Excellus BCBS Medicare Advantage Reviews

BlueCross BlueShield offers diverse Medicare Advantage plans, including HMO and PPO options, with benefits like vision, dental, and hearing coverage, aimed at enhancing healthcare quality and overall well-being for beneficiaries.
By . Last update: June 17, 2024

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Excellus BlueCross BlueShield Medicare Advantage Reviews
The Excellus BlueCross BlueShield logo is a registered trademark of Excellus Health Plan, Inc.

Excellus BlueCross BlueShield, commonly known as Excellus BCBS, offers Medicare Advantage plans designed to meet the diverse needs. Known for its strong presence in New York, Excellus BCBS provides comprehensive HMO and PPO plans. These plans often feature added benefits like vision, dental, and hearing coverage, alongside comprehensive wellness programs.

In this editorial review, we’ll explore some of Excellus’ best Medicare Advantage plans, examining what they cover, how much they cost, and what customers have to say about their experiences.

Table of Contents

Member Reviews for Excellus BlueCross BlueShield

The following Excellus BlueCross BlueShield reviews have been left by our members.

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  • High-Quality Health Plans: Excellus BCBS is known for providing high-quality health plans to its members.
  • Large Presence in New York: As one of the largest Medicare Advantage plan providers in New York, it offers extensive options and services.
  • Multiple Medicare Advantage Options: They offer a variety of Medicare Advantage plans, including HMOs and PPOs, to cater to different needs.
  • Blue365 Discounts: Members can access Blue365 discounts, providing savings on health and wellness products and services.


  • Limited Geography: Excellus BCBS plans are primarily available only in New York, limiting accessibility for those in other regions.
  • Lower Health Plan Ratings: While the plans are highly rated overall, the ratings for the health plan aspect are somewhat lower compared to competitors.
  • No Stand-Alone Prescription Drug Plans: Excellus BCBS does not offer stand-alone prescription drug plans or Medicare Advantage plans without prescription coverage. This might be a drawback for those needing different prescription coverage.
Compare Top Medicare Advantage Plans from Excellus BlueCross BlueShield
Excellus BlueCross BlueShield Medicare Advantage Reviews
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  • Additional benefits may include dental, vision, hearing, lifestyle and transportation
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How Do Excellus BlueCross BlueShield Medicare Advantage Plans Work?

Excellus BlueCross BlueShield Medicare Advantage plan members have all their hospital (Medicare Part A) and medical (Medicare Part B) benefits included in their plan. This includes everything from preventive care and vaccinations to visits with doctors and specialists, as well as hospital stays, skilled nursing services, and hospice care.

All Excellus BlueCross BlueShield Medicare Advantage plans include coverage for:

  • Inpatient hospital admissions.
  • Doctor and specialist care.
  • Preventive care, screenings, and vaccinations.
  • Diagnostic services, lab work, X-rays and other imaging.
  • Outpatient services.
  • Ambulance transportation for emergencies.
  • Durable medical supplies and equipment.

Medicare rules say that all Excellus BlueCross BlueShield plans must provide at least the same coverage and benefits as Original Medicare. But, each plan sets its own out-of-pocket costs.

Some Excellus BlueCross BlueShield plans offer additional benefits like routine dental, vision, hearing, and wellness programs, which are not usually covered by Original Medicare.

When you join a Excellus BlueCross BlueShield Medicare Advantage plan, you can manage all your healthcare needs under one plan. This often comes with lower out-of-pocket costs and extra benefits suited to your health and lifestyle.

However, it's important to note that lower costs aren't guaranteed. Costs depend on the specific plan and how much you use healthcare services. Also, the Excellus BlueCross BlueShield plan you choose may have access restrictions, such as needing referrals and prior authorization. Original Medicare does not have these restrictions.

