As with any Medicare Advantage plan, members may enroll only during specific times of the year. Details about when you may enroll in Medicare Advantage plans are available at medicare.gov or by calling 1-800-665-8037, 8 a.m. - 8 p.m., seven days a week. (TDD/TYY 1-888-451-9957).
Blue Medicare HMO gives you coverage within our network of doctors and specialists. Our Enhanced plan includes our most robust medical benefits and is available with or without Medicare prescription drug benefits. We also offer a Standard plan that offers basic prescription drug coverage.
Blue Medicare HMO is available in the following counties:
With Blue Medicare HMO, you can select a primary care provider (PCP) from within the Blue Medicare HMO network to coordinate your care. There's no penalty for visiting a network specialist on your own without a referral from your PCP.
If you see a doctor outside the network without prior approval from BCBSNC (except in an emergency, an urgent care situation or for out-of-area renal dialysis care), neither Medicare nor BCBSNC are responsible for the costs involved.
You can fill your prescriptions at participating pharmacies throughout the state. Most of the major chain pharmacies are part of our network, so you can fill your prescriptions at any of their locations nationwide. You can also fill prescriptions through our mail order prescription program.
Members may enroll in the plan only during specific times of the year. Contact BCBSNC 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 co-payments/co-insurance may change on January 1 of each year. For Medicare supplement plans, the changes occur on June 1 of each year. Please contact BCBSNC for details.
BCBSNC is a Medicare Advantage organization with a Medicare contract. 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 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, 8 a.m. to 8 p.m.
The SilverSneakers program is provided by Healthways, Inc., a third-party vendor independent of BCBSNC. The program is available only to members covered under Blue Medicare HMO or Blue Medicare PPO plans. BCBSNC is not liable in any way for the services received; results are not guaranteed. Decisions regarding medical care should be made with the advice of a doctor. ®, SM Marks of the Blue Cross and Blue Shield Association. SM1 Mark of Blue Cross and Blue Shield of North Carolina. ®1 Mark of Healthways, Inc.
The information on this page is current as of 10/01/2012.
Y0079_5875 CMS Approved 10012012