2026 Excellus BlueCross BlueShield Medicare Advantage & Prescription Drug Plans
Medicare Blue Choice Core (HMO)
Medicare Blue Choice Prime (HMO)
Medicare Blue Choice Optimum (HMO-POS)
$0
$55
$215
No Deductible
No Deductible
No Deductible
$615 Deductible (Tiers 2-5)
$615 Deductible (Tiers 2-5)
$100 Deductible (Tiers 3-5)
$0
$0
$0
Urgent/Emergency Only
Urgent/Emergency Only
$3,000 OON (Calendar year). Applies to medical not Part D. Once benefit maximum is met, member is liable.
$10
$5
$0
$55
$40
$30
Preventive Dental Only, Optional Supplemental Buy-up
Preventive Dental Only, Optional Supplemental Buy-up
$500 annual allowance INN & OON, will pay up to dental fee schedule, Optional Supplemental Buy-up
$125
$150
$200
$5 - 25%
$5 - 25%
$0 - 37%
$475/Day for days 1-5
$0/Day after the fifth day.
$400/Day for days 1-5
$0/Day after the fifth day
$285/Day for days 1-5
$0/Day after the fifth day
Outpatient Surgeries
$40
$40
$40
$115
$115
$115
$9,250 INN (calendar year). Applies to medical not Part D. After the maximum is met, all claims covered in full.
$8,000 INN (calendar year). Applies to medical not Part D. After the maximum is met, all claims covered in full.
$6,700 INN (calendar year). Applies to medical not Part D. After the maximum is met, all claims covered in full.
Out-Of-Pocket Protection
No Coverage
No Coverage
14 meals, 7-day period. After discharge from an acute inpatient or SNF Stay. No annual limit.
portation Benefit
No Coverage
No Coverage
12 one way trips to health related location within 50 mile limit
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Enroll by December 31 to avoid a lapse in coverage.
Call to Enroll
1-866-906-5125 (TTY 711)
October 1 through March 31
8:00 a.m. to 8:00 p.m., 7 days a week
Call to enroll 1-866-906-5125 (TTY 711)
Enroll by December 31 to avoid a lapse in coverage.
For residents in Livingston, Monroe, Ontario, Seneca, Wayne & Yates Counties, NY
Choose your Excellus BlueCross BlueShield
plan with clarity and confidence.
Click on a plan below to view additional details.
$0 Medicare Blue Choice®
Core (HMO)
May be a good fit for those who:
- Were enrolled in our Medicare Blue Choice® Extra (HMO) or Medicare Blue Choice® Select (HMO) for 2025
- Schedule their care locally
- Value a low monthly payment and fixed cost shares
- Have limited medical needs and utilization
View more information
$55 Medicare Blue Choice®
Prime (HMO)
May be a good fit for those who:
- Were enrolled in our Medicare Blue Choice® Discovery (PPO), Medicare Blue Choice® Advanced (HMO-POS), or Medicare Blue Choice® Value Plus (HMO-POS) for 2025
- Qualify for a Low-Income Subsidy (LIS) or Extra Help
- Are looking to strike a balance between coverage and cost
View more information
$224.80 Medicare Blue Choice®
Optimum (HMO-POS)
May be a good fit for those who:
- Require in-person care from providers outside of our network
- Are looking to maximize their benefits and get our top-tier coverage
- Are managing a complex health condition and could benefit from a coordinated approach to their health care
- Utilize multiple higher tier prescription drugs
View more information
3 simple steps to finding your new plan for 2026
What are your needs and options for the upcoming year?
- Compare your options side-by-side below
- Consider how it may differ from your current coverage
- Understand what out-of-pocket costs you can expect in 2026
- Download our pre-enrollment checklist to make sure you have all of the information you need to make your decision and enroll
Using your preferred method, enroll in the best plan for you!
- Download our step-by-step enrollment tool User Guide, then enroll yourself online
- If you work with a broker, contact them for helpful enrollment guidance
- Give us a call, and we'll get you enrolled over the phone: 1-866-906-5125 (TTY 711)
- Visit a Resource Center
2026 ExcellusBlueCross BlueShield Medicare Advantage & Prescription Drug Plans
OPTION A
Medicare Blue Choice Core (HMO) 2026
OPTION B
Medicare Blue Choice Prime (HMO) 2026
OPTION C
Medicare Blue Choice Optimum (HMO-POS) 2026
$0
$50
$215
No Deductible
No Deductible
No Deductible
$615 Deductible (Tiers 2-5)
$615 Deductible (Tiers 2-5)
$100 Deductible (Tiers 3-5)
$0
$0
$0
Urgent/Emergency Only
Urgent/Emergency Only
$3,000 OON (Calendar year). Applies to medical not Part D. Once benefit maximum is met, member is liable.