Extra Benefits from Excellus BlueCross BlueShield

Excellus BCBS Medicare Advantage plans often include a range of additional benefits aimed at enhancing the overall healthcare experience for their members. Common benefits include:

  • Dental, Vision, and Hearing Coverage: Most plans offer allowances for routine dental, vision, and hearing services.
  • Fitness Programs: Many plans include access to fitness programs such as SilverSneakers, promoting physical activity and well-being.
  • Over-the-Counter (OTC) Allowances: Members can receive a quarterly or annual allowance for over-the-counter items, helping to cover the cost of everyday health products.
  • Meal Delivery Services: Certain plans may offer meal delivery services, particularly following a hospital stay, to support recovery and nutrition.
  • Wellness Programs: These programs focus on preventive care and healthy living, often including resources and support for managing chronic conditions.

What Types of Plans Does Excellus BlueCross BlueShield Offer?

Not all Excellus BlueCross BlueShield plans are the same. And, Excellus BlueCross BlueShield may not offer all plan types where you live, so it pays to explore using our Medicare Advantage Plan Finder tool. Here are the plan types Excellus BlueCross BlueShield offers:[6]

Medicare preferred provider organization (PPO) plans provide the most freedom, allowing you to see any provider that accepts the insurance. With a PPO plan, you generally do not need to choose a primary care doctor, and you don’t need referrals to see specialists. And you can seek out-of-network care, although it may cost more than seeing an in-network doctor.

HMO point-of-service plans are HMO plans that allow members to get some out-of-network services, but you’ll pay more for those services.

Health maintenance organization (HMO) plans require that you use a specific network of doctors and hospitals. Also, with a Excellus BlueCross BlueShield HMO plan you may need a referral from your primary care doctor in order to see a specialist. Out-of-network benefits are usually very limited. However, in an emergency you are not limited to care from your local hospital of emergency room.

NOTE: Excellus BlueCross BlueShield may also offer Medicare Advantage Special Needs Plans (SNPs). Due to the highly specialized nature of D-SNP (dual eligible), C-SNP (chronic condition), and I-SNP (institutional) insurance plans, we review them separately.

How Much Do Excellus BlueCross BlueShield Plans Cost?

Your costs in a Excellus BlueCross BlueShield plan will depend on the specific plan selected, your location, your usage of plan services, and the plan’s out-of-pocket costs. Detailed information about out-of-pocket costs for all Excellus BlueCross BlueShield Medicare Advantage Plans is available in our plan finder.

Generally, Excellus BlueCross BlueShield will charge you a monthly premium, which can vary based on the level of coverage and additional benefits included. You must also continue to pay your Part B premium. If you're a high-income earner, Medicare may add a Income Related Monthly Adjustment Amount (IRMAA) to your premium.[5]

Excellus BlueCross BlueShield’s monthly premiums are highly dependent on where you live. For instance, the average cost of a Medicare Advantage plan from Excellus BlueCross BlueShield in New York is $29.20 per month, but in New York the average cost is $29.20 per month. These averages do not include Special Needs Plans.

Excellus BlueCross BlueShield's Premiums vs. Competitors

The following list shows Excellus BlueCross BlueShield's nationwide average monthly premium (excluding Special Needs Plans) vs. several competitors.

Excellus BlueCross BlueShield

There also may be copayments or coinsurance for healthcare services, such as doctor visits or hospital stays. The costs in each Excellus BlueCross BlueShield plan we evaluated varied based on the level of coverage and the type of services received.

Some plans offer $0 premiums or minimal copayments for certain services, while others might have higher premiums with lower out-of-pocket expenses. Carefully reviewing the cost and coverage details of each plan is the only way to find the one that aligns best with your needs.[7]

We analyzed the following popular Excellus BlueCross BlueShield plans to give you an idea of what members pay to use healthcare services. This is just a sample, use our Medicare Advantage Plan Finder to see plans and costs where you live.

