2009 Plan details

Blue Medicare PPO gives you the freedom to see providers in or out of network.¹ You can see specialists without a referral, and all medically necessary benefits are covered in and out of network. All PPO plans include Part D coverage.²

Available in select counties in North Carolina

Blue Medicare PPO is available in the following counties:

Alamance	Catawba	Guilford	Northampton	Stokes
Alexander	Chatham	Halifax	Onslow	Surry
Alleghany	Cumberland	Hertford	Orange	Wake
Ashe	Davidson	Hoke	Perquimans	Watauga
Avery	Davie	Iredell	Person	Wayne
Bertie	Durham	Johnston	Pitt	Wilkes
Brunswick	Edgecombe	Lee	Randolph	Yadkin
Cabarrus	Forsyth	Martin	Richmond
Caldwell	Gaston	Mecklenburg	Rockingham
Carteret	Gates	Nash	Rowan
Caswell	Greene	New Hanover	Stanly

Providers and specialists without a referral

You can choose in- or out-of-network providers and specialists without a referral. While you’ll need to select a primary care provider (PCP) for your care, you can still visit a doctor outside of the network, but you’ll be responsible for more of the cost for out-of-network services.

Network of pharmacies

You can fill your prescriptions at participating pharmacies throughout the state. Most of the major chain pharmacies are part of our network, and you can fill your prescriptions at any of their locations nationwide. You can also fill your prescriptions through our mail order prescription program, which uses one of the largest network mail order pharmacies in the country.

1 With the exception of emergency or urgent care, 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.

2 Formulary applies for all plans that include Medicare prescription drug coverage.

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 10/16/08.