Medicare Beneficiaries

Policies and Procedures

Policies, Procedures, Privacy and Legal

Web Privacy and Usage

Prior Approval and Quantity Limits

60 Day Notice of Formulary Changes

Appeal Process for Prescription Drugs

Grievance Procedures for Prescription Drugs

Transition Process for Prescription Drugs

Coverage for Prescription Drugs

Blue Medicare HMO and Blue Medicare PPO

Blue Medicare HMO and Blue Medicare PPO Quality Assurance

Blue Medicare HMO and Blue Medicare PPO Notice of Possible Contract Termination

Blue Medicare HMO and Blue Medicare PPO Notice of Privacy Practices

Blue Medicare HMO and Blue Medicare PPO Out of Network Coverage Policy

Blue Medicare HMO and Blue Medicare PPO Member Rights and Responsibilities

Blue Medicare HMO and Blue Medicare PPO Appeals and Grievances

Blue Medicare HMO and Blue Medicare PPO Out of Network Coverage for Prescription Drugs

Blue Medicare HMO and Blue Medicare PPO Exclusions and Limitations

Blue Medicare Rx

Blue Medicare Rx Mail Order Drug Program

Blue Medicare Rx Coverage Determinations, Appeals and Grievances

Blue Medicare Rx Quality Assurance

Blue Medicare Rx Transition Process

Blue Medicare Rx Notice of Possible Contract Termination

Blue Medicare Rx Notice of Privacy Practices

Blue Medicare Rx Member Rights and Responsibilities

Blue Medicare Rx Exclusions and Limitations



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 11/4/08.