$10
$5
$0
$55
$40
$30
Preventative Dental Only, Optional Supplemental Buy-up
Preventive Dental Only, Optional Supplemental Buy-up
$500 annual allowance INN & OON, will pay up to dental fee schedule, Optional Supplemental Buy-up
$125
$150
$200
$5 - 25%
$5 - 25%
$0 - 37%
$0
$
$
$40
$40
$40
$115
$115
$115
$9,250 INN (calendar year). Applies to medical not Part D. After the maximum is met, all claims covered in full.
$8,000 INN (calendar year). Applies to medical not Part D. After the maximum is met, all claims covered in full.
$6,700 INN (calendar year). Applies to medical not Part D. After the maximum is met, all claims covered in full.
$
$
$
No Coverage
No Coverage
12 one way trips to health related location within 50 mile limit
50%/50%
80%/80%
Basic Restorative (Enhanced)
0%/0%
80%/80%
0%/0%
60%/60%
0%/0%
50%/50%/$1000 MAX
$500
$1,000
Annual Cost
OPTION A
OPTION B
$276.24
$642.12
$455.04
$1,057.92
$438.36
$1,019.76
$616.92
$1,435.56
Plan coverage 9/01/23 through 8/31/2024. Fall enrollment 9/1/23-10/15/23. Spring enrollment 1/1/24-2/15/24. .
Whichever plan you choose, you'll enjoy:
$0 preventive dental
$0 routine hearing exams
$0 fitness benefit from Silver&Fit®
$0 preventive vaccines
$0 preventive care services
Whichever plan you choose, you'll enjoy:
$0 preventive dental
$0 routine hearing
$0 fitness benefit from Silver&Fit®
$0 preventive vaccines
$0 preventive care services
2026 Excellus BlueCross BlueShield Medicare Advantage & Prescription Drug Plans
Medicare Blue Choice®
Core (HMO)
Medicare Blue Choice®
Prime (HMO)
Medicare Blue Choice® Optimum (HMO-POS)
$0
$55
$224.80
No deductible
No deductible
No deductible
$615 deductible (Tiers 2-5)
$615 deductible (Tiers 2-5)
$100 deductible (Tiers 3-5)
$0
$0
$0
Urgent/emergency only
Urgent/emergency only
$3,000 OON (calendar year). Applies to medical not Part D. Once benefit maximum is met, member is liable.
$10
$5
$0
$55
$40
$30
Preventive dental only, optional supplemental buy-up
Preventive dental only, optional supplemental buy-up
$500 annual allowance IN & OON, will pay up to dental fee schedule, optional supplemental buy-up
$200
$215
$200
Preferred pharmacy
(30-day supply)
Tier 1: $5
Tier 2: $15
Tier 3: 21%
Tier 4: 25%
Tier 5: 25%
Tier 1: $4
Tier 2: $15
Tier 3: 21%
Tier 4: 25%
Tier 5: 25%
Tier 1: $0
Tier 2: $5
Tier 3: 20%
Tier 4: 37%
Tier 5: 31%
Standard pharmacy
(30-day supply)
Tier 1: $10
Tier 2: $20
Tier 3: 25%
Tier 4: 50%
Tier 5: 25%
Tier 1: $9
Tier 2: $20
Tier 3: 25%
Tier 4: 50%
Tier 5: 25%
Tier 1: $5
Tier 2: $10
Tier 3: 20%
Tier 4: 50%
Tier 5: 31%
$475/day for days 1-5
$0/day after the fifth day.
$400/day for days 1-5
$0/day after the fifth day
$285/day for days 1-5
$0/day after the fifth day
$450
$350
$250
$40
$40
$40
$115
$115
$115
$9,250 IN (calendar year). Applies to medical not Part D. After the maximum is met, all claims covered in full.
$8,000 IN (calendar year). Applies to medical not Part D. After the maximum is met, all claims covered in full.
$6,700 IN (calendar year). Applies to medical not Part D. After the maximum is met, all claims covered in full.
No coverage
No coverage
14 meals, 7-day period. After discharge from an acute inpatient or skilled nursing facility stay. No annual limit.
