Blue Shield Retiree PPO Medicare Supplement Plan
Blue Shield Retiree PPO plan offers Medicare-eligible retirees and LTD Terms a Medicare supplement plan that pays for services after you receive payment from Medicare.
Plan Details
View 2026 Blue Shield Retiree PPO + Blue Shield Medicare Rx Plan plan details
View 2025 Blue Shield Retiree PPO plan details
Plan Documents
A Summary Plan Description (SPD) or Evidence of Coverage (EOC) is the official, detailed plan document for each plan outlining information about eligibility, costs and cost-sharing, included and excluded services, claims process, procedures for filing grievances, complaints, and appeals. Medicare health plans are not required to produce SBC plan overviews, but some of Stanford's plans have provided a short-form version of their plan highlights as summaries.
2026 Plan Documents
- 2026 Blue Shield Retiree PPO Summary of Benefits (medical)
- 2026 Blue Shield Retiree PPO Summary of Benefits (group prescription drug plan)
2025 Plan Documents
- 2025 Blue Shield Retiree PPO Summary of Benefits (brochure)
- 2025 Blue Shield Retiree PPO Evidence of Coverage/Summary Plan Description (long document)
Forms & Resources
- Medicare Supplement FAQ
- Blue Shield website for Stanford participants
- Blue Shield Amazon mail order prescription sign-up flyer*
- Fitness Your Way gym membership flyer
- Blue Shield OON_OOC claim form
*Note: If you are currently utilizing Amazon Pharmacy Home Delivery, you will need to update your Rx ID number, BIN, and PCN in Amazon’s Pharmacy Portal. If you have not received your new Blue Shield member ID Card by January 1, please call Blue Shield's customer service.