Medicare Supplement (also called Medigap)

These are plans offered through private insurance companies. They help fill the gaps in Original Medicare (Parts A and B). These plans may pay for some or all of the costs of deductibles, copays, and coinsurance.

  • You pay two monthly premiums-one for your plan and one for your Medicare Part B coverage.
  • These are standardized plans approved by Medicare. Each insurance company chooses how many plans it will offer.
  • Depending on the plan you choose, you will have little to no out-of-pocket costs for Medicare-covered services.
  • There is no provider network, and you do not need referrals to see specialists. You can go anywhere Medicare is accepted.
  • Medicare Supplement plans do not include prescription drug coverage. You must purchase a Part D drug plan separately. 

 

  • How do I qualify for a Medicare Supplement plan?
    • You must have Medicare Parts A and B.
    • You must be an Alaska resident.
  • How do I use my plan?

    When you use providers who accept Medicare, you will not have to file your own claims. Just take your Red, White & Medicare Card and your Medicare Supplement plan ID card to your physician or hospital and you will pay the appropriate copay or coinsurance for your plan. There are no claim forms to fill out, claims are submitted by your physician or hospital directly to Medicare, and then automatically crossed over to your Medicare Supplement plan. You will receive Medicare Summary Notices from Medicare and from your Medicare Supplement plan.

  • Save $60 per year

    Sign up for automatic monthly withdrawals and save $60 a year. Call us at 1-800-752-6663 for more information.

    Click here to access an Automatic Payment Option (APO) form.


This application is not a guarantee that you will receive coverage. Upon approval of your application, you will receive an approval letter and a contract.You can become a Premera Blue Cross Blue Shield of Alaska (Premera) Medicare supplement member if you:
Reside in Alaska,
Currently have both Medicare Part A and Part B, and
Don't receive Medicaid assistance other than payment of your Medicare Part B premium.

You do not need more than one Medicare supplement plan. If you currently have a Medicare supplement plan or Medicare Advantage plan (including a Medicare HMO or PPO), you cannot be enrolled unless you intend to replace your current coverage. Please complete a replacement form. If you purchase this contract, you may want to evaluate your existing health coverage and decide if you need multiple coverages.

You may be eligible for benefits under Medicaid and may not need a Medicare supplement plan. Medicaid is a public aid program for people with low income. It is not the same as Medicare.

If, after purchasing this plan, you become entitled to Medicaid, the benefits and subscription charges under your Medicare Supplement contract can be suspended, if requested, during your entitlement to benefits under Medicaid for 24 months. You must request this suspension within 90 days of being eligible for Medicaid. If you are no longer entitled to Medicaid, your suspended Medicare supplement plan (or, if that is no longer available, a substantially equivalent plan) will be re-instituted if requested within 90 days of losing Medicaid eligibility.

Counseling services may be available in your state to provide advice concerning your purchase of Medicare supplement coverage and concerning medical assistance through the state Medicaid program, including benefits as a "Qualified Medicare Beneficiary" (QMB) or a "Specified Low-Income Medicare Beneficiary" (SLMB).

Except that you must provide information on diseases and disorders for which you have symptoms, please do not provide any information on any part of this application about genetic testing or genetic information, including any decision by an insurance company that is based on a genetic test or genetic information.

Plan A 021202 (06-2010); 021198 (06-2010); Plan N 021203 (06-01-2010); 021199 (06-01-2010); Plan F 021204 (06-2010); 021200 (06-2010); High Deductible Plan F 021205 (06-2010); 021201 (06-2010); Plan G 042196 (01-2018); 042195 (01-2018); High Deductible Plan G 049580 (01-2020); 049581 (01-2020).