No coverage
No Coverage
12 one-way trips to health related location within 50-mile limit
IN = in-network; OON = out-of-network
2026 Excellus BlueCross BlueShield Medicare Advantage & Prescription Drug Plans
Medicare Blue Choice®
Core (HMO)
Medicare Blue Choice®
Prime (HMO)
Medicare Blue Choice® Optimum (HMO-POS)
$0
$55
$224.80
No deductible
No deductible
No deductible
$615 deductible (Tiers 2-5)
$615 deductible (Tiers 2-5)
$100 deductible (Tiers 3-5)
$0
$0
$0
Urgent/emergency only
Urgent/emergency only
$3,000 OON (calendar year). Applies to medical not Part D. Once benefit maximum is met, member is liable.
$10
$5
$0
$55
$40
$30
Preventive dental only, optional supplemental buy-up
Preventive dental only, optional supplemental buy-up
$500 annual allowance IN and OON, will pay up to dental fee schedule, optional supplemental buy-up
$200
$215
$200
Preferred pharmacy
(30-day supply)
Tier 1: $5
Tier 2: $15
Tier 3: 21%
Tier 4: 25%
Tier 5: 25%
Tier 1: $4
Tier 2: $15
Tier 3: 21%
Tier 4: 25%
Tier 5: 25%
Tier 1: $0
Tier 2: $5
Tier 3: 20%
Tier 4: 37%
Tier 5: 31%
Standard pharmacy
(30-day supply)
Tier 1: $10
Tier 2: $20
Tier 3: 25%
Tier 4: 50%
Tier 5: 25%
Tier 1: $9
Tier 2: $20
Tier 3: 25%
Tier 4: 50%
Tier 5: 25%
Tier 1: $5
Tier 2: $10
Tier 3: 20%
Tier 4: 50%
Tier 5: 31%
$475/day for days 1-5
$0/day after the fifth day
$400/day for days 1-5
$0/day after the fifth day
$285/day for days 1-5
$0/day after the fifth day
$450
$350
$250
$40
$40
$40
$115
$115
$115
$9,250 IN (calendar year). Applies to medical not Part D. After the maximum is met, all claims covered in full.
$8,000 IN (calendar year). Applies to medical not Part D. After the maximum is met, all claims covered in full.
$6,700 IN (calendar year). Applies to medical not Part D. After the maximum is met, all claims covered in full.
No coverage
No coverage
14 meals, 7-day period. After discharge from an acute inpatient or skilled nursing facility stay. No annual limit.
No coverage
No coverage
12 one-way trips to health related location within 50-mile limit
IN = in-network; OON = out-of-network
2026 Excellus BlueCross BlueShield Medicare Advantage & Prescription Drug Plans
Medicare
Blue Choice®
Core (HMO)
Medicare
Blue Choice®
Prime (HMO)
Medicare Blue Choice® Optimum (HMO-POS)
$0
$55
$224.80
No deductible
No deductible
No deductible
$615 deductible (Tiers 2-5)
$615 deductible (Tiers 2-5)
$100 deductible (Tiers 3-5)
$0
$0
$0
Urgent/emergency only
Urgent/emergency only
$3,000 OON (calendar year). Applies to medical not Part D. Once benefit maximum is met, member is liable.
$10
$5
$0
$55
$40
$30
Preventive dental only, optional supplemental buy-up
Preventive dental only, optional supplemental buy-up
$500 annual allowance IN and OON, will pay up to dental fee schedule, optional supplemental buy-up
$200
$215
$200
Preferred pharmacy
(30-day supply)
Tier 1: $5
Tier 2: $15
Tier 3: 21%
Tier 4: 25%
Tier 5: 25%
Tier 1: $4
Tier 2: $15
Tier 3: 21%
Tier 4: 25%
Tier 5: 25%
Tier 1: $0
Tier 2: $5
Tier 3: 20%
Tier 4: 37%
Tier 5: 31%
Standard pharmacy
(30-day supply)
Tier 1: $10
Tier 2: $20
Tier 3: 25%
Tier 4: 50%
Tier 5: 25%
Tier 1: $9
Tier 2: $20
Tier 3: 25%
Tier 4: 50%
Tier 5: 25%
Tier 1: $5
Tier 2: $10
Tier 3: 20%
Tier 4: 50%
Tier 5: 31%
$475/day for days 1-5
$0/day after the fifth day.