Important costs for plan ID H3335-015-0 reviewed in Madison County, NY.
  • Monthly premium: $86
  • Out-of-pocket max: $5,000
  • Primary Care: $$0
  • Specialist: $$0
  • Tier 1 Prescriptions: $5.00 copay, $0 deductible
  • Urgent Care: $$0
  • Emergency Room: $$0
  • Ground Ambulance: $$0
  • Inpatient Care:
  • Extra Benefits: None
Important costs for plan ID H3335-055-0 reviewed in Madison County, NY.
  • Monthly premium: $0
  • Out-of-pocket max: $7,900
  • Primary Care: $$0
  • Specialist: $$0
  • Tier 1 Prescriptions: $5.00 copay, $350 deductible
  • Urgent Care: $$0
  • Emergency Room: $$0
  • Ground Ambulance: $$0
  • Inpatient Care:
  • Extra Benefits: None
Important costs for plan ID H3335-058-0 reviewed in Madison County, NY.
  • Monthly premium: $14
  • Out-of-pocket max: $7,900
  • Primary Care: $$0
  • Specialist: $$0
  • Tier 1 Prescriptions: $5.00 copay, $275 deductible
  • Urgent Care: $$0
  • Emergency Room: $$0
  • Ground Ambulance: $$0
  • Inpatient Care:
  • Extra Benefits: None

Is Excellus BlueCross BlueShield a Good Medicare Advantage Plan?

Excellus BCBS provides a range of Medicare Advantage plans tailored to meet diverse healthcare needs. The quality of these plans can be assessed through various consumer intelligence and review websites. We reference several below to provide a comprehensive view of Excellus BCBS’s performance.

J.D. Power Ranking

J.D. Power is a well-respected organization known for its comprehensive consumer satisfaction surveys across various industries, including healthcare. Their U.S. Medicare Advantage Study evaluates member satisfaction with Medicare Advantage plans based on eight factors, such as level of trust, customer service, and complaint resolution.

Excellus BCBS was ranked #1 in New York, indicating that it excels in meeting the needs and expectations of its members in this region. A high ranking from J.D. Power is relevant as it signifies that a plan is well-regarded by its members, which can be a crucial factor for prospective enrollees when choosing a Medicare Advantage plan.

Other top-ranked plans in the J.D. Power report include HealthFirst, Humana, and EmblemHealth.

NCQA Health Plan Score

In the 2023 ratings, Excellus BCBS received ratings between 3.0 and 4.0 stars from the National Committee for Quality Assurance (NCQA). Approximately 15% of plans received 4.0 stars, while the rest scored 3.5 stars or lower, placing Excellus BCBS in a competitive position within the market.

NCQA is a prominent organization that focuses on improving healthcare quality through the administration of evidence-based standards, measures, and programs. Each year, NCQA rates health plans using a 5-point scale based on several critical factors, including the quality of care, patient satisfaction, and the health plans' efforts to maintain and improve these standards.

NCQA scores are relevant because they provide an objective measure of a plan's performance in delivering high-quality healthcare services. These scores help consumers identify plans that have demonstrated a commitment to high standards of care and continuous improvement, making it easier for them to choose plans that are more likely to meet their healthcare needs effectively.

Better Business Bureau (BBB) Rating

The Better Business Bureau (BBB) provides ratings based on various factors, including customer complaints and the company’s response to them. Excellus BCBS holds an A- rating from the BBB, reflecting strong customer service and reliability in handling member concerns.

Excellus BlueCross BlueShield's Medicare Star Ratings

Excellus BlueCross BlueShield's average 5-star rating: 4.26*
*Our calculation is weighted by enrollments in public plans, excluding Special Needs Plans, with CMS star ratings across 2 contracts covering 169,011 members.

To understand the government's perspective on the quality of Excellus BlueCross BlueShield's Medicare Advantage plans, you can refer to the Centers for Medicare and Medicaid Services' star ratings. These ratings grade each plan on a scale from 1 (worst) to 5 (best) stars, based on quality of care and customer satisfaction. The ratings are updated annually.[9]

All Medicare Advantage plans are assessed using CMS's health plan criteria. Plans that come with prescription drug coverage are evaluated on additional drug plan metrics. Based on the latest year of data and adjusted for enrollment numbers, Excellus BlueCross BlueShield’s 2024 Medicare Advantage plans have an average rating of 4.26 stars.[9] [11]

Of all Excellus BlueCross BlueShield members who are in contracts with a Medicare star rating, 100% are in contracts rated 4 stars or above as of January 1, 2024.

