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Blue Cross Blue Shield of Massachusetts Announces Decreased Rates for Medex Products

CONTACT: Katie Fryman
(617) 246-4827

HMO and PPO Health Plans also available for Medicare Beneficiaries

BOSTON — October 6, 2008 — Blue Cross Blue Shield of Massachusetts (BCBSMA) today announced the company has received approval from the Centers for Medicare and Medicaid Services (CMS) for its 2009 Medicare Advantage products. In addition, the Massachusetts Division of Insurance has approved BCBSMA's 2009 rates for direct-pay Medex® health plans.

BCBSMA also sought and received approval to make direct-pay Medex rates effective from January 1 - December 31, 2009. The move will allow BCBSMA to align the Medex rate effective date with the rate effective dates for other Medicare Advantage and Medicare Part D plans, making it easier for seniors to evaluate all of their health insurance choices. In addition, the company announced that there are no rate increases for the Medex products in 2009. The senior product with the highest enrollment, Medex Bronze, received a rate decrease.

"We are pleased that seniors will not experience a rate increase in 2009," said Ken Arruda, Senior Director of Senior Products. "BCBSMA's Medex health plans provide Massachusetts' Medicare recipients with flexible options for the highest quality care.:

BCBSMA is committed to offering seniors a variety of health plan options, at a range of costs, to help ensure that seniors have access to a health plan that suits their individual needs. The 2009 rate changes are as follows:


Quarterly Billed Rate

Quarterly Billing Rate

2009 Quarterly % Decrease

Billed Rate

Monthly Billing Rate

2009 Monthly % Decrease















The company's Medicare Advantage products are offered in consumer markets with Part D drug benefits, and to employer and union sponsors with or without Part D drug benefits. The competitively priced plan offers in-network and out-of-network services without a referral. Medicare Advantage plan benefits, premiums, and service areas are subject to change annually on January 1. Important changes to Medicare Advantage products are as follows:

Medicare HMO Blue
Medicare HMO Blue is a Medicare Advantage managed care plan. As with our other managed care plans, members must use network providers except in case of emergency or urgent care situations outside of the service area. Members must live in the Medicare HMO area, which is all of Massachusetts, except Nantucket, Dukes or Hampshire counties. Premiums for the new plans with drug coverage range from $119-$173.

Medicare PPO Blue
Medicare PPO Blue includes comprehensive benefits similar to Medicare HMO Blue. Medicare PPO Blue also provides members with the added flexibility of not needing to obtain referrals for specialty care, as well as coverage for services rendered by providers who are not in the plan's network. However, members who see an out-of-network provider generally have to pay more out-of-pocket costs than if they see an in-network physician, except for emergency services. BCBSMA offers two Medicare PPO Blue plans with drug coverage. Premiums for the new plans with drug coverage will range from $126 to $180.


Blue Cross Blue Shield of Massachusetts ( ) was founded more than 70 years ago by a group of community-minded business leaders. Today, headquartered in Boston, BCBSMA provides coverage to more than 3 million members, 2.5 million in Massachusetts. BCBSMA believes in rewarding doctors and hospitals for delivering safe and effective care, and in empowering patients to take more responsibility, become educated health care consumers and become stronger partners with their doctors. Blue Cross Blue Shield of Massachusetts is an independent licensee of the Blue Cross Blue Shield Association.


Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association.
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