Blue Medicare HMO, Blue Medicare PPO, and Blue Medicare Rx Members
My Benefits
Benefits Overview
- Visiting the doctor
Your primary care physician (PCP) will coordinate your health care. You're not required to see your PCP before visiting a specialist, but it's strongly recommended so that your PCP is fully aware of the medical care you're receiving. Learn more about choosing a PCP and how to access your health care. - For Blue Medicare HMO, you must use plan providers, except in emergency/urgent care situations, or for out-of-area renal dialysis. If you obtain routine care from out-of-network providers, neither Medicare nor Blue Medicare HMO are responsible for the costs.
- Member liability with Blue Medicare PPO may be greater for services received out of network than services received in network. Many out-of-network services are subject to coinsurance, which is based on the Medicare allowed amount and not on the potentially lower contract amount. With the exception of emergency or urgent care, it may cost more to get care from non-plan or non-preferred providers.
- Using Medicare prescription drug coverage
If your plan includes Medicare prescription drug coverage, learn how easy it is to fill your prescriptions at a local pharmacy or through mail order.
Summary of Benefits for Blue Medicare HMO plans
Summary of Benefits for Blue Medicare PPO plans
Summary of Benefits for Blue Medicare RX
Available in select counties
Blue Medicare HMO and PPO are available in the following counties:
| Alamance | Caldwell | Duplin | Halifax | Lincoln | Person | Stokes |
| Alexander | Carteret | Durham | Harnett | Martin | Pitt | Surry |
| Alleghany | Caswell | Edgecombe | Haywood | Mecklenburg | Polk | Tyrrell |
| Ashe | Catawba | Forsyth | Henderson | Nash | Randolph | Wake |
| Avery | Chatham | Franklin | Hertford | New Hanover | Richmond | Warren |
| Beaufort | Chowan | Gaston | Hoke | Northampton | Robeson | Washington |
| Bertie | Columbus | Gates | Hyde | Onslow | Rockingham | Watauga |
| Bladen | Cumberland | Granville | Iredell | Orange | Rowan | Wayne |
| Brunswick | Davidson | Greene | Johnston | Pender | Sampson | Wilkes |
| Cabarrus | Davie | Guilford | Lee | Perquimans | Stanly | Yadkin |
Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1, 2011. Please contact Blue Medicare HMO, Blue Medicare PPO or Blue Medicare Rx (PDP) for details.
Blue Medicare HMO and Blue Medicare PPO plans are offered by PARTNERS National Health Plans of North Carolina, Inc. (PARTNERS), a subsidiary of Blue Cross and Blue Shield of North Carolina (BCBSNC). PARTNERS is a Medicare Advantage organization with a Medicare contract to provide HMO and PPO plans. Plans are administered by BCBSNC. BCBSNC and PARTNERS do not discriminate based on color, gender, religion, national origin, age, race, disability, handicap, sexual orientation, genetic information, source of payment or health status as defined by the Centers for Medicare & Medicaid Services (CMS). All qualified Medicare beneficiaries may apply. You must be entitled to Medicare Part A and enrolled in Medicare Part B and must reside in the CMS-approved service area. You must continue to pay your Medicare Part B premium, if not otherwise paid for under Medicaid or another third party. BCBSNC and PARTNERS are independent licensees of the Blue Cross and Blue Shield Association.
Blue Medicare HMO and Blue Medicare PPO plans are offered by PARTNERS National Health Plans of North Carolina, Inc. (PARTNERS), a subsidiary of Blue Cross and Blue Shield of North Carolina (BCBSNC). PARTNERS is a Medicare Advantage organization with a Medicare contract to provide HMO and PPO plans. Plans are administered by BCBSNC. BCBSNC and PARTNERS do not discriminate based on color, gender, religion, national origin, age, race, disability, handicap, sexual orientation, genetic information, source of payment or health status as defined by the Centers for Medicare & Medicaid Services (CMS). All qualified Medicare beneficiaries may apply. You must be entitled to Medicare Part A and enrolled in Medicare Part B and must reside in the CMS-approved service area. You must continue to pay your Medicare Part B premium, if not otherwise paid for under Medicaid or another third party. BCBSNC and PARTNERS are independent licensees of the Blue Cross and Blue Shield Association.
The information on this page is current as of 10/01/2009.