You can find all plan ratings in your area using our Medicare Advantage Plan finder tool.


Excellus BlueCross BlueShield's Top Plans

Here's a list of Excellus BlueCross BlueShield's most popular plans (by enrollments):[9][10]

Medicare Advantage Search and compare Medicare Advantage plans available in your area.

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Frequently Asked Questions

The following are the most frequently asked questions we found about Excellus BlueCross BlueShield's Medicare Advantage plans:

MA Plan Pros

  1. The maximum out-of-pocket cost is $7,550 a year
  2. Many plans cost $0 extra a month
  3. Most plans include drug coverage
  4. Many include basic hearing, dental, and vision benefits
  5. May include gym discounts (Silver Sneakers)

MA Plan Cons
  1. Can only switch during Open Enrollment
  2. Not easy to compare because plans are not standardized
  3. No nationwide coverage (plans don't travel with you)
  4. Most are HMO plans that require referrals to see a specialist
  5. Plans can change health and drug coverage each year

Learn more in this article.

Some Medicare Advantage plans offer a zero-dollar monthly premium because what Medicare pays the plan, plus your Medicare Part B premium, cover the full cost. For healthy people who want to keep their monthly costs low, these plans are an attractive option. But, just be aware that the premium is not the only cost. Plans also have copays or coinsurance you must pay when you use services. To learn more about free Medicare Advantage plans, read Why are Some Medicare Advantage Plans Free?

There is no debate when it comes to which plan offers better coverage. Original Medicare and a supplement plan offer the best coverage, but it costs more up-front. For a complete breakdown of the differences between Medicare Advantage plans and Medigap plans, read: Medicare Advantage vs Medigap: Which is Best for You?

Researching your health plan options is important. Here are some key questions to consider before choosing a Medicare Advantage plan as well as additional companies to read about:

Key Questions

All plans potentially have monthly premiums, deductibles, copayments, and/or coinsurance, including plans from Excellus BlueCross BlueShield. Are these costs within your budget?

  • Does the plan cover your prescriptions? Knowing how a plan covers them is important if you have regular prescriptions because costs and coverage vary widely from plan to plan.
  • Are your doctors in the plan’s network? If you have preferred providers, ensure they participate in the plan’s network.
  • Is routine dental, vision, and hearing covered? Traditional Medicare doesn’t cover these services. If you need it, be sure to explore plans that cover it.
  • What extras does the plan include? Plans may include many beneficial extras, like gym memberships (SilverSneakers), medical transportation, meal delivery, telehealth, and more.

If you have additional questions, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).

About Excellus BlueCross BlueShield

Excellus BlueCross BlueShield (Excellus Health Plan, Inc.) is a nonprofit health insurance company headquartered in Rochester, New York. Serving the residents of upstate New York for over 80 years, Excellus BCBS offers a range of healthcare plans, including Medicare Advantage, individual, and family plans. Their Medicare Advantage plans are known for comprehensive coverage options that include vision, dental, and hearing benefits, along with wellness programs aimed at improving overall health and well-being.

In recent news, Excellus was ranked #1 in New York in the 2023 J.D. Power U.S. Medicare Advantage Study, reflecting high member satisfaction. This recognition underscores their commitment to quality care and excellent customer service. Excellus BCBS continues to focus on expanding its services and enhancing the value offered to its members through innovative healthcare solutions and member-centric services.

You can enroll in an Excellus BlueCross BlueShield Medicare Advantage plan during your Initial Enrollment Period (IEP) when you turn 65, during the annual Open Enrollment Period (October 15 - December 7), or during a Special Enrollment Period (SEP) granted by Medicare based on specific circumstances, such as moving or losing employer coverage.


MedicareWire uses trustworthy sources to inform its work, including government websites, government data, actuarial service data, consumer intelligence websites, and peer-reviewed studies. All content is fact-checked for accuracy, timeliness, and relevance. We used the following information sources in this review: