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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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Blue Medicare HMO and Blue Medicare PPO

Monthly Plan Premium for People who get Extra Help from Medicare to
Help Pay for their Prescription Drug Costs

If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower than what it would be if you did not get extra help from Medicare. The amount of extra help you get will determine your total monthly plan premium as a member of our Plan.

This table shows you what your monthly plan premium will be if you get extra help.

2018 LIS Table
2017 LIS Table

*This does not include any Medicare Part B premium you may have to pay.

Blue Medicare HMO's and Blue Medicare PPO's premium includes coverage for both medical services and prescription drug coverage.

If you aren't getting extra help, you can see if you qualify by calling:

  • Your State Medicaid Office, or
  • The Social Security Administration at 1-800-772-1213. TTY users should call 1-800-325-0778 between 7 a.m. and 7 p.m., Monday through Friday.

If you have any questions, please call Customer Services at 1-888-310-4110 for HMO, 1-877-494-7647 for PPO, (TTY: 1-888-451-9957). We are available for phone calls 8.a.m. to 8 p.m. daily. Calls to these numbers are free.

In certain cases, CMS systems do not reflect a beneficiary's correct low-income subsidy (LIS) status at a particular point in time. As a result, the most up-to-date and accurate subsidy information has not been communicated to the Part D plan.

To address these situations, CMS created the best available evidence (BAE) policy in 2006. This policy requires sponsors to establish the appropriate cost-sharing for low-income beneficiaries when presented with evidence that the beneficiary's information is not accurate.

Please click on the link to CMS website below for materials related to the CMS Best Available Evidence (BAE) policy.

Important Legal Information and Disclaimers

The information on this page is current as of 10/1/2017.

Y0079_7833 CMS Approved 10172017