2010 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	Chatham	Greene	Mecklenburg	Rockingham
Alexander	Chowan	Guilford	Nash	Rowan
Alleghany	Columbus	Halifax	New Hanover	Sampson
Ashe	Cumberland	Harnett	Northampton	Stanly
Avery	Davidson	Haywood	Onslow	Stokes
Beaufort	Davie	Henderson	Orange	Surry
Bertie	Duplin	Hertford	Pender	Tyrrell
Bladen	Durham	Hoke	Perquimans	Wake
Brunswick	Edgecombe	Hyde	Person	Warren
Cabarus	Forsyth	Iredell	Pitt	Washington
Caldwell	Franklin	Johnston	Polk	Watauga
Carteret	Gaston	Lee	Randolph	Wayne
Caswell	Gates	Lincoln	Richmond	Wilkes
Catawba	Granville	Martin	Robeson	Yadkin

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.

The benefit information provided herein is a brief summary, but not a comprehensive description of available benefits. Additional information about benefits is available to assist you in making a descision about your coverage. This is an advertisement; for more information contact the plan.

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.