF THIS STATE REQUIRE THAT YOU BE INFORMED OF THIS SITUATION. ZIP CODE CHECK COVERAGE APPL YING FOR: □ BLUE CROSS - 65 □ BLUE SHIELD - 65 Blue Shield - 65 is open only to persons with, or applying for. Blue Cross memberships. 1. ARE YOU ELIGIBLE TO RECEIVE BENEFITS UNDER MEDICARE, PART A (HOSPITAL)? 2. ARE YOU ELIGIBLE TO RECEIVE BENEFITS UNDER MEDICARE, PART B (PHYSICIANS)? 3. DO YOU HA VE ANY OTHER TYPES OF HOSPITAL, MEDICAL-SURGICAL COVERAGE IN ADDITION TO THAT TO WHICH YOU ARE ENTITLED UNDER MEDICARE? YES □ NO □ □ □ □ □ “I hereby apply for the Blue Cross-Blue Shield contracts indicated above. I understand and agree that same will not be effective, nor will the Plans have any liability, unless and until this application is accepted and approved and contracts issued with an Identification Card showing effective date. I do hereby authorize any doctor, hospital, private duty nurse, dispenser of prescription drugs, appliances, ambulance service or any person or institution for which claims are submitted for your payment to furnish you any records pertaining to me while covered by this contract. I declare that all statements made on this application are complete and true.” A—112 (137) 2/70 SIGNATURE DATE.