$400/day for days 1-5
$0/day after the fifth day
$285/day for days 1-5
$0/day after the fifth day
$450
$350
$250
$40
$40
$40
$115
$115
$115
$9,250 IN (calendar year). Applies to medical not Part D. After the maximum is met, all claims covered in full.
$8,000 IN (calendar year). Applies to medical not Part D. After the maximum is met, all claims covered in full.
$6,700 IN (calendar year). Applies to medical not Part D. After the maximum is met, all claims covered in full.
No coverage
No coverage
14 meals, 7-day period. After discharge from an acute inpatient or skilled nursing facility stay. No annual limit.
portation benefit
No coverage
No coverage
12 one-way trips to health related location within 50-mile limit
IN = in-network; OON = out-of-network
2026 Excellus BlueCross BlueShield Medicare Advantage & Prescription Drug Plans
Medicare Blue Choice® Core (HMO)
Medicare Blue Choice® Prime (HMO)
Medicare Blue Choice® Optimum (HMO-POS)
$0
$55
$224.80
No deductible
No Deductible
No Deductible
$615 deductible (Tiers 2-5)
$615 deductible (Tiers 2-5)
$100 Deductible (Tiers 3-5)
$0
$0
$0
Urgent/emergency only
Urgent/emergency only
$3,000 OON (calendar year). Applies to medical not Part D. Once benefit maximum is met, member is liable.
$10
$5
$0
$55
$40
$30
Preventive dental only, optional supplemental buy-up
Preventive dental only, optional supplemental buy-up
$500 annual allowance IN & OON, will pay up to dental fee schedule, optional supplemental buy-up
$200
$215
$200
Preferred pharmacy
(30-day supply)
Tier 1: $5
Tier 2: $15
Tier 3: 21%
Tier 4: 25%
Tier 5: 25%
Tier 1: $4
Tier 2: $15
Tier 3: 21%
Tier 4: 25%
Tier 5: 25%
Tier 1: $0
Tier 2: $5
Tier 3: 20%
Tier 4: 37%
Tier 5: 31%
Standard pharmacy
(30-day supply)
Tier 1: $10
Tier 2: $20
Tier 3: 25%
Tier 4: 50%
Tier 5: 25%
Tier 1: $9
Tier 2: $20
Tier 3: 25%
Tier 4: 50%
Tier 5: 25%
Tier 1: $5
Tier 2: $10
Tier 3: 20%
Tier 4: 50%
Tier 5: 31%
$475/day for days 1-5
$0/day after the fifth day.
$400/day for days 1-5
$0/day after the fifth day
$285/day for days 1-5
$0/day after the fifth day
$450
$350
$250
$40
$40
$40
$115
$115
$115
$9,250 IN (calendar year). Applies to medical not Part D. After the maximum is met, all claims covered in full.
$8,000 IN (calendar year). Applies to medical not Part D. After the maximum is met, all claims covered in full.
$6,700 IN (calendar year). Applies to medical not Part D. After the maximum is met, all claims covered in full.
No coverage
No coverage
14 meals, 7-day period. After discharge from an acute inpatient or skilled nursing facility stay. No annual limit.
No coverage
No coverage
12 one-way trips to health related location within 50-mile limit
IN = in-network; OON = out-of-network
2026 Excellus BlueCross BlueShield Medicare Advantage & Prescription Drug Plans
Medicare Blue Choice® Core (HMO)
Medicare Blue Choice® Prime (HMO)
Medicare Blue Choice® Optimum (HMO-POS)
$0
$55
$224.80
ductible
No de-
ductible
No deductible
No deductible
scription de-
ductible
$615 de-
ductible (Tiers 2-5)
$615 deductible (Tiers 2-5)
$100 Deductible (Tiers 3-5)
$0
$0
$0
Urgent/
emer-
gency only
Urgent/
emergency only
$3,000 OON (calendar year). Applies to medical not Part D. Once benefit maximum is met, member is liable.
$10
$5
$0
$55
$40
$30
Pre-
ventive dental only, optional sup-
plemental buy-up
Preventive dental only, optional sup-
plemental buy-up
$500 annual allowance IN & OON, will pay up to dental fee schedule, optional supplemental buy-up
$200
$215
$200
scription drugs
Preferred pharmacy
(30-day supply)
Tier 1: $5
Tier 2: $15
Tier 3: 21%
Tier 4: 25%
Tier 5: 25%
Tier 1: $4
Tier 2: $15
Tier 3: 21%
Tier 4: 25%
Tier 5: 25%
Tier 1: $0
Tier 2: $5
Tier 3: 20%
Tier 4: 37%
Tier 5: 31%
scription drugs
Standard pharmacy
(30-day supply)
Tier 1: $10
Tier 2: $20
Tier 3: 25%
Tier 4: 50%
Tier 5: 25%
Tier 1: $9
Tier 2: $20
Tier 3: 25%
Tier 4: 50%
Tier 5: 25%
Tier 1: $5
Tier 2: $10
Tier 3: 20%
Tier 4: 50%
Tier 5: 31%
$475/day for days 1-5
$0/day after the fifth day.
$400/day for days 1-5
$0/day after the fifth day
$285/Day for days 1-5
$0/Day after the fifth day
patient surgeries
$450
$350
$250
wide urgent care
$40
$40
$40
wide emer-
gency care
$115
$115
$115
$9,250 IN (calendar year). applies to medical not part D. After the maximum is met, all claims covered in full.
$8,000 IN (calendar year). Applies to medical not Part D. After the maximum is met, all claims covered in full.
$6,700 IN (calendar year). Applies to medical not Part D. After the maximum is met, all claims covered in full.
No coverage
No coverage
14 meals, 7-day period. After discharge from an acute inpatient or skilled nursing facility stay. No annual limit.
portation benefit
No coverage
No coverage
12 one-way trips to health related location within 50-mile limit
IN = in-network; OON = out-of-network
Additional resources
Find more tools and materials to help inform your choice of an Excellus BlueCross BlueShield Medicare Advantage plan for 2026.
Discover More
View our quick video to understand the different enrollment methods you can choose from.
View Video
Learn about Part D prescription drug benefits and costs, and how they may differ next year.
Learn More
Sign Up
Discover more
View our quick video to understand the different enrollment methods you can choose from.
View video
Learn about Part D prescription drug benefits and costs, and how they may differ next year.
Learn more
Sign up
Discover more
View our quick video to understand the different enrollment methods you can choose from.
View video
Learn about Part D prescription drug benefits and costs, and how they may differ next year.
Learn more
Sign up
Discover More
View our quick video to understand the different enrollment methods you can choose from.
View Video
Learn about Part D prescription drug benefits and costs, and how they may differ next year.
Learn More
Sign Up
1-866-906-5125 (TTY 711), open 7 days a week from 8 a.m. to 8 p.m.*
To chat with a licensed agent, click the blue chat box on the screen.
Chat is available Mon. - Thurs. from 8 a.m. – 8 p.m., and Fri. 9 a.m. - 8 p.m.
KEEP ME INFORMED
*From now until March 31. From April 1 to September 30, representatives are available Monday - Friday from 8 a.m. to 8 p.m.
Copyright © 2025 Excellus BlueCross BlueShield, a nonprofit independent licensee of the Blue Cross Blue Shield Association. All rights reserved.
Terms of Use | Web Privacy Policy | Accessibility Statement | Notice of Privacy Practices
Excellus BCBS is an HMO plan with a Medicare contract. Enrollment in Excellus BCBS depends on contract renewal. Cost shares listed for various benefits are applicable to providers within our network unless otherwise noted. Out-of-network/non-contracted providers are under no obligation to treat Excellus BCBS members, except in emergency situations. Please call our Customer Care number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. Please check the Summary of Benefits for full plan details. SafeRide® is an independent company, offering transportation services in the Excellus BCBS service area. Mom’s Meals® is an independent company providing home delivered meals and nutritional services to Excellus BCBS members. TruHearing® is an independent company that offers hearing products and services to Excellus BCBS members. Preventive dental services are 2 cleanings, 2 oral exams and 1 set of up to 4 bitewing X-rays or 1 full mouth X-ray per year. The Silver&Fit program is provided by American Specialty Health Fitness, Inc. (ASH Fitness), a subsidiary of American Specialty Health Incorporated (ASH). Please talk with your doctor before starting or changing your exercise routine. All programs and services are not available in all areas. Fitness center participation may vary by location and is subject to change. For accommodations of persons with special needs at meetings call 1-866-906-5125 (TTY 711).
Submit a complaint about your Medicare plan at www.Medicare.gov or learn about filing a complaint by contacting the Medicare Ombudsman.
Date Last Updated 10/01/2025
