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BlueCross BlueShield of North Carolina

Important Legal Information and Disclaimers

Blue Medicare HMO and Blue Medicare PPO

Medicare evaluates plans based on a 5-star rating system. Star ratings are calculated each year and may change from one year to the next.

Members may enroll in the plan only during specific times of the year. Contact us for more information.

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

For Medicare Advantage and Part D plans, benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1 of each year. Please contact us for details.

Blue Cross and Blue Shield of North Carolina is an HMO and PPO plan with a Medicare contract. Enrollment in Blue Cross and Blue Shield of North Carolina depends on contract renewal. Blue Cross and Blue Shield of North Carolina does not discriminate based on race, ethnicity, national origin, religion, gender, age, mental or physical disability, health status, claims experience, medical history, genetic information, evidence of insurability or geographic location within the service area. All Blue Cross and Blue Shield of North Carolina items and services are available to all eligible beneficiaries in the service area. Limitations, copayments, and restrictions 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 you would like Medicare Advantage documents in a different language or format, or your coverage has ended and you need proof of coverage or a Certification of Health Insurance Coverage, you can call us 7 days a week, 8 a.m. to 8 p.m.

Blue Medicare HMO: 1-888-310-4110
Blue Medicare PPO: 1-877-494-7647
For TDD/TTY: 1-888-451-9957

Blue Medicare Rx (PDP)

Medicare evaluates plans based on a 5-star rating system. Star ratings are calculated each year and may change from one year to the next.

Prescription drug coverage is not sold as a benefit of any Medicare supplement plan.

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

For Medicare Advantage plans, benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1 of each year. Please contact Blue Cross and Blue Shield of North Carolina for details.

Blue Cross Blue Shield of North Carolina is a PDP plan with a Medicare contract. Enrollment in Blue Cross Blue Shield of North Carolina depends on contract renewal. Blue Cross and Blue Shield of North Carolina does not discriminate based on race, ethnicity, national origin, religion, gender, age, mental or physical disability, health status, claims experience, medical history, genetic information, evidence of insurability or geographic location within the service area. All Blue Cross and Blue Shield of North Carolina items and services are available to all eligible beneficiaries in the service area. Limitations, copayments, and restrictions may apply. You must be entitled to Medicare Part A and enrolled in Medicare Part B and must reside in CMS-approved service area. You must continue to pay your Medicare Part B premium.

If you would like Part D documents in a different language or format, or your coverage has ended and you need proof of coverage or a Certification of Health Insurance Coverage, you can call us 7 days a week, 8 a.m. to 8 p.m.

Blue Medicare Rx (PDP): 1-888-247-4142
For TDD/TTY: 1-888-247-4145

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U9737, 2/14

The information on this page is current as of 10/1/2014.

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