Blue Medicare HMO, Blue Medicare PPO, and Blue Medicare Rx (PDP) Members

Policies and Procedures

Notice of possible contract termination

Blue Cross and Blue Shield of North Carolina (BCBSNC), has a contract with the Centers for Medicare & Medicaid Services (CMS) to provide a Medicare Advantage prescription drug plan (MAPD). CMS is the government agency that runs Medicare. This contract renews each year. At the end of each year, the contract is reviewed, and either BCBSNC or CMS can decide to end it. Members will get 90 days advance, written notice in this situation. It is also possible for our contract to end at some other time. If the contract is going to end, we will generally tell members 90 days in advance. Advance notice may be as little as 30 days or even fewer days if CMS ends our contract in the middle of the year. In this notice, we would provide a written description of alternatives available for obtaining qualified prescription drug coverage in North Carolina. We are also required to notify the general public of a contract termination via local newspapers.

If BCBSNC decides to stop offering Blue Medicare HMO or PPO or change the service area so that it no longer includes the area where you live, membership in Blue Medicare HMO or PPO will end for everyone in that service area, and members will have to change to a different prescription drug plan. Members will continue to get prescription drugs through Blue Medicare HMO or PPO until the contract ends.



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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 Cross Blue Shield of North Carolina (BCBSNC) is a Medicare Advantage organization with a Medicare contract to provide HMO and PPO plans. BCBSNC does 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 is an independent licensee of the Blue Cross and Blue Shield Association.

The information on this page is current as of 10/01/2009.