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Important Legal Information and Disclaimers

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

Policies and Procedures

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Notice of possible contract termination

BCBSNC has a contract with the Centers for Medicare & Medicaid Services (CMS), the government agency that runs Medicare, to provide a standalone prescription drug plan, Blue Medicare Rx. This contract renews each year. At the end of each year, the contract is reviewed, and either BCBSNC or CMS can decide to end it. Members will get 90 days advance, written notice in this situation. It is also possible for our contract to end at some other time. If the contract is going to end, we will generally tell members 90 days in advance. Advance notice may be as little as 30 days or even fewer days if CMS ends our contract in the middle of the year. In this notice, we would provide a written description of alternatives available for obtaining qualified prescription drug coverage in North Carolina. We are also required to notify the general public of a contract termination via local newspapers.

If BCBSNC decides to stop offering the Blue Medicare Rx plan or change our service area so that it no longer includes the area where you live, membership in BCBSNC's Blue Medicare Rx plan will end for everyone in that service area, and members will have to change to a different prescription drug plan. Members will continue to get prescription drugs through BCBSNC's Blue Medicare Rx plan until membership ends.



Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1 of each year. Please contact BCBSNC for details.

Blue Cross and Blue Shield of North Carolina is an HMO and PPO plan with a Medicare contract. Blue Cross and Blue Shield of North Carolina is a PDP 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 or 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, 8a.m. to 8 p.m.

Blue Medicare HMO:
1-888-310-4110 (TDD/TYY 1-888-451-9957)
Blue Medicare PPO:
1-877-494-7647 (TDD/TYY 1-888-451-9957)
Blue Medicare Rx (PDP):
1-888-247-4142 (TDD/TYY 1-888-247-4145)

®, SM Mark 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 10/01/2011.

Y0079_5325 CMS Approved 10192011