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Important Legal Information and Disclaimers

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

My Benefits

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Benefits Overview
  • Newly covered Services
    Please click here to see a list of new benefits.
  • Visiting the Doctor and Other Providers1
    Your primary care physician (PCP) will coordinate your health care. You're not required to see your PCP before visiting a specialist, but it's strongly recommended so that your PCP is fully aware of the medical care you're receiving. Learn more about choosing a PCP and how to access your health care.
    • For Blue Medicare HMO, you must use plan providers1, except in emergency/urgent care situations, or for out-of-area renal dialysis. If you obtain routine care from out-of-network providers, neither Medicare nor Blue Medicare HMO are responsible for the costs.
    • 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. With the exception of emergency or urgent care, it may cost more to get care from non-plan or non-preferred providers.
  • Using Medicare Prescription Drug Coverage
    If your plan includes Medicare prescription drug coverage, learn how easy it is to fill your prescriptions at a local pharmacy or through mail order. In order to obtain the greatest savings on your prescription medications, please visit one of our preferred network providers.1
  • Star Ratings
Blue Medicare HMO Medical Only Blue Medicare HMO Medical Only Coverage Map
Alamance Cleveland Henderson Onslow Transylvania
Alexander Columbus Hertford Orange Tyrrell
Alleghany CumberlandHoke Pamlico Union
Anson Davidson Hyde Pender Vance
Ashe Davie Iredell Perquimans Wake
Avery Duplin Johnston Person Warren
Beaufort Durham Jones Pitt Washington
Bertie Edgecombe Lee Polk Watauga
Bladen Forsyth Lincoln Randolph Wayne
Brunswick Franklin Madison Richmond Wilkes
Buncombe Gaston Martin Robeson Wilson
Cabarrus Gates McDowell Rockingham Yadkin
Caldwell Granville MecklenburgRowan Yancey
Carteret Greene Mitchell Sampson
Caswell Guilford Montgomery Scotland
Catawba Halifax Nash Stanly
Chatham Harnett New HanoverStokes
Chowan Haywood NorthamptonSurry

Blue Medicare HMO Standard Blue Medicare HMO Standard Coverage Map
Alexander Columbus Johnston Person Wilson
Alleghany Cumberland Jones Pitt Yancey
Anson Duplin Lee Polk
Ashe Durham Lincoln Randolph
Avery Edgecombe Madison Richmond
Beaufort Franklin Martin Robeson
Bertie Gaston McDowell Rockingham
Bladen Gates Mecklenburg Sampson
Brunswick Granville Mitchell Scotland
Buncombe Greene Montgomery Stanly
Cabarrus Guilford Nash Transylvania
Caldwell Halifax New Hanover Tyrrell
Carteret Harnett Northampton Union
Caswell Haywood Onslow Vance
Catawba Henderson Orange Warren
Chatham Hertford Pamlico Washington
Chowan Hoke Pender Watauga
Cleveland Hyde Perquimans Wayne

Blue Medicare HMO Essential Blue Medicare HMO Essential Coverage Map

Blue Medicare HMO Enhanced Blue Medicare HMO Enhanced Coverage Map
Alexander Franklin Northampton
Alleghany Gaston Orange
Ashe Gates Pender
Avery Granville Person
Beaufort Greene Polk
Bertie Guilford Robeson
Bladen Halifax Rockingham
Buncombe Haywood Sampson
Caldwell Henderson Scotland
Carteret Hertford Vance
Catawba Hyde Warren
Chatham Johnston Watauga
Chowan Jones Wayne
Cleveland Lee Yancey
Columbus Madison
Cumberland Martin
Durham Nash
Edgecombe New Hanover

Blue Medicare PPO Enhanced Blue Medicare PPO Enhanced Coverage Map
Alamance Davidson Mecklenburg Wake
Alexander Duplin Mitchell Warren
Anson Edgecombe Nash Washington
Beaufort Forsyth Onslow Watauga
Bertie Gaston Orange Wayne
Bladen Gates Person Wilkes
Brunswick Guilford Pitt Wilson
Buncombe Harnett Polk Yancey
Cabarrus Haywood Randolph
Caldwell Henderson Richmond
Carteret Hertford Robeson
Caswell Hoke Rockingham
Catawba Iredell Rowan
Chatham Jones Sampson
Chowan Lee Scotland
Cleveland Madison Stokes
Columbus Martin Surry
Cumberland McDowell Transylvania

1 Formulary, pharmacy network, and provider network may change at any time. You will receive notice when necessary.

Important Legal Information and Disclaimers

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®, SM Marks of the Blue Cross and Blue Shield Association. SM1 Mark of Blue Cross and Blue Shield of North Carolina.

The information on this page is current as of 10/1/2015.

Y0079_7169 CMS Approved 11102015