Notice of possible contract termination

Blue Cross and Blue Shield of North Carolina (BCBSNC), has a contract with the Centers for Medicare & Medicaid Services (CMS) to provide a Medicare Advantage prescription drug plan (MAPD). BCBSNC is also a Medicare-approved Part D sponsor. CMS is the government agency that runs Medicare. 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 Blue Medicare HMO, Blue Medicare PPO or Blue Medicare Rx coverage, or change the service area so that it no longer includes the area where you live, membership in Blue Medicare HMO, Blue Medicare PPO or Blue Medicare Rx affected by that change will end for everyone in the affected plan within that service area, and members will have to change to a different Medicare Advantage or Medicare drug plan. Members will continue to get medical services or prescription drugs through Blue Medicare HMO, Blue Medicare PPO or Blue Medicare Rx until the contract ends.

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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 Blue Shield of North Carolina (BCBSNC) is a Medicare Advantage organization with a Medicare contract to provide HMO and PPO plans. BCBSNC is a Medicare-approved Part D sponsor. BCBSNC 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 BCBSNC 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.

The information on this page is current as of 10/01/2012.

Y0079_5875 CMS Approved